01Approach to the Critical Patient/attcp42

Immediate stabilization

›Primary survey priorities

›Airway and breathing

›Supplemental oxygen for SpO2 < 94%

›Intubation if GCS <= 8 or airway compromise

›Circulation and hemorrhage control

›Two large-bore IV access minimum

›IO access if IV access fails

›Activate massive transfusion protocol for SBP < 90 mmHg or HR > 120 bpm

›Apply pelvic binder immediately at level of greater trochanters for suspected unstable fracture

›Commercial binder preferred over sheet

›Remove within 24 hours to prevent pressure necrosis

›Replace with external fixation when indicated

Hemodynamic targets

›Resuscitation goals

›Permissive hypotension target SBP 80-90 mmHg until hemorrhage controlled

›Avoid aggressive crystalloid resuscitation

›Balanced hemostatic resuscitation preferred

›Massive transfusion protocol ratio 1:1:1 pRBC to FFP to platelets

›Whole blood as alternative when available

›Tranexamic acid within 3 hours of injury

›Lethal triad recognition and prevention

›Coagulopathy: INR > 1.5 or TEG/ROTEM evidence

›Hypothermia: core temperature < 35 C

›Acidosis: pH < 7.2 or lactate > 5 mmol/l

Escalation triggers

›Critical escalation criteria

›Hemodynamic instability persisting after 2 units pRBC

02History/hx50

Mechanism and event

›Mechanism of injury

›High-energy mechanisms

›Motor vehicle collision

›Motorcycle crash

›Pedestrian struck

›Fall from height

›Crush injury

›Low-energy mechanisms

›Ground-level fall in elderly or osteoporotic patients

›Pathologic fracture risk in malignancy

›Event details

›Speed, direction of impact

›Seatbelt use, ejection status

›Height of fall

Presenting symptoms

›Pain distribution

›Groin, hip, low back, sacral

›Perineal or suprapubic pain

›Inability to ambulate after injury

›Genitourinary symptoms

›Hematuria

›Inability to void

›Blood at urethral meatus

›Vaginal bleeding

›Neurologic symptoms

›Lower extremity weakness or numbness

›Saddle anesthesia

03Physical Exam/exam48

Vitals and general

›Hemodynamic snapshot

›SBP < 90 mmHg as late hemorrhagic shock sign

›Tachycardia > 120 bpm may precede hypotension

›Monitor trends over serial reassessment

›Respiratory rate and oxygen saturation

›Tachypnea from pain or shock physiology

›Level of consciousness

›GCS <= 8 independent predictor of early death (HR 4.9)

›Low GCS triggers urgent hemorrhage control

Inspection and palpation

›Visual inspection

›Perineal or scrotal ecchymosis (Destot sign)

›Labial swelling

›Open wounds communicating with fracture

›Leg-length discrepancy or rotational deformity

›Morel-Lavallee lesion: closed degloving injury over greater trochanter

›Palpation findings

›Tenderness over symphysis pubis, iliac crests, sacrum, SI joints

›Posterior palpation sensitivity 98% for posterior ring injury

›Pelvic stability: gentle AP and lateral compression once only

›Avoid repeated manipulation

›Limits role in era of CT scanning

Genitourinary and rectal exam

›Urethral assessment

›Blood at urethral meatus: do not place Foley until injury excluded

›High-riding prostate on rectal exam suggests urethral disruption

›Retrograde urethrogram before catheterization

04Differential Diagnosis/ddx37

Life-threatening diagnoses

›Immediate threats

›Hemorrhagic shock from pelvic venous plexus bleeding

›ICD-10 S32 pelvic ring fracture

›Venous bleeding accounts for majority of pelvic hemorrhage

›Arterial hemorrhage from iliac vessels

›ICD-10 S35 injury of blood vessels at abdomen level

›Contrast blush on CT identifies arterial source

›Open pelvic fracture with sepsis risk

›ICD-10 S31 open wound of abdomen, lower back, and pelvis

›Mortality 20-24%

Fracture pattern differential

›Associated skeletal injuries

›Acetabular fracture

›May coexist with pelvic ring disruption

›CT differentiates from isolated ring injury

›Hip fracture: femoral neck or intertrochanteric

›Pain with log roll

›Shortened, externally rotated leg

›Hip dislocation

›Deformity and inability to move hip

›Requires urgent reduction

›Lumbar spine fracture

›Midline tenderness

›Neurologic deficits from cord or cauda equina

Mimics and concurrent injuries

›Retroperitoneal and abdominal injury

›Intra-abdominal solid organ injury: concurrent in up to 67% of pelvic fractures

05Laboratory Tests/lt40

Hemorrhage and resuscitation labs

›Type and crossmatch

›Essential; anticipate massive transfusion

›Order immediately for any unstable patient

›Uncrossmatched O-negative pRBC if no time to type

›Complete blood count

›Serial hemoglobin monitoring

›Initial Hgb not sensitive for acute blood loss

›Serial values more informative than single measurement

›Platelet count for transfusion threshold

›Target > 50 x 10^9/l in active hemorrhage

›Coagulation studies

›PT/INR and PTT

›Baseline coagulopathy identification

›Anticoagulant effect assessment

›Fibrinogen level

›Target > 1.5 g/l during resuscitation

Viscoelastic and shock markers

›TEG or ROTEM point-of-care testing

›Targeted resuscitation in coagulopathy

›Identifies clot formation defects

›Guides specific blood product use

›Preferred over standard coagulation in hemorrhagic shock

›Lactate

›Tissue hypoperfusion marker

›> 2 mmol/l indicates shock physiology

›Serial values guide resuscitation adequacy

›Base deficit on blood gas

06Diagnostic Tests/dt78

Scoring Systems

›Young and Burgess classification

›Most widely used system based on force vectors

›Lateral Compression (LC): most common at approximately 60% of injuries

›Anteroposterior Compression (APC): open book injury pattern

›Vertical Shear (VS): high instability and mortality risk

›Combined Mechanism (CM): complex pattern

›LC subtypes

›LC-1: stable posterior ring with sacral impaction

›LC-2: iliac wing fracture with posterior instability

›LC-3: contralateral open book component

›APC subtypes

›APC-I: < 2.5 cm symphysis diastasis, stable

›APC-II: > 2.5 cm diastasis, anterior SI ligament disruption

›APC-III: complete posterior ligament disruption

›30-day mortality by pattern

›LC-3: 19%

›APC-3: 16%

›VS: 12%

›LC-1: 8.2% (not always benign)

›Tile classification

›Stability-based system complementary to Young-Burgess

›Type A: stable

›Type B: rotationally unstable, vertically stable

›Type C: rotationally and vertically unstable

›Tile C: independently associated with higher 90-day mortality (HR 3.6)

MRI

›MRI indications for pelvic ring fracture

›Occult posterior ring fractures in elderly or osteoporotic patients

›Detects up to 54% additional fractures missed by CT

›Recommended when X-ray and CT are negative but clinical suspicion persists

›Protocol

›T1 and STIR sequences for bone marrow edema

›Coronal and axial planes for SI joint and sacrum

›Soft tissue injury assessment

›Ligamentous injury of posterior SI complex

›Lumbosacral plexus injury characterization

›Morel-Lavallee lesion extent

›Limitations

›Not first-line in hemodynamically unstable patients

›Time constraints in acute setting

›MRI incompatible with some monitoring equipment

CT

›CT pelvis with IV contrast

›Gold standard imaging for pelvic ring fractures

›100% sensitivity for bony fractures

›Identifies contrast extravasation (arterial blush)

›Characterizes hematoma size and extent

›Arterial injury indicators

›Pelvic hematoma >= 500 cm3 raises strong suspicion for arterial injury even without visible blush

›Active extravasation mandates angioembolization

›3D reconstruction

›Aids surgical planning for sacral fractures and SI joint disruptions

›Required for complex posterior ring injuries

›CT angiography

›When arterial hemorrhage is suspected

›Identifies specific vessel injury

›Guides selective embolization planning

›AP pelvis radiograph role

›First-line screening in hemodynamically unstable patients per ATLS

›Limited sensitivity 50-68% for all fractures

›May be omitted in stable patients proceeding directly to CT

›Retrograde urethrogram

›Before Foley placement if urethral injury suspected

›Indications: blood at meatus, high-riding prostate, perineal hematoma

›Water-soluble contrast study under fluoroscopy

Ultrasound

›FAST and E-FAST

›Primary role: exclude concurrent intraperitoneal hemorrhage

›Not sensitive for retroperitoneal bleeding

›Positive FAST in hemodynamically unstable patient mandates operative intervention

›E-FAST additional assessment

›Pneumothorax screening in polytrauma

›Pericardial effusion exclusion

›Limitations

›Cannot reliably detect retroperitoneal hematoma

›Negative FAST does not exclude pelvic hemorrhage

›CT required for definitive hemorrhage source identification

›Vascular ultrasound

›DVT surveillance in recovery phase

›Up to 34% develop proximal DVT

›Screening protocol per institutional guidelines

07Disposition/dispo36

Immediate disposition

›ICU admission criteria

›All hemodynamically unstable patients

›Massive transfusion requirement

›Pelvic packing or angioembolization performed

›External fixation placed

›Neurologic compromise

›GCS <= 8

›Lumbosacral plexus injury requiring monitoring

›Operating room or interventional radiology

›Hemodynamic instability not responding to binder and resuscitation

›Preperitoneal pelvic packing and external fixation

›Angioembolization for arterial blush on CT

›Open pelvic fracture

›Irrigation and debridement

›Fecal diversion consideration

Floor and monitored bed admission

›Hemodynamically stable with mechanically unstable fractures

›Surgical planning for definitive fixation

›Timing: hemodynamically stable patients may undergo early fixation within 24 hours

›Physiologically deranged polytrauma: delay fixation beyond day 4

›Associated injuries requiring monitoring

›Genitourinary injury management

›Neurologic injury observation

Transfer criteria

›Transfer to Level I trauma center

›Non-trauma centers with unstable pelvic fractures

›Apply pelvic binder before transfer

08Treatment/t98

Pelvic binder and mechanical stabilization

›Pelvic binder application

›Apply at level of greater trochanters

›Not at iliac crests: prevents adequate reduction

›Commercial binder preferred over sheet

›Timing and removal

›Apply immediately for suspected unstable fracture

›Remove within 24 hours to avoid pressure necrosis

›Replace with external fixation if indicated

›Indications

›Suspected APC-II or APC-III (open book pattern)

›Any hemodynamically unstable pelvis fracture

›Caution in LC-type injuries: may worsen lateral compression

Hemorrhage control interventions

›Preperitoneal pelvic packing (PPP)

›Hemodynamically unstable patients not responding to binder and resuscitation

›Primarily addresses venous bleeding (majority of pelvic hemorrhage)

›Combined with external fixation for effective counterpressure

›External fixation frame selection

›Anterior frames for APC-II/III, LC-II/III

›C-clamp for vertical shear

›Contraindicated in comminuted sacral fractures, iliac wing fractures, LC-type injuries

›Angioembolization

›Arterial hemorrhage with contrast blush on CT

›Only intervention independently associated with reduced mortality in large national study

›Selective embolization preferred over nonselective

›Bilateral embolization if no localizing blush but hemodynamic instability persists

›REBOA (Resuscitative Endovascular Balloon Occlusion of the Aorta)

›Zone III occlusion as bridge in patients in extremis

›Promising but not yet independently shown to improve survival

›Requires endovascular expertise

›Bridge to definitive hemorrhage control

Resuscitation

›Massive transfusion protocol

›Ratio 1:1:1 pRBC to FFP to platelets

›Activates for SBP < 90 mmHg or HR > 120 bpm with mechanism

›Reassess every 30 minutes

›Whole blood

›Alternative when available

›Emerging evidence for improved outcomes

›Tranexamic acid (TXA)

›Antifibrinolytic adjunct for hemorrhagic shock

›1 g IV over 10 minutes as loading dose

›Followed by 1 g IV over 8 hours

›Administer within 3 hours of injury for maximum benefit

›CRASH-2 trial evidence for trauma hemorrhage

›Calcium replacement

›Ionized calcium target > 1.1 mmol/l

›Give 1 g calcium chloride IV per 4 units pRBC transfused

›Citrate chelation from massive transfusion depletes calcium

Definitive surgical fixation

›Stable fracture patterns: nonoperative

›APC-I and LC-I

›Weight bearing as tolerated

›Functional rehabilitation

›Orthopedic follow-up at 2, 6, and 12 weeks

›Unstable fracture patterns: surgical fixation

›APC-II/III: pubic symphysis plating for diastasis > 2.5 cm

›Percutaneous iliosacral screws for posterior ring

›LC-II/III: posterior ring stabilization

›Vertical shear: spinopelvic fixation for vertically unstable sacral fractures

›Timing

›Hemodynamically stable: early fixation within 24 hours acceptable

›Physiologically deranged polytrauma: delay until after day 4

VTE prophylaxis

›Pharmacologic prophylaxis

›Enoxaparin 30 mg subcutaneous BID

›Initiate when hemostasis is achieved

›LMWH standard per Western Trauma Association guidelines

›Aspirin 81 mg BID

›PREVENT CLOT trial: noninferior to LMWH for prevention of death from any cause after pelvic and extremity fractures

›Alternative when anticoagulation risk is higher

›Avoid anticoagulants until active hemorrhage is controlled

›Mechanical prophylaxis

›Sequential compression devices when pharmacologic prophylaxis contraindicated

›Apply to upper extremities if lower extremity injury

›Extended prophylaxis

›Consider up to 4 weeks post-discharge in high-risk patients

›Proximal DVT rate up to 34%; PE rate up to 12%

Analgesia

›Multimodal analgesia approach

›Acetaminophen 1 g IV or oral every 6 hours

›Baseline analgesia, opioid sparing

›Regional nerve blocks

›Fascia iliaca block for hip and anterior pelvic pain

›Consult acute pain or anesthesia service

›Caution with NSAIDs in acute setting

›Bleeding risk with platelet inhibition

›Renal perfusion compromise in shock states

›Opioids

›Use judiciously; avoid excessive doses masking hemodynamic changes

›Titrate to effect with respiratory monitoring

Associated injury management

›Genitourinary injuries

›Urology consult if Foley cannot be placed or urethral injury suspected

›Suprapubic catheter if urethral disruption confirmed

›Cystogram for bladder injury evaluation

›Open fracture management

›Fecal diversion (colostomy) for open fractures with rectal or perineal wounds

›Mortality 20-24%; aggressive wound management essential

›Wound irrigation and debridement in OR

›Antibiotics per open fracture protocol

›Morel-Lavallee lesion

›Closed degloving injury requiring drainage

›Wound care and surgical debridement if infected

09Special Populations/sp77

Pregnancy

›Physiologic considerations

›Pelvic vascularity markedly increased in pregnancy

›Hemorrhage risk substantially higher

›Resuscitation thresholds may need lowering

›Uterus displaces abdominal organs and alters injury pattern

›Fetal injury risk with high-energy pelvic trauma

›Physiologic hemodilution of pregnancy

›Baseline Hgb lower; adjust transfusion thresholds

›Pelvic binder use

›Use with caution in pregnancy

›Fundal height assessment required

›Binder position may compress uterus

›Obstetrics consult urgently

›Fetal monitoring

›Cardiotocography after 24 weeks gestation

›Minimum 4-hour monitoring after trauma

›Kleihauer-Betke test for fetomaternal hemorrhage

›Rh-negative mothers: anti-D immunoglobulin 300 mcg IM

›Imaging

›CT if hemodynamically unstable despite radiation risk

›Fetal radiation from pelvis CT approximately 25-50 mGy

›MRI preferred when time allows for stable patients

›Lead shielding for non-target areas when feasible

›Obstetric consultation

›Immediate for all pelvic trauma in pregnancy

›Emergency cesarean section if nonreassuring fetal status

›Perimortem cesarean at 4 minutes of maternal arrest if > 24 weeks

Geriatric

›Injury pattern differences

›Low-energy falls sufficient to cause ring disruption

›Osteoporosis reduces threshold for fracture

›Fragility fractures may involve sacrum predominantly

›Associated comorbidities increase complexity

›Anticoagulant use increases hemorrhage risk

›Baseline cardiac and renal compromise affects resuscitation

›Mortality risk

›Increasing age is independent predictor of mortality

›90-day mortality significantly higher than younger patients

›Comorbidity burden compounds injury severity

›Medication considerations

›Anticoagulant reversal

›Warfarin: vitamin K 10 mg IV plus 4-factor PCC

›DOAC: specific reversal agent per agent used

›Antiplatelet agents: platelet transfusion threshold lower

›Calcium and vitamin D supplementation during recovery

›Supports fracture healing in osteoporotic bone

›VTE prophylaxis dose adjustment for renal function

›Enoxaparin dose reduction if CrCl < 30 ml/min

›Functional outcomes

›Pre-injury functional status critical to recovery expectations

›Frailty assessment for disposition planning

›Early physical and occupational therapy involvement

Pediatrics

›Epidemiology and mechanism

›Pelvic ring fractures rare in children due to cartilaginous elasticity

›High-energy mechanism required in most cases

›Growth plate injuries may accompany ring disruption

›Pubic apophyseal avulsion fractures common in adolescent athletes

›Distinguished from traumatic ring disruption

›Physiologic differences

›Children tolerate hemorrhage longer before cardiovascular decompensation

›Sudden decompensation after prolonged compensation

›Tachycardia is earlier and more reliable shock sign than hypotension

›Estimated blood volume 70-80 ml/kg

›Crystalloid resuscitation 20 ml/kg boluses

›Transition to pRBC early for ongoing hemorrhage

›Dosing adjustments

›TXA 15-30 mg/kg IV over 10 minutes (max 1 g)

›Followed by 15-30 mg/kg over 8 hours

›pRBC transfusion 10-20 ml/kg per aliquot

›LMWH VTE prophylaxis weight-based dosing per pediatric hematology guidance

›Pelvic binder

›Pediatric-sized commercial binders available

›Sheet improvisation often necessary in small children

›Apply at greater trochanters

›Growth and long-term outcomes

›Growth plate involvement may cause leg-length discrepancy

›Long-term orthopedic surveillance required

›Remodeling potential higher than adults

10Background/b74

Epidemiology

›Incidence and mechanism distribution

›Pelvic ring fractures account for 3-8% of all skeletal fractures

›Bimodal age distribution: young males from high-energy trauma and elderly females from low-energy falls

›Motor vehicle collisions most common high-energy mechanism

›Mortality rates

›Overall 32% in severe high-energy fractures

›Up to 36% in hemodynamically unstable patients requiring hemorrhage control interventions

›Open pelvic fractures: mortality 20-24%

›Hemorrhage epidemiology

›Hemodynamic instability in 5-20% of pelvic fractures

›Arterial injury identified in 10-20% of unstable fractures

›Venous plexus and cancellous bone bleeding account for majority

›VTE complications

›Up to 34% develop proximal DVT

›Up to 12% develop PE without prophylaxis

›Mortality predictors

›GCS <= 8: HR 4.9 for early death

›Tile C pattern: HR 3.6 for 90-day mortality

›Increasing age, initial SBP, injury severity score

Pathophysiology

›Structural anatomy of the pelvic ring

›Pelvic ring stability depends on posterior SI complex

›Anterior ring: symphysis pubis and rami contribute 40% of stability

›Posterior ring: SI joints, sacrum, and posterior ligaments contribute 60%

›Ligamentous stabilizers

›Anterior SI ligament, posterior SI ligament

›Sacrospinous and sacrotuberous ligaments

›Complete disruption required for vertical instability

›Hemorrhage mechanisms

›Pelvic venous plexus: presacral and perivesical

›High-volume low-pressure venous bleeding

›Tamponade achieved by intact posterior peritoneum

›Internal iliac artery branches

›Superior gluteal artery most commonly injured

›Arterial bleeding identified by contrast extravasation on CT

›Cancellous bone surface area

›Sacral and iliac wing fractures expose large vascular surfaces

›Disruption patterns and force vectors

›Lateral compression: sacral impaction, no pelvic volume increase

›May paradoxically reduce internal volume

›Anteroposterior compression: pelvic volume increases 3- to 4-fold with APC-III

›Disrupts tamponade effect of retroperitoneum

›Vertical shear: disrupts all posterior stabilizers

›Highest instability and associated organ injury rate

Therapeutic Considerations

›Damage control orthopedics principles

›Phase I: hemorrhage control and temporary stabilization

›Pelvic binder, external fixation, preperitoneal packing

›Angioembolization for arterial source

›Phase II: physiologic recovery

›Correct lethal triad (coagulopathy, hypothermia, acidosis)

›ICU optimization before definitive fixation

›Phase III: definitive fixation

›Timing guided by physiologic recovery and injury pattern

›Early fixation in stable patients within 24 hours

›Hemorrhage control algorithm

›Angioembolization independently associated with reduced mortality in national database study (JAMA Surgery 2023)

›Selective embolization avoids end-organ ischemia

›Role of REBOA as bridge gaining evidence

›Preperitoneal packing

›Effective for venous source bleeding

›Requires external fixation for counterpressure to be effective

›Functional recovery data

›Full recovery rates vary by fracture pattern

›LC-1/LC-2 approximately 41-46%

›Vertical shear approximately 31%

›Combined mechanism approximately 27%

›Long-term complications

›Chronic pain, gait abnormality

›Sexual dysfunction, urinary incontinence

›Malunion or nonunion

›Post-traumatic arthritis of SI joint

›Evidence for VTE prophylaxis

›PREVENT CLOT trial (NEJM 2023): aspirin 81 mg BID noninferior to LMWH for prevention of death after pelvic and extremity fractures

›Simplified prophylaxis option for appropriate patients

›Western Trauma Association guidelines support early pharmacologic prophylaxis once hemostasis achieved

11Patient Discharge Instructions/pdi34

copy discharge instructions

›Diagnosis and injury understanding

›You have been diagnosed with a pelvic ring fracture

›The pelvis is the bony ring at the base of your spine that connects to your hips

›Depending on the severity, you may have restrictions on weight bearing

›Expected recovery timeline

›Stable fractures typically heal in 6-12 weeks

›Unstable fractures requiring surgery may take 3-6 months for full recovery

›Follow your orthopedic surgeon's specific weight-bearing instructions

›Activity and weight-bearing restrictions

›Follow orthopedic surgeon weight-bearing instructions exactly

›Do not increase activity beyond prescribed limits

›Use prescribed mobility aids (walker, crutches, wheelchair)

›Driving restrictions

›Do not drive until cleared by your surgeon

›Pain medication use prohibits driving

›Medications

›Blood clot prevention medication as prescribed

›Take aspirin or injectable blood thinner exactly as directed

›Do not stop without consulting your doctor

›Pain medications as prescribed

›Do not operate heavy machinery or drive on opioid medications

›Stool softener to prevent constipation from opioid use

›Follow-up appointments

›Orthopedic or trauma surgery follow-up within 1-2 weeks

›Repeat imaging at 2, 6, and 12 weeks to assess healing

›Physical therapy referral as directed

›Return to emergency department immediately for

12References/r30

Guidelines and key sources

›Kazley JM, Potenza MA, Marthy AG, et al. Team Approach: Evaluation and Management of Pelvic Ring Injuries. JBJS Reviews. 2020

›Comprehensive multidisciplinary management framework

›PMID 33006457

›Anand T, El-Qawaqzeh K, Nelson A, et al. Association Between Hemorrhage Control Interventions and Mortality in US Trauma Patients With Hemodynamically Unstable Pelvic Fractures. JAMA Surgery. 2023

›Angioembolization independently associated with reduced mortality

›Large national trauma database analysis

›Coccolini F, Stahel PF, Montori G, et al. Pelvic Trauma: WSES Classification and Guidelines. World Journal of Emergency Surgery. 2017

›International consensus guidelines for pelvic trauma management

›PMC5241998

›Major Extremity Trauma Research Consortium (METRC), O'Toole RV, Stein DM, et al. Aspirin or Low-Molecular-Weight Heparin for Thromboprophylaxis after a Fracture. NEJM. 2023

›PREVENT CLOT trial: aspirin noninferior to LMWH for VTE prevention

›doi 10.1056/NEJMoa2205973

›Langford JR, Burgess AR, Liporace FA, Haidukewych GJ. Pelvic Fractures: Part 1. Evaluation, Classification, and Resuscitation. JAAOS. 2013

›Classification systems and resuscitation principles

›PMID 23908251

Supporting literature

›Winther SS, Singh UM, Nielsen AE, et al. Unstable Pelvic Ring Fractures Managed Surgically. Injury. 2026

›13-year cohort study of predictors of early mortality

›PMID 41558223

›Ley EJ, Brown CVR, Moore EE, et al. Updated Guidelines to Reduce Venous Thromboembolism in Trauma Patients: Western Trauma Association Critical Decisions Algorithm. J Trauma Acute Care Surg. 2020

›VTE prophylaxis decision framework

›PMID 32590563

›Therrien CC, Uil M, Ten Duis K, et al. Functional Status and Health-Related Quality of Life Following Young and Burgess Classified Pelvic Ring Injuries. PloS One. 2025

›Functional outcome data by fracture classification

›PMID 41955237

›Raniga S, Pal D, Mehta C, et al. High-Energy Pelvic Ring Injuries: A Comprehensive Imaging Review. Radiographics. 2025

›Comprehensive imaging review for pelvic ring fractures

Evidence & Review

Evidence & Review