Severe pelvic trauma

Introduction Severe pelvic fractures are a major cause of morbidity and mortality in trauma patients. The most common mechanisms that lead to major pelvic fractures are motor vehicle and motorcycle collisions, falls from height, and pedestrians being struck by motor vehicles. As hemorrhage is the main cause of mortality in pelvic trauma, it is critical to assess hemodynamic stability and identify ongoing bleeding in the chest, abdomen, and long bones. If no clear source of hemorrhage is identified and patient remains unstable, suspicion for primary pelvic hemorrhage should be high. Suspect pelvic fracture in all cases of serious or multi-trauma patients. In pelvic trauma, there is a high incidence of associated injuries that may cause long-term complications; therefore, special attention should be paid to the rectal and urogenital examinations. Classification: The most commonly used classification system for pelvic fractures is the Young–Burgess system (Table 12.1; Figure 12.1). This system categorizes injuries on the basis of mechanism of injury and can be used to predict the risk of blood loss.