Management of pelvic fractures

The management of patients with pelvic fractures can be demanding. Severe pelvic fractures pose a great challenge for physicians and can greatly contribute to significant patient morbidity and mortality. The purpose of this review is to highlight recent, positive changes in the management of patients with pelvic fractures.

The current status of pelvic fracture management is presented, including a recently proposed algorithm for management, an evaluation of roles of angioembolization and preperitoneal packing. Additionally, the approach of bilateral internal iliac artery ligation as a salvage procedure is reviewed, and the outcome of acute (<24 h) pelvic fracture operative fixation. Regardless of the strategy adopted, a multidisciplinary approach is required for the proper management of hemodynamically unstable patients with pelvic fractures.

The key elements in managing patients with pelvic fractures are swift and adequate resuscitation, reversal of shock and acidosis, and rapid control of hemorrhage to facilitate survival of these patients. Multimodality therapies including external pelvic stabilization, angioembolization and preperitoneal pelvic packing are useful adjuncts that require appropriately trained and immediately available personnel. A multidisciplinary approach has been shown to be beneficial for patient outcomes.