Pelvic Fracture

Mechanism: high-energy (RTC, fall from height, crush) — major trauma. Classification (Young-Burgess): • Lateral compression (LC) — most common; broadly stable. • Anteroposterior compression (APC) — open book; high bleeding risk. • Vertical shear (VS) — vertical displacement; unstable. • Combined. Massive haemorrhage common — pelvic venous plexus, fracture surfaces, arterial injury (internal iliac branches). • ABCDE; haemorrhage control priority. • Pelvic binder applied at greater trochanters (NOT iliac crests) — reduces volume, tamponades bleeding. • 2 large-bore IV access; bloods + cross-match × 4–6 units; ABG + lactate. • Activate Major Haemorrhage Protocol if hypotensive. • Tranexamic acid 1 g IV within 3h. • AVOID rectal exam initially (clinical relevance limited; defer until imaging).