Shock trauma room management of pelvic injuries. A systematic review of the literature

Abstract

Injuries to the pelvis may occur as a life threatening situation which then requires immediate surgical treatment. A review of the literature represents the range of current recommendations. Clinical trials were systematically collected (Medline, Cochrane and hand searches) reviewed and classified into evidence levels (1 to 5 according to the Oxford system). According to the literature there is a consent that immediate resuscitation and surgical intervention is essential in complex pelvic fractures. In contrast the way of emergency stabilization of the pelvis (fixateur externe or c-clamp) is still under discussion as well as the radiological diagnostic (x-ray or CT) and the way of bleeding control (tamponade or embolization). Emergency management of pelvic fractures means treatment of a life threatening injury in first place. Although there are different methods that can be used, they all follow the same principle of resuscitation and mechanical stabilization of the pelvis in parallel.