Acute management of pelvic ring injuries: identifying common treatment principles across institutional algorithms.
Sascha Halvachizadeh, Christian T Hübner, Roman Pfeifer et al.
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In 30 seconds
This PRISMA-guided systematic review compared published institutional algorithms for acute pelvic ring injury management. Searches identified 25 studies describing algorithms, pathways, or protocols published from 2006 through 2025. All 25 algorithms used physiology-based decision-making, and 23/25 (92%) specified early noninvasive mechanical stabilization. Other common components included computed tomography (20/25, 80%), pelvic packing (20/25, 80%), and angiography with potential angioembolization (19/25, 76%). The authors found substantial consistency across algorithms despite institutional variation, particularly in physiologic assessment, stabilization, resuscitation, imaging, and hemorrhage control.
Key findings
- Physiology-based decision-making appeared in all included algorithms (25/25, 100%).
- Early noninvasive mechanical stabilization was specified in 23/25 algorithms (92%); pelvic binders were specified in 17/25 (68%).
- Computed tomography and pelvic packing were each included in 20/25 algorithms or publications (80%).
- Angiography with potential angioembolization was included in 19/25 algorithms (76%).
Why it matters
Acute pelvic ring injury pathways address time-critical decisions about stabilization, imaging, resuscitation, and hemorrhage control. The review shows that published algorithms commonly share these core elements, offering clinicians a synthesis of prevailing pathway components while highlighting variation in specific interventions and decision points.
What to keep in mind
The review compares published algorithms rather than patient outcomes, so it does not establish whether particular pathway components improve clinical outcomes.