Misunderstanding the pelvic fracture A talk by Gunnar Sandesjöö at TBS23

1. MISUNDER-
STANDING
THE PELVIC
FRACTURE
GUNNAR
SANDERSJÖÖ

2. NOBODY DIES FROM THEIR PELVIC FRACTURE
WHY DO I ACCEPT THE USE OF PELVIC BINDERS?

3. NOBODY DIES FROM THEIR PELVIC FRACTURE
THEY BLEED TO DEATH

6. HOW DOES THE BLEEDING START?
HOW DOES THE BLEEDING STOP?
WHY DOESN’T THE BLEEDING STOP?

8. Anatomical consequences of ”open-book”
pelvic ring disruption. A cadaver experimental
study
Patrick Baque et al. Surg Radiol Anat (2005)
27; 487-490
13 tablespoons

10. BOYLE´S LAW
PV = k

11. Pressure-volume characteristics of the intact
and disrupted pelvic peritoneum
Grimm et al. J Tcrauma (1998) 44(3); 454-459c
1 L - 13 mm Hg
5 L - 21 mm Hg
6 L - 35 mm Hg

12. Pressure-volume characteristics of the intact
and disrupted pelvic peritoneum
Grimm et al. J Tcrauma (1998) 44(3); 454-459c
20 L - 36 mm Hg

13. Pressure-volume characteristics of the intact
and disrupted pelvic peritoneum
Grimm et al. J Tcrauma (1998) 44(3); 454-459c
20 L - 42 mm Hg

15. Anatomic distribution of hematoma following pelvic fracture
Uludag et al, Br J Radiol 2018 May;91(1085)
5% limited to the
true pelvis
83% gluteal
58% abdominal
42% paravertebral
55% flanks

16. HOW DOES THE BLEEDING START?
HOW DOES THE BLEEDING STOP?
WHY DOESN’T THE BLEEDING STOP?

19. NOBODY DIES FROM THEIR PELVIC FRACTURE
WHY DO I ACCEPT THE USE OF PELVIC BINDERS?