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Updated: May 28, 2026
Laparoscopic Non-Mesh Cerclage Pectopexy for Pelvic Organ Prolapse
Published on: September 13, 2022
[Pelvic ring injuries: current concepts of management]
Salásek Martin1, Pavelka Tomás
1Univerzita Karlova v Praze, Lékarská fakulta a FN Plzen, Klinika ortopedie a traumatologie pohybového ustrojí. martin.salasek@seznam.cz
Insights
Pelvic ring injuries, often from high-energy trauma, can cause severe bleeding. Management focuses on stabilization, imaging, and timely surgical fixation for optimal recovery.
Area of Science:
- Orthopedic Surgery
- Trauma Management
Context:
- Pelvic ring injuries are frequently associated with high-energy trauma.
- These injuries often present with life-threatening hemorrhage and associated abdominal, thoracic, or head trauma.
Purpose:
- To outline the critical prehospital and in-hospital management strategies for pelvic ring injuries.
- To detail diagnostic approaches and surgical interventions for achieving hemodynamic stability and anatomical reduction.
Summary:
- Prehospital care emphasizes airway management, oxygenation, fluid resuscitation, and immobilization.
- Diagnostic imaging includes CT for stable patients and plain radiography/ultrasound for unstable patients.
- Hemodynamic stability is achieved with pelvic C-clamps or external fixators, with pelvic packing or internal iliac artery ligation for arterial bleeding.
- Acute management favors minimally invasive internal fixation (transiliacal fixator, iliosacral screws).
- Open reduction internal fixation with pelvic plates or spinopelvic fixation is considered after general state stabilization (approx. 5 days).
- Post-surgical recovery involves bed rest and rehabilitation.
Impact:
- Effective management of pelvic ring injuries reduces mortality and morbidity.
- Timely and appropriate surgical intervention restores pelvic stability and function.
- Comprehensive care, from prehospital to rehabilitation, is crucial for patient recovery and return to normal life.
Abstract:
Pelvic ring injuries occur at any age. Most injuries to the pelvis are due to high-energy trauma, these injuries are therefore associated with abdominal, thoracic and head injuries. Unstable disruption of the pelvic ring has been often coupled with massive or life-threatening haemorrhage. The goal of the prehospital management is to keep airway open, start oxygen therapy, fluid replacement therapy and apply appropriate immobilization device. On admission of hemodynamically stable patients CT is preferred, for hemodynamically unstable the plain antero-posterior pelvis radiograph and ultrasound. To achieve hemodynamic stability, the pelvic C-clamp or external fixator should be applied. Pelvic packing or ligation of internal iliac artery is performed in the presence of arterial bleeding. In the acute period minimally invasive internal fixation with closed reduction should be used (transiliacal internal fixator, iliosacral screws). The open reduction with internal fixation can be performed after stabilization of the general state of health (after about 5 days), pelvic plates and spinopelvic fixation are appropriate for this approach. To recover the patient into normal life, bed rest and rehabilitation follows after surgical treatment.
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