Fractures of the pelvis are found reasonably often in major trauma, but they’re a really challenging presentation. They are difficult to assess and accurately diagnose in the prehospital setting, mortality rates are high, particularly in patients with haemodynamic instability and there are often associated injuries. Associated mortality from patients with pelvic fractures who reach hospital is reported to be up to 19%, with mortality rates as high as 37% reported in the presence of haemodynamic instability.

In this episode we’ll run through pelvic injuries, all the way from anatomy and mechanisms of injury, to assessment and management.

As always make sure you have a look at the references and supporting material attached in the show notes, and get in touch with any questions or comments and take care of yourselves.

Enjoy!

Simon, Rob & James

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References

Guidelines on Pelvic Trauma; World Society of Emergency Surgery

Hemorrhage in Pelvic FractureUpdate and Systematic Review; Eastern Association for the Surgery of TraumaPractice Management Guidelines

Pre-hospital Management of Pelvic Fractures; FPHC consensus guidelines

The prehospital management of pelvic fractures. Caroline Lee. Emerg Med J. 2007

Pre-hospital pelvic girdle injury: Improving diagnostic accuracy in a physician-led trauma service. E. Yong. Injury. 2016

Effectiveness of non invasive external pelvic compression: a systematic review of the literature. Peyman Bakhshayesh. Scand J Trauma Resusc Emerg Med. 2016

Straight leg elevation to rule out pelvic injury. Caroline Bolt. Injury. 2018

An assessment of pelvic binder placement at a UK major trauma centre. H Naseem. RCSann. 2018

Haemodynamics as a determinant of need for pre-hospital application of a pelvic circumferential compression device in adult trauma patients. D.McCreary. Injury. 2020

Major trauma: assessment and initial management. NICE guideline 2016

Pelvic Fractures in Hospital; NICE Pathways