A patient after a head-on vehicle collision has a pelvic X-ray showing symphyseal diastasis >2.5 cm with disruption of the sacroiliac joint. Classified as APC (Anterior-Posterior Compression) Type II by Tile/Young-Burgess, the immediate priority in hemodynamically unstable patients is:
- A Pelvic binder/sheet application followed by resuscitation and pelvic packing or angioembolization ✓
- B Emergency laparotomy for internal hemorrhage control
- C Immediate open reduction and internal fixation of the symphysis
- D External fixation as definitive treatment
Correct answer: A. Pelvic binder/sheet application followed by resuscitation and pelvic packing or angioembolization
Explanation
Hemodynamic instability in APC-II pelvic ring injuries is predominantly due to venous bleeding from the presacral plexus and cancellous bone surfaces. The first priority is mechanical closure of the pelvic volume using a pelvic binder or circumferential sheet to tamponade bleeding. If instability persists, preperitoneal pelvic packing (with temporary external fixation) or angioembolization of arterial bleeders is performed. ORIF is a definitive procedure done after resuscitation and hemorrhage control when the patient is stable.
Reference: Maheshwari Essential Orthopaedics, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.