Publication Name	World Journal of Clinical Cases
Manuscript ID	108403
Country	Italy

Category	Surgery
Manuscript Type	Editorial
Article Title	In the shadow of stability lies ruin: Occult vascular injuries in geriatric pelvic trauma
Manuscript Source	Invited Manuscript
All Author List	Luca Galassi, Matteo Lino Ravini, Roberto Bassani, Giulio Mercandalli and Giuseppe Diodato Santoro
Funding Agency and Grant Number
Corresponding Author	Luca Galassi, Lecturer, MD, Researcher, Postgraduate School of Vascular and Endovascular Surgery, University of Milan, Milan 20122, Lombardy, Italy. luca.galassi@unimi.it
Key Words	Pelvic fractures; Frailty; Hemorrhage; Vascular surgical procedures; Embolization; Multidisciplinary care team; Anticoagulants; Critical care; Geriatric
Core Tip	Isolated pubic ramus fractures, often labeled as stable on imaging, can pose serious risks in elderly patients. Frailty, anticoagulant therapy, and vascular fragility increase the likelihood of delayed hemorrhage from small arterial branches, even after low-energy trauma. Clinical decline is often subtle, with signs like confusion or fatigue mistaken for baseline status. Overreliance on fracture morphology can delay recognition of life-threatening bleeding. Incorporating frailty screening, serial hemoglobin checks, and early vascular consultation supports timely diagnosis and intervention. A dynamic, multidisciplinary approach is essential to reduce complications and ensure safer outcomes for this high-risk, frequently underestimated population.
Citation	Galassi L, Ravini ML, Bassani R, Mercandalli G, Santoro GD. In the shadow of stability lies ruin: Occult vascular injuries in geriatric pelvic trauma. World J Clin Cases 2025; In press

Received	2025-04-14 02:58
Peer-Review Started	2025-04-14 02:58
To Make the First Decision
Return for Revision	2025-05-12 02:14
Revised	2025-05-24 09:27
Second Decision	2025-07-21 03:00
Accepted by Journal Editor-in-Chief
Accepted by Executive Editor-in-Chief	2025-07-22 01:18
Articles in Press	2025-07-22 01:18
Publication Fee Transferred
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	2307-8960 (online)
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