Pelvic & Acetabular Trauma
Recognise concealed haemorrhage and coordinate safe assessment of high-energy pelvic injury.
Quick revision ↓ Medical Dictionary
01Major-trauma context
Pelvic injury after high-energy trauma may coexist with chest, abdominal, spinal and limb injuries. Assess haemodynamic state and activate the major-haemorrhage pathway when indicated. Visible external blood loss may be minimal despite substantial pelvic or other internal bleeding.
02Protect the pelvis
When indicated, trained staff apply a pelvic binder according to the trauma pathway with correct positioning at the greater trochanters. Avoid repeated manual springing of a suspected unstable pelvis. Reassess skin and pressure exposure, and coordinate binder removal with the specialist plan rather than removing it casually for examination.
03Associated injuries
Look for perineal wounds, blood at the urethral opening and other clues to urogenital injury. Suspected urethral injury changes catheter planning and warrants specialist assessment; repeated blind attempts can worsen harm. Include a documented neurological assessment when the patient’s condition permits.
04Imaging and haemorrhage control
Imaging depends on stability and the major-trauma pathway. A stable enough patient may need CT to define injury and bleeding. Haemorrhage control can involve several specialist techniques, selected according to physiology and resources; diagnostic investigation must not delay necessary resuscitation or definitive control.
05Acetabular injury and recovery
Acetabular fractures involve the hip joint surface and may accompany dislocation. Assess sciatic nerve function and articular congruity through the specialist pathway. Long-term care considers weight-bearing restrictions, thrombosis prevention and rehabilitation, with monitoring for stiffness, post-traumatic arthritis and persistent neurological problems.
High-Yield Revision
- Pelvic bleeding can be concealed.
- Avoid repeated pelvic springing.
- Binder position and removal require an agreed plan.
Common Pitfalls
- Judging blood loss only by external bleeding.
- Repeated blind catheter attempts when urethral injury is suspected.
References & Further Reading
Read the relevant guideline sections alongside these original clinical teaching cases. Local pathways, available services and individual patient factors determine care.
Reference review: 28 September 2026. Consult current local protocols for prescribing, procedures and escalation.