What is a Fractured Pelvis?
A fractured pelvis is a break of the ring of bones that connect your spine to the hips. These fractures usually result from high energy injuries such as car accidents or falls from a height in younger patients and most often from falls in the elderly patient. The pelvis can be broken into many pieces or just crack slightly depending on the quality of bone and the type of injury. Pelvic fractures are described according to where and how the bone breaks and they are classified into different types by injury pattern. Differentiation of these injuries can be complex and these injuries can be treated by an orthopedic trauma specialist at the Reno Orthopedic Center in Reno, Sparks, or Carson City.
Illustration of pelvic bone. Reproduced with permission from OrthoInfo. © American Academy of Orthopaedic
Surgeons. https://orthoinfo.org/
Illustration of pelvic bone. Reproduced with permission from OrthoInfo. © American Academy of Orthopaedic
Surgeons. https://orthoinfo.org/
What does the Pelvis do?
The pelvis is the structure responsible for connecting the spine to the lower body. With a broken pelvis you cannot walk, sit or move well without pain. The pelvis protects the bladder, intestines and many important blood vessels. Many of the important leg muscles and abdominal muscles attach to the pelvis and allow for body motion and function.
Fractures Pelvis Symptoms
Some symptoms of a broken or fractured pelvis can include…
- Pain in your groin, hip or lower back
- Swelling over the pelvic bone
- Pain when moving your legs
- Numbness or tingling in your groin or upper thighs
- Abdomen pain
- Difficulty urinating
- Difficulty and pain when walking or standing
How is a Broken Pelvis Diagnosed?
Pelvic fractures are often caused by high energy injuries. Most patients are brought to a trauma center because these injuries often have associated head, chest or abdominal trauma.
- Physical examinationsare critical in the evaluation of these injuries. Important nerves and blood vessels run next to this bone and can be injured when it breaks. Diagnosis of an injury to some blood vessels requires urgent surgery. Several types ofpelvispelvicfractures cause life threatening injuries and without stabilization, patients can die.
- X-raysare used to evaluate the location and severity of the brokenpelvicbone. This helps doctors and patients make an informed decision on treatment. Often 5 or more x-rays are taken to show the injury pattern.
- CT (Computed Tomography) scansare often ordered to help plan treatment and surgery. These can create a 3-D image of theinjurybroken pelvic bonewhich gives doctors specific knowledge about the size and location of the broken bones. In elderly patients with pelvis pain and normal x-rays or CT scans, an MRI is sometimes ordered to diagnose a fracture due to weak bone or osteoporosis known as an insufficiency fracture.
Broken Pelvic Bone X-Ray
Fractured Pelvis Treatment & Surgery
Treatment for pelvic fractures can be non-surgical or surgical depending on the stability of the broken bone and whether the fracture is displaced or not. Severe pelvic fractures usually require surgery.
Non-Surgical Treatment
Nonsurgical treatment is recommended for stable pelvic fractures that are non-displaced. These include isolated pubic ramus fractures, isolated sacral fractures, avulsion fractures and some iliac wing fractures. Insufficiency fractures in elderly patients are usually treated non-operatively as well.
If non-operative care is chosen, regular follow-up care for a physical exam and x-rays is important to ensure that the fracture stays in good position and heals appropriately. Cutting down or quitting smoking and tight blood sugar control if you are a diabetic is important for the healing process. One fall or continued lack of compliance with early walking against medical advice can cause bones to move and result in the need for surgery.
Some types of fractures allow for immediate weight bearing while others do not. Patients will require gait aids such as crutches or walkers. Depending on health and injury pattern this bone can take 3-4 months to heal without surgery. Physical therapy for hip and knee range of motion is started around 6 weeks once bone has healed enough to prevent displacement with motion. Most patients will be placed on a blood thinner to avoid clots for 2-6 weeks.
