Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2025 Sep 1;99(3):319-327.
doi: 10.1097/TA.0000000000004609. Epub 2025 Apr 2.

Pelvic fracture bleeding control: What you need to know

Todd W Costantini  1 , Clay Cothren Burlew, Whitney R Jenson, Roman Pfeifer, Felix Karl-Ludwig Klingebiel, Rishi Kundi, Thomas M Scalea, Raul Coimbra
Affiliations
Review

Pelvic fracture bleeding control: What you need to know

Todd W Costantini et al. J Trauma Acute Care Surg. .

Abstract

Significant bleeding due to pelvic fracture is associated with high mortality and must be treated promptly to optimize outcomes. The initial evaluation should focus on hemostatic resuscitation, placement of a pelvic binder, and evaluation for additional nonpelvic sources of hemorrhage. There are several options for pelvic hemorrhage control including external fixator placement, angioembolization, preperitoneal pelvic packing, and open internal iliac ligation or surgical embolization of the internal iliac artery. The specific hemorrhage control intervention selected to control pelvic bleeding must be tailored to the patient's physiologic status and local resource availability. This article discusses "What You Need to Know" to provide optimal care for patients with hemorrhage due to severe pelvic fracture.

Keywords: Pelvic hemorrhage; angioembolization; external fixation; hemorrhage control; pelvic packing.

PubMed Disclaimer

References

    1. Costantini TW, Coimbra R, Holcomb JB, Podbielski JM, Catalano R, Blackburn A, et al. Current management of hemorrhage from severe pelvic fractures: results of an American Association for the Surgery of Trauma multi-institutional trial. J Trauma Acute Care Surg . 2016;80(5):717–723 discussion 23–5.
    1. DuBose JJ, Burlew CC, Joseph B, Keville M, Harfouche M, Morrison J, et al. Pelvic fracture-related hypotension: a review of contemporary adjuncts for hemorrhage control. J Trauma Acute Care Surg . 2021;91(4):e93–e103.
    1. Duchesne J, Costantini TW, Khan M, Taub E, Rhee P, Morse B, et al. The effect of hemorrhage control adjuncts on outcome in severe pelvic fracture: a multi-institutional study. J Trauma Acute Care Surg . 2019;87(1):117–124.
    1. Costantini TW, Galante JM, Braverman MA, Phuong J, Price MA, Cuschieri J, et al. Developing a National Trauma Research Action Plan: results from the acute resuscitation, initial patient evaluation, imaging, and management research gap Delphi survey. J Trauma Acute Care Surg . 2022;93(2):200–208.
    1. Costantini TW, Coimbra R, Holcomb JB, Podbielski JM, Catalano RD, Blackburn A, et al. Pelvic fracture pattern predicts the need for hemorrhage control intervention—results of an AAST multi-institutional study. J Trauma Acute Care Surg . 2017;82(6):1030–1038.

LinkOut - more resources