BIG T Trauma Series Ep. 16 – Pelvic Fractures

This episode of Behind The Knife focuses on the evaluation and management of hemodynamically unstable pelvic fractures. The discussion highlights the high mortality rates associated with these injuries, emphasizing the challenges posed by the pelvic venous plexus and associated bleeding. The panel stresses the importance of early pelvic binder application and avoiding femoral venous catheters for resuscitation. A key point is differentiating between patients who require immediate surgery versus those who can initially be managed with interventional radiology (IR), with a general threshold of four units of blood as a trigger for operative intervention. The panel also reviews specific injuries, such as urethral and bladder injuries, and provides a series of nuanced cases to illustrate decision-making in complex scenarios.