← All decks
Orthopaedics
Pelvic Ring Injury
Built from Orthopedic Trauma Essentials
What’s inside
8 sections · 76 slides
Overview
- What this covers
- The two problems every pelvic ring injury poses
The ring, and why it bleeds
What the pelvis is made of and what happens when it breaks
- The pelvis is a ring, not a bone
- The bony pelvic ring, female and male
- The two joints that hold the ring shut
- The sacroiliac joint surface
- What bleeds when the ring breaks
- Pubic rami fractures on a front-on pelvis film
- Why closing the ring early helps
- Two ways to close the ring
Binder or external fixator
What the comparison studies actually found
- What a pelvic binder is
- What an external fixator is
- External fixator frame on the pelvis
- Does the frame hold better than the strap?
- Where the binder falls short
- Binder against external fixator, side by side
- Binder first, frame when needed
Still bleeding after the binder
Packing, embolisation, and the balloon in the aorta
- The reassessment that decides everything
- If the pressure still will not come up
- What angiographic embolisation is
- What preperitoneal pelvic packing is
- Embolisation against packing
- What the comparison studies show
- Reading the packing versus embolisation table
- Hemorrhage control in unstable pelvic fractures: PP versus AE
- What REBOA is
- A resuscitative aortic occlusion balloon catheter
- Does REBOA save lives?
- Where this leaves the bleeding pelvis
The clot after the bleed
Thrombosis risk, and whether a filter helps
- From bleeding to clotting
- Why these patients clot
- Swollen leg of a deep vein thrombosis
- What an inferior vena cava filter is
- Where a vena cava filter sits
- The filter device itself
- The evidence swung the other way
- What the guidelines say
- Filters: not routine
Tranexamic acid
A cheap drug where the clock decides the benefit
- What tranexamic acid is
- The tranexamic acid molecule
- How the drug fits into the bleeding
- CRASH-2: the trial that set the rule
- 7.7% → 5.3%
- Late tranexamic acid is not neutral
- PATCH-Trauma: giving it before hospital
- Tranexamic acid in pelvic surgery
- Tranexamic acid: what to remember
LC-1 injuries
Finding the fracture that only looks stable
- What LC-1 means
- The clinical problem in one line
- Static films are not enough
- The shape of the break predicts the slip
- 68%
- The sentinel sign
- Static imaging versus dynamic imaging
- The Sagi examination under anaesthesia
- How the pelvis is stressed
- What the Sagi study found
- A negative stress test is reassuring
- Parry: the same answer without anaesthesia
- What the lateral stress radiograph showed
- Reading the LC-1 instability table
- Summary of studies on instability and surgical indications in LC-1 pelvic ring injuries
- Deciding what to do with an LC-1 injury
- Markers that should trigger a stress test
- LC-1: what to remember
Pulling it together
The six answers this topic actually gives
- The six answers
- Numbers worth carrying
- Traps to avoid
- Where the evidence is still open
- References
- References (continued)
- References (continued)
- References (continued)
- References (continued)
- References (continued)
- Orthopedic Trauma Essentials 2026