INTERNATIONAL CONFERENCE PEDAGOGICAL REFORMS AND
THEIR SOLUTIONS
VOLUME 11, ISSUE 01, 2025
102
DOUBLE PELVIC FRACTURES: CLINICAL CHALLENGES AND MANAGEMENT
Pradip P.S.R.
1
Kuldashev K.A.
2
Egamov Y.S.
3
Xodjaliyev J.
4
Kuldasheva Y.
5
Inamova
G.K
6
Rasulov J.
7
Andijan State Medical Institute, Uzbekistan
Abstract:
Double pelvic fractures are rare but life-threatening injuries commonly associated
with high-energy trauma. They are characterized by bilateral or combined disruptions of the
pelvic ring leading to severe instability and massive hemorrhage. Early diagnosis with CT
imaging and rapid hemodynamic stabilization are critical.
Double pelvic fractures are among the most severe injuries encountered in trauma care, as they
compromise the pelvic ring at multiple points, leading to significant biomechanical instability
and high risk of life-threatening hemorrhage. These injuries are frequently associated with high-
energy mechanisms such as motor vehicle collisions, industrial accidents, and falls from
significant heights. The complex anatomy of the pelvis, combined with the proximity of major
blood vessels and visceral organs, makes bilateral pelvic fractures a critical emergency
requiring immediate and coordinated intervention.
In addition to mechanical instability, double pelvic fractures are strongly correlated with
damage to the genitourinary tract, abdominal organs, and neurovascular structures, which
complicates management and increases morbidity and mortality. Early diagnosis through
radiographic and CT imaging is essential for accurate classification and surgical planning. The
main goals of management include rapid hemodynamic stabilization, hemorrhage control, and
restoration of pelvic stability using external fixation or C-clamps, followed by definitive
reconstruction when the patient’s condition allows.
This study aims to highlight the clinical challenges, diagnostic strategies, and treatment
outcomes of patients with double pelvic fractures, emphasizing the importance of a
multidisciplinary approach to improve survival rates and long-term functional recovery.
Methods:
A retrospective analysis of 20 patients with confirmed double pelvic fractures treated between
2019 and 2023 was performed. Inclusion criteria included bilateral or combined disruptions of
the pelvic ring confirmed on CT imaging. Data collected included demographic characteristics,
mechanism of injury, hemodynamic parameters, associated organ damage, and treatment
modality.
All patients underwent standard trauma assessment based on ATLS protocols.
Hemodynamically unstable patients received immediate pelvic binding and blood transfusion.
External fixation or pelvic C-clamp was applied within the first 24 hours in unstable cases.
Definitive surgical stabilization with ORIF was performed once patients were clinically stable.
Data were analyzed for survival rates, complication incidence, and functional recovery over a
12-month follow-up.
Results:
Out of 20 patients, 15 (75%) presented with severe hemodynamic instability on admission. The
most common mechanism of injury was high-speed motor vehicle collisions (60%). Associated
INTERNATIONAL CONFERENCE PEDAGOGICAL REFORMS AND
THEIR SOLUTIONS
VOLUME 11, ISSUE 01, 2025
103
injuries included bladder rupture in 20%, urethral trauma in 15%, and intra-abdominal organ
damage in 30% of patients.
Early external fixation within 24 hours was performed in 14 patients and correlated with a 40%
reduction in transfusion requirements compared to delayed stabilization. Mortality rate was
20%, primarily due to uncontrolled hemorrhage and associated head or thoracic trauma.
Functional recovery at 12 months was satisfactory in 70% of survivors, with early rehabilitation
improving mobility outcomes.
Conclusion:
Double pelvic fractures represent one of the most severe forms of musculoskeletal trauma due
to their high association with hemorrhagic shock, organ damage, and complex biomechanical
instability of the pelvic ring. The findings of this study confirm that early recognition and
immediate intervention are crucial to improving patient survival and functional recovery.
Computed tomography remains the gold standard for accurate diagnosis and classification,
allowing for precise surgical planning. Rapid implementation of hemorrhage control measures,
including pelvic binding, external fixation, and massive transfusion protocols, significantly
decreases early mortality. The results further demonstrate that early mechanical stabilization
within the first 24 hours not only reduces blood loss but also creates favorable conditions for
subsequent definitive surgery and rehabilitation.
Successful management requires a multidisciplinary approach involving trauma surgeons,
orthopedic specialists, anesthesiologists, and critical care teams. Rehabilitation programs
initiated in the early postoperative period are essential to restoring mobility and preventing
long-term disability.
Ultimately, the study underscores that the combination of advanced imaging, standardized
trauma protocols, and early stabilization techniques can transform the prognosis of double
pelvic fractures from a highly fatal injury to one with substantial chances of recovery and
functional independence.
