Injury
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Mortality following pelvic fractures has declined dramatically as better methods of controlling haemorrhage, such as angioembolisation to control arterial bleeding, have been introduced. But about 10% of patients still die, despite these advances. To save these patients, the key questions in managing pelvic fractures are: which patients are at highest risk for a life-threatening bleed, in these patients, what is the exact anatomical source of the bleeding and what is the best way to stop it? There is wide consensus that bleeding is most likely to occur with unstable fractures. ⋯ Current treatment protocols rely on angiographic embolisation and external fixation, either alone or in combination. Direct pelvic packing is gaining in popularity, but, ultimately, the ideal treatment method remains unclear. The purpose of this review is to examine our current understanding of the pathophysiology and management of bleeding pelvic fractures.
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There are five major steps that one must navigate successfully to take a study idea and turn it into a publication that may have an impact on clinical practice. These steps include developing the study question(s), developing the study plan, implementing the study plan, reporting the results and submitting the manuscript(s) for publication. ⋯ Furthermore, the review is augmented with tables and checklists that may serve as tools in the planning and execution of a clinical study. Though it does not address every detail for each of the steps discussed, readers of all experience levels should find it a useful tool in the planning, execution and reporting of their next clinical study.