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Pelvic Ring Injuries

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Textbook of Polytrauma Management

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Abstract

High-energy pelvic fractures continue to represent a major challenge in trauma management due to the high rates of post-injury mortality of around 30%–40% in the modern peer-reviewed literature. The main root cause of potentially preventable mortality relates to the delayed recognition of the extent of retroperitoneal hemorrhage and post-injury coagulopathy. Current management strategies for pelvic ring disruptions with associated hemorrhagic shock include resuscitative endovascular balloon occlusion of the aorta (REBOA) for patients “in extremis” in conjunction with point-of-care guided resuscitation for post-injury coagulopathy. There is increasing international consensus regarding the benefits of early pelvic external fixation in conjunction with direct preperitoneal pelvic packing (PPP) and subsequent angioembolization in patients with ongoing hemorrhage resulting in significantly improved survival from retroperitoneal exsanguinating hemorrhage. Modern classification systems provide guidance for grading of injury mechanisms and risk stratification of patients with hemodynamically unstable pelvic ring injuries in order to support protocol-driven acute resuscitation strategies and improved outcomes in this highly vulnerable patient cohort.

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Author information

Authors and Affiliations

  1. Department of Specialty Medicine, Rocky Vista University, College of Osteopathic Medicine, Parker, CO, USA

    Philip F. Stahel & Darryl A. Auston

Authors
  1. Philip F. Stahel
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  2. Darryl A. Auston
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Editor information

Editors and Affiliations

  1. Department of Trauma Surgery, University Hospital Zürich, Zürich, Switzerland

    Hans-Christoph Pape

  2. Department of Orthopaedic Surgery & Sports Medicine, The University of South Florida Morsani College of Medicine, Tampa, FL, USA

    Joseph Borrelli Jr.

  3. Ernest E. Moore Shock Trauma Center at Denver Health, University of Colorado, Denver, CO, USA

    Ernest E. Moore

  4. Klinik für Traumatologie, University Hospital of Zürich, Zürich, Switzerland

    Roman Pfeifer

  5. Rocky Vista University, College of Osteopathic Medicine, Parker, CO, USA

    Philip F. Stahel

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Stahel, P.F., Auston, D.A. (2022). Pelvic Ring Injuries. In: Pape, HC., Borrelli Jr., J., Moore, E.E., Pfeifer, R., Stahel, P.F. (eds) Textbook of Polytrauma Management . Springer, Cham. https://doi.org/10.1007/978-3-030-95906-7_19

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  • DOI: https://doi.org/10.1007/978-3-030-95906-7_19

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-95905-0

  • Online ISBN: 978-3-030-95906-7

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