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Injuries are generally classified based on mechanism as either blunt or penetrating. Each has a different method of evaluation and treatment.
In blunt injuries, solid organs are commonly injured with acceleration/deceleration injuries (i.e., motor vehicle collisions [MVC], falls from height) and crush injuries. Blunt injuries are associated with greater mortality than penetrating ones. The spleen is the most commonly injured solid organ, followed by the liver.
A stab wound, one such penetrating injury, is less likely to cause intra-abdominal injury and penetrate the peritoneum requiring surgical intervention when compared with projectile wounds.
Severe pelvic fractures are a major cause of morbidity and mortality in trauma patients. As hemorrhage is the main cause of mortality in pelvic trauma, it is critical to assess hemodynamic stability and identify ongoing bleeding in the chest, abdomen and long bones. If no clear source of hemorrhage is identified and a patient remains unstable, suspicion for primary pelvic hemorrhage should be high. Suspect pelvic fracture in all cases of serious or multisystem trauma patients.
In pelvic trauma, there is a high incidence of associated injuries; therefore, special attention should be paid to the rectal and urogenital examinations. The most commonly used classification system for pelvic fractures is the Young–Burgess system. This system categorizes injuries on the basis of mechanism of injury and can be used to predict the risk of blood loss.