Abstract
The characteristics and treatment of pelvic fractures vary between general conditions and modern war. An expert consensus has been reached based on pelvic injury epidemiology and the concepts of battlefield treatment combined with the existing levels of military medical care in modern warfare. According to this consensus, first aid, emergency treatment and early treatment of pelvic fractures are introduced in three separate levels. In Level I facilities, simple triage and rapid treatment following the principles of advanced trauma life support are recommended to evaluate combat casualties during the first-aid stage. Re-evaluation, further immobilization and fixation, and hemostasis are recommended at Level II facilities. At Level III facilities, the main components of damage control surgery are recommended, including comprehensive hemostasis, a proper resuscitation strategy, the treatment of concurrent visceral and blood vessel damage, and battlefield intensive care. The grading standard for evidence evaluation and recommendation was used to reach this expert consensus.
Highlights
The characteristics and treatment of pelvic fractures vary between general conditions and modern war
Based on the epidemiology and the latest treatment techniques for pelvic injuries in modern warfare and combined with the current Chinese People’s Liberation Army (PLA)‘s treatment echelon system, we present an expert consensus on the classification and treatment of pelvic fractures in modern war
The evidence and recommendation grades adopted in this expert consensus are mainly based on the standards recommended by the Oxford Evidence-Based Medicine Center and on the criteria commonly used in clinical studies [1,2,3,4]
Summary
The characteristics and treatment of pelvic fractures vary between general conditions and modern war. Consensus 1: In modern warfare, a major portion of injuries are from explosive blasts, and the increased severity of the resulting pelvic fractures and the increased proportion of open wounds make these patients prone to fatal massive bleeding, perineal injuries, pelvic organ damage, and traumatic lower limb amputation.
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