Indications and techniques for external fixation of the pelvis

Pelvic ring disruption is often accompanied by severe, multiple injuries to the organs, vessels, and nerves within the true pelvis. Mortality in the acute resuscitative period is usually due to hemorrhage and hemodynamic instability. Establishing rapid, provisional pelvic stability with external fixation is of immediate importance in the hemodynamically unstable patient, because fixation contributes to hemostasis. Orthopaedic surgeons should anticipate the likelihood of hemorrhage in patients with pelvic ring disruption and should apply external fixation immediately to minimize morbidity and mortality.