Management of Pelvic Trauma.

Pelvic fractures are common after blunt trauma with patients' presentation ranging from stable with insignificant fractures to life-threatening exsanguination from unstable fractures. Often, hemorrhagic shock from a pelvic fracture may go unrecognized and high clinical suspicion for a pelvic source lies with the clinician. A multidisciplinary coordinated effort is required for management of these complex patients. In the exsanguinating patient, hemorrhage control remains the top priority and may be achieved with external stabilization, resuscitative endovascular balloon occlusion of the aorta, preperitoneal pelvic packing, angiographic intervention, or a combination of therapies. These modalities have been shown to reduce mortality in this challenging population.

Open and contaminated pediatric pelvic ring injury case report: Fixation without metal.

INTRODUCTION: Pelvic fractures are relatively uncommon in children, accounting for 0.3-7.5% of all pediatric injuries (Gänsslen et al., 2013; Ismail et al., 1996; Peltier, 1965; Galano et al., 2005; Spiguel et al., 2006). This case report describes a pediatric open pelvic injury caused by a crush mechanism between a car and guardrail. CASE: A 13year old male presented with an open APC 3 pelvic injury after being pinned between a car and guardrail. His definitive treatment included bilateral SI screw placement, as well as a less invasive method for anterior pelvic ring disruption (Internal Brace suture anchor dynamic fixation). DISCUSSION/CONCLUSION: A less invasive method for the anterior pelvic ring was used to avoid additional dissection due to extensive soft tissue loss, and to decrease hardware burden, which lessens the chance of complications such as infection. Suture fixation of the pubic symphysis provided stable fixation to allow healing in the current case of open pelvic fracture.