Pelvic fractures can cause life‑threatening haemorrhage before the fracture pattern is even named. The first priority is to apply a binder over the greater trochanters to reduce pelvic volume and control bleeding. Assess posterior‑ring stability and contamination to guide definitive management. ⏱ Chapters 0:00 Intro 0:54 Read the image 1:59 EXPLAINER 2:34 EXPLAINER 3:05 EXPLAINER 4:17 Read the image 4:47 EXPLAINER 7:11 EXPLAINER 7:47 EXPLAINER 8:44 Read the image 9:17 EXPLAINER 9:58 EXPLAINER 12:13 EXPLAINER 12:48 EXPLAINER 13:13 Read the image 13:46 EXPLAINER 14:48 EXPLAINER 16:03 Recap & sources This video walks through the critical early steps in managing pelvic ring injuries: recognising haemodynamic instability, correct binder placement, initiating haemorrhage control pathways, and evaluating posterior‑ring integrity using the four‑anchor approach (force, posterior ring, volume, contamination). It explains why posterior‑ring injury dictates stability and treatment, outlines the Denis zone system for sacral fractures, and highlights associated injuries that change the sequence of care. 🦴 IN THIS VIDEO YOU'LL LEARN • How to position a pelvic binder correctly over the greater trochanters • The four‑anchor decision framework for pelvic fractures: force, posterior ring, volume, contamination • How to assess posterior‑ring stability using sacral Denis zones and SI joint integrity • When to activate massive transfusion protocols and angioembolisation for haemorrhage control • How open pelvic injuries alter management priorities and require multidisciplinary input • Key clinical signs that indicate pelvic bleeding versus other sources of shock • Why posterior‑ring disruption is the treatment‑defining finding in pelvic ring injuries • How to document neurological and genitourinary exams before catheterisation or transfer • The role of CT imaging after immediate resuscitation and binder application 📌 KEY TAKEAWAYS ✔️ Binder over the greater trochanters, not the iliac crests, reduces pelvic volume instantly ✔️ Posterior‑ring injury, not anterior displacement, dictates the need for fixation ✔️ Haemorrhage control comes before fracture classification in unstable patients ✔️ Open pelvic fractures demand early antibiotics, debridement and urology/colorectal involvement ✔️ Document sacral Denis zones to predict neurological risk and guide screw safety ✔️ A non‑responder to resuscitation needs immediate haemorrhage‑control measures, not a perfect Tile or Young‑Burgess label 👩⚕️ WHO THIS IS FOR This video is designed for orthopaedic trainees, medical students, clinicians managing trauma, and interested patients who want to understand the urgent priorities in pelvic fracture care. 📚 RELATED TOPICS: Open book pelvis · Sacral fracture Denis zones · Pelvic binder application · Angioembolisation in pelvic trauma · Urethral injury assessment · Tile and Young‑Burgess classification 🔗 More free orthopaedic teaching at Orthovellum.com — subscribe for weekly videos. 🎨 CREDITS • Complex pelvic fracture case report, PMC10492189 — CC BY 4.0 — https://pmc.ncbi.nlm.nih.gov/articles/PMC10492189/ • Diagnostics (MDPI) 2022 — CC BY 4.0 — https://pmc.ncbi.nlm.nih.gov/articles/PMC8870907/ • OrthoVellum Medical Education Team — Original OrthoVellum educational illustration • Cerevisae — CC BY-SA 4.0 — https://commons.wikimedia.org/wiki/File:Pelvis_AP_view_showing_fracture_of_the_left_ischium_and_left_acetabular_wall.jpg • Valerio et al., Cureus — CC BY 4.0 — https://europepmc.org/article/PMC/PMC13268618#cureus-0018-00000108982-i09 • Gewiess et al. — CC BY 4.0 — https://europepmc.org/article/PMC/PMC11663159 • Keel MJ et al., Eur J Trauma Emerg Surg (PMC3495274) — CC BY — https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3495274/ • Girgis et al., Journal of Clinical Medicine — CC BY 4.0 — https://europepmc.org/article/PMC/PMC11856568#jcm-14-01289-g004 • Chen H et al., BMC Musculoskelet Disord — Open Access (CC BY) — https://openi.nlm.nih.gov/detailedresult?img=PMC3750865 • Girgis et al., Journal of Clinical Medicine — CC BY 4.0 — https://europepmc.org/article/PMC/PMC11856568#jcm-14-01289-g003 ⚠️ DISCLAIMER: Educational only — not individual medical advice. Always consult a qualified clinician for diagnosis and treatment. #pelvicfractures #pelvicrodinjuries #bindertrauma #haemorrhagecontrol #posteriorring #sacralfracture #traumaortho #emergencymedicine #fracturemanagement #orthoeducation #tilenotation #youngburgess #openbookpelvis #angiography #neurologicalassessment