Treatment options in the hemodynamically unstable patient with a pelvic fracture

The pelvis is a ring-like structure composed of 3 bones. The stability of the pelvic ring is dependent on ligamentous integrity. Injuries of the pelvic ring are classified according to the direction of forces on the pelvis and resultant fracture patterns. Pelvic fractures are potentially life-threatening injuries. High-energy force can cause a disruption of the integrity of the veins, arteries, and bones of the pelvic ring, which can lead to hemorrhage. Key components of treatment after a pelvic fracture are the management of hemorrhage and hemodynamic instability. This article will address various treatment options that include the use of pelvic binders, fluid resuscitation, radiographic imaging, interventional radiology techniques, and operative techniques. Treatment goals with pelvic fractures that include stabilization of the fracture and maintaining hemodynamic stability will be discussed.