ABSTRACT
During primary resuscitation at the scene of the accident, the severity of a pelvic injury
is often underestimated. Open pelvic disruption represents an example. These are,
however, rare injuries that lead to spectacular clinical presentations of external massive
bleeding and/or severe pelvic deformities. However, the appearance of a highly
unstable life-threatening pelvic injury is usually even more inconspicuous when an
intact soft tissue envelope is present. Only extended intrapelvic hemorrhage leads to
recognizable variations of the external contour. In more than 80% of the mechanically
unstable pelvic fractures, the injuries are combined with other severe accompanying
injuries. The rate of additional pelvic injuries in polytraumatized patients is around
25% (4). The overall extent of the pelvic trauma is often only realized when a critical
blood loss is reached.
