Classify fracture pattern as "stable" or "unstable"
If unstable pelvis:
Wrap with sheet or pelvic binder: Place pelvic binder over greater trochanters
Do not over-reduce a lateral compression fracture (places increased strain on post pelvis)
Placing pelvic binder in vertical shear injury (fall from height) may worsen fracture
Anticipate hypotension: 80-90% Venous plexus bleeding, 10-20% Arterial bleeding
FAST exam to rapidly detect hemoperitoneum
If hemoperitoneum is present→ OR
If vital signs are unstable→ OR for damage control laparotomy, not CT
If vital signs are stable and no hemoperitoneum→ CTAP with IV contrast
Contact IR for possible pelvic angiographic embolization
Pre-peritoneal packing can rescue failed angiography (usually in venous bleeding)
Also an option for primary hemorrhage control
Look for vaginal or rectal bleeding, suggests open fracture (uncommon)
If unstable pelvis:
Wrap with sheet or pelvic binder: Place pelvic binder over greater trochanters
Do not over-reduce a lateral compression fracture (places increased strain on post pelvis)
Placing pelvic binder in vertical shear injury (fall from height) may worsen fracture
Wrap with sheet or pelvic binder: Place pelvic binder over greater trochanters
Do not over-reduce a lateral compression fracture (places increased strain on post pelvis)
Placing pelvic binder in vertical shear injury (fall from height) may worsen fracture
If hemoperitoneum is present→ OR
If vital signs are unstable→ OR for damage control laparotomy, not CT
If vital signs are stable and no hemoperitoneum→ CTAP with IV contrast
Contact IR for possible pelvic angiographic embolization
Contact IR for possible pelvic angiographic embolization
Also an option for primary hemorrhage control
Open book<unk> Disruption of pubic symphysis >2.5cm and the pelvis opens like a book and may be accompanied by sacroilial joint disruption
External rotation of the hemipelvis requires binding and likely surgical fixation
Straddle<unk> Unstable
Both rami fractured on both sides or both rami on one side with pubic symphysis diastasis
High rate of urinary tract and bowel injury
Acetabular<unk> 
Pelvic avulsion fracture
Anterior superior iliac spine
Occurs from forceful sartorius muscle contraction (adolescent sprinters)
Bed rest for 3-4 wk with hip flexed and abducted, crutches, ortho follow up in 1-2wk
Anterior inferior iliac spine
Occurs from forceful rectus femoris muscle contraction (adolescent soccer players)
Bed rest for 3-4 wk with hip flexed, crutches, ortho follow up in 1-2wk
Disruption of pubic symphysis >2.5cm and the pelvis opens like a book and may be accompanied by sacroilial joint disruption
External rotation of the hemipelvis requires binding and likely surgical fixation
Unstable
Both rami fractured on both sides or both rami on one side with pubic symphysis diastasis
High rate of urinary tract and bowel injury
Anterior superior iliac spine
Occurs from forceful sartorius muscle contraction (adolescent sprinters)
Bed rest for 3-4 wk with hip flexed and abducted, crutches, ortho follow up in 1-2wk
Anterior inferior iliac spine
Occurs from forceful rectus femoris muscle contraction (adolescent soccer players)
Bed rest for 3-4 wk with hip flexed, crutches, ortho follow up in 1-2wk
Occurs from forceful sartorius muscle contraction (adolescent sprinters)
Bed rest for 3-4 wk with hip flexed and abducted, crutches, ortho follow up in 1-2wk
Occurs from forceful rectus femoris muscle contraction (adolescent soccer players)
Bed rest for 3-4 wk with hip flexed, crutches, ortho follow up in 1-2wk
Pain control in ED with femoral nerve blocks.
Nerve Block: Fascia Iliaca Compartment
3 in 1 block (femoral, obturator, lateral cutaneous nerve of thigh)
No difference in 2 blocks listed above 
Nerve Block: Fascia Iliaca Compartment
3 in 1 block (femoral, obturator, lateral cutaneous nerve of thigh)
No difference in 2 blocks listed above
Pelvic fractures
Diaphragmatic trauma
Acetabular pelvic fractures
Liver trauma
Knee fractures
Splenic trauma
Straddle pelvic fracture
Lumbar burst fracture