Angioembolization superior for arterial blush on CT
Combination approach emerging in damage control algorithms
Operative timing evidence
Early definitive fixation (< 24 hours) in stable patients
Reduces VTE risk
Facilitates earlier mobilization
Delayed fixation (> day 4) in polytrauma
Avoids second-hit inflammatory response
Damage control orthopaedics principle
Stability assessment evidence
ED fluoroscopic stress radiographs — DeKeyser et al. JBJS 2022
Safe and reliable with no adverse events in prospective series
Negative predictive value > 95% for nonoperative success
Beckmann scoring — Dekeyser et al. JAAOS 2023
Radiographic score correlates with stress exam outcome
May identify stable patients who do not require stress exam
Long-term outcomes
Full functional recovery rates: LC-I 41%, LC-II 46%, LC-III only 11%
Therrien et al. PLoS One 2025
Chronic pain in 30-50% of LC fractures at 1 year
Sexual dysfunction and urologic complications — LC-III highest rates
Sacroiliac dysfunction — common long-term sequela
Patient Discharge Instructions
copy discharge instructions
Pelvic fracture discharge instructions
You have been diagnosed with a pelvic fracture from a lateral compression injury
This means a bone in your pelvis was broken by a side impact force
Most fractures of this type heal well with rest and activity modification
Weight-bearing instructions
Follow your orthopedic surgeon's specific instructions
Most stable fractures allow weight-bearing as tolerated with crutches or walker
Do not put full weight through your leg until cleared by your surgeon
Activity restrictions
Avoid driving until cleared by your surgeon (minimum 6 weeks)
No heavy lifting or strenuous activity during healing phase
Avoid climbing stairs without assistance initially
Pain management
Take prescribed pain medications as directed
Acetaminophen 500-1000 mg every 6 hours as baseline
Apply ice wrapped in cloth to the hip for 20 minutes at a time
Avoid ibuprofen or naproxen unless specifically prescribed
Bladder and bowel care
Constipation is common — increase fluids and fiber
Stool softeners if prescribed — take as directed
Contact us if you are unable to urinate
Blood clot prevention
Take blood thinner medication as prescribed — do not skip doses
Keep legs moving — ankle pumps and gentle leg exercises hourly
Compression stockings if provided — wear as instructed
Follow-up appointment
Orthopedic surgery follow-up within 1-2 weeks
Bring all imaging and discharge paperwork
Repeat X-rays will be taken to confirm fracture position is maintained
Return to emergency department immediately if you develop
Worsening pain not controlled by your medications
New inability to bear weight that was previously possible
Numbness or tingling in your groin, inner thighs, or buttocks (saddle area)
Weakness in your legs
Inability to urinate or control your bladder or bowel
Fever above 38.5 degrees Celsius
Blood in urine
Calf swelling, redness, or warmth (possible blood clot)
Increasing bruising around groin or thighs
Any concern that something feels wrong
References
Guidelines and key sources
Young-Burgess classification
Young JW, Burgess AR, Brumback RJ, Poka A. Pelvic Fractures: Value of Plain Radiography in Early Assessment and Management. Radiology. 1986
Foundational classification system for pelvic ring injuries
Gao Y, Lou Z, Tang X. Rethinking LC-type in Young-Burgess Classification. Medicine. 2025. PMID 41029132
Contemporary reassessment of LC subtype prevalence and outcomes
Hemorrhage management
LaGrone LN et al. AAST/ACS Clinical Protocol for Damage-Control Resuscitation. J Trauma Acute Care Surg. 2024
Current standard for balanced resuscitation in trauma hemorrhage
Coccolini F et al. Pelvic Trauma: WSES Classification and Guidelines. World J Emerg Surg. 2017. PMC5241998
International guidelines for pelvic trauma management
Anand T et al. Hemorrhage Control Interventions and Mortality in Pelvic Fractures. JAMA Surgery. 2023
Angioembolization vs packing outcomes
Puchwein P, Hallmann B, Eibinger N. Bleeding Management in Pelvic Trauma. Curr Opin Anaesthesiol. 2025. PMID 40071960
Stability assessment
DeKeyser GJ et al. Emergency Department Stress Radiographs of LC-1 Pelvic Ring Injuries. JBJS. 2022. PMID 34921551
Prospective validation of ED stress exam safety and reliability
Dekeyser GJ et al. Comparing ED Stress of LC-1 Pelvis Fractures With Beckmann Scoring. JAAOS. 2023. PMID 36727708
Validation of radiographic instability scoring system
Ellis JD et al. Anterior Pelvic Ring Fracture Pattern Predicts Displacement in LC Sacral Fractures. J Orthop Trauma. 2022. PMID 35583370
Epidemiology and outcomes
Weaver MJ et al. Patterns of Injury in Lateral Compression Pelvic Fractures. Clin Orthop Relat Res. 2012. PMID 22585347
Manson T et al. Young-Burgess Classification: Mortality, Transfusion, Non-Orthopaedic Injuries. J Orthop Trauma. 2010. PMID 20871246
Therrien CC et al. Functional Status and HRQoL Following Young-Burgess Pelvic Ring Injuries. PloS One. 2025. PMID 41955237
Long-term functional outcomes by LC subtype
Khurana B et al. Pelvic Ring Fractures: What the Orthopaedic Surgeon Wants to Know. Radiographics. 2014. PMID 25208283
Demetriades D et al. Pelvic Fractures: Epidemiology and Associated Injuries. J Am Coll Surg. 2002. PMID 12113532
Imaging
Raniga S et al. High-Energy Pelvic Ring Injuries: Comprehensive Imaging Review. Radiographics. 2025. PMID 40996897
Padia SA et al. SIR Position Statement on Endovascular Intervention for Trauma. J Vasc Interv Radiol. 2020
Mennen AHM et al. Imaging of Pelvic Ring Fractures in Older Adults. Osteoporos Int. 2023. PMID 37286662
MRI utility in elderly fragility pelvic fractures
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.