Abstract
High-energy pelvic fractures in trauma patients cause significant morbidity and mortality. A systematic approach to the early evaluation and management of these patients leads to improved outcomes. The initial care of patients with a displaced pelvic fracture and hemodynamic instability should focus upon three areas: 1) resuscitation, 2) bony stability, and 3) hemorrhage control. Aggressive resuscitation with blood products and clotting factors is paramount. The initial reduction of the pelvic ring and temporary stabilization can be achieved through the use of pelvic sheeting or binder placed in the field or trauma bay. Urgent surgical stabilization with external or internal fixation is often required. Hemorrhage control can be achieved through pelvic packing and/or angioembolization. The initial management of displaced pelvic fractures is multidisciplinary and should involve close collaboration between trauma surgery, orthopedic surgery, anesthesia, and interventional radiology.
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