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Review
. 2024 May 13;18(1):16.
doi: 10.1186/s13037-024-00396-x.

The pathophysiology of pelvic ring injuries: a review

Philip F Stahel  1   2   3 , Navid Ziran  4   5   6
Affiliations
Review

The pathophysiology of pelvic ring injuries: a review

Philip F Stahel et al. Patient Saf Surg. .

Abstract

Traumatic pelvic ring injuries continue to represent a major challenge due to the high rates of post-injury mortality of around 30-40% in the 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. The understanding of the underlying pathophysiology of pelvic trauma is predicated by classification systems for grading of injury mechanism and risk stratification for developing post-injury coagulopathy with subsequent uncontrolled exsanguinating hemorrhage. This review article elaborates on the current understanding of the pathophysiology of severe pelvic trauma with a focus on the underlying mechanisms of retroperitoneal bleeding and associated adverse outcomes.

Keywords: Coagulopathy; Lethal triad; Pathophysiology; Pelvic ring injury; Retroperitoneal hemorrhage.

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Conflict of interest statement

P.F.S. is employed by HCA Healthcare. The views expressed in this manuscript exclusively represent the author’s personal perspective and do not necessarily represent official views of HCA Healthcare or any of its affiliated entities. P.F.S. and N.Z. are editors on the journal’s editorial board (www.pssjournal.com). The authors attest that they were not involved in the peer-review process or editorial management and decision-making related to this submission.

Figures

Fig. 1
Fig. 1
Pelvic ring injury classification, severity grading, and risk stratification for associated traumatic hemorrhage. Abbreviations: APC, antero-posterior compression; AO, Arbeitsgemeinschaft für Osteosynthesefragen; CM, combined mechanism, LC, lateral compression; OTA, Orthopaedic Trauma Association; VS, vertical shear
Fig. 2
Fig. 2
The lethal triad of traumatic hemorrhage
Fig. 3
Fig. 3
Clinical case scenario of a patient with life-threatening exsanguinating hemorrhage associated with a high-energy pelvic ring disruption
See this image and copyright information in PMC

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