Evidence map›Paper›PMID 42886289›Full record

SynthesisEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2026

Acute management of pelvic ring injuries: identifying common treatment principles across institutional algorithms.

Sascha Halvachizadeh, Christian T Hübner, Roman Pfeifer, Alona Katzir, Claude Sagi, Nikolaos K Kanakaris, Peter V Giannoudis, Ishvinder Grewal, Cyril Mauffrey, Hans-Christoph Pape and 1 more

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Synthesis in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

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No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

11 authors.

Sascha HalvachizadehDepartment of Trauma, University Hospital of Zurich, Zurich, Switzerland. sascha.halvachizadeh@usz.ch.ORCID https://orcid.org/0000-0003-1393-3232
Christian T HübnerDepartment of Trauma, University Hospital of Zurich, Zurich, Switzerland.ORCID https://orcid.org/0009-0003-9285-8660
Roman PfeiferDepartment of Trauma, University Hospital of Zurich, Zurich, Switzerland.
Alona KatzirDepartment of Orthopaedic Surgery, Parkland Memorial Hospital, Dallas, USA.
Claude SagiDepartment of Orthopaedic Surgery, University of Cincinnati, Cincinnati, USA.
Nikolaos K KanakarisLeeds Major Trauma Centre, University of Leeds, Leeds, UK.
Peter V GiannoudisLeeds Major Trauma Centre, University of Leeds, Leeds, UK.
Ishvinder Grewal
Cyril MauffreyDepartment of Orthopedic Surgery, Denver Health Medical Center, Denver, USA.
Hans-Christoph PapeDepartment of Trauma, University Hospital of Zurich, Zurich, Switzerland.
Adam J Starr

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPelvic ring injuries are associated with substantial morbidity and mortality, particularly in patients presenting with hemodynamic instability and major hemorrhage. Numerous institutions have developed management algorithms for the acute treatment of pelvic ring injuries; however, the common principles underlying these pathways remain unclear.

methodsA systematic review was conducted in accordance with the PRISMA 2020 guidelines. PubMed/MEDLINE, Embase, and Scopus were searched on January 8, 2026, for peer-reviewed publications published from January 1, 2006, through December 31, 2025 that described algorithms, pathways, or protocols for the acute management of pelvic ring injuries. Two independent reviewers performed study selection and data extraction. Algorithm components related to mechanical stabilization, physiologic assessment, imaging, hemorrhage control, and damage control resuscitation were extracted and compared using descriptive quantitative and qualitative synthesis.

resultsThe search identified 328 records that underwent title and abstract screening, and 63 articles were assessed for full-text eligibility. Twenty-five studies were included in the final analysis. All included algorithms (25/25, 100%) used physiology-based decision-making. Early noninvasive mechanical stabilization was specified in 23/25 algorithms (92%); pelvic binders were specified in 17/25 (68%). Angiography with potential angioembolization was included in 19/25 algorithms (76%), exploratory laparotomy in 10/25 (40%), and resuscitative endovascular balloon occlusion of the aorta (REBOA) in 3/25 (12%). Computed tomography was incorporated into 20/25 algorithms (80%), whereas pelvic radiography was included in 18/25 (72%). Fracture morphology was used as a treatment decision point in 4/25 algorithms (16%), and pelvic packing was described in 20/25 publications (80%).

conclusionPublished algorithms for the acute management of pelvic ring injuries demonstrate substantial consistency despite institutional variation. Early mechanical stabilization, physiologic assessment, damage control resuscitation, radiologic evaluation, and structured hemorrhage-control pathways were identified as the most common components of contemporary management algorithms.

Indexed as

AlgorithmsFractures, BonePelvic BonesHemorrhageHumansResuscitationDamage control resuscitationHemorrhage controlManagement algorithmPelvic fracturePelvic ring injuryPRISMASystematic review

Identifiers

PMID42886289

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.