Pelvis Fractures

A pelvic fracture is a condition that arises due to breakage of the pelvic bones. It may damage the internal organs, nerves and blood vessels associated with the pelvic region.

The pelvis is composed of three bones, namely ilium, ischium, and pubis that are fused together. It is located at the base of the spine, where it is connected to the sacrum, the last section of the spine, with the help of strong ligaments. At either side, the pelvis articulates with the hip bones at a cup-shaped socket, known as acetabulum. Various organs related to the digestive and reproductive systems lie within the pelvis ring, and is innervated by several large nerves and blood vessels. The pelvis ring also acts as point of attachment for muscles from the upper and lower part of the body.

Types

Based on the damage of the pelvis ring and associated structures, pelvic fractures can be categorized as:

• Stable pelvic fractures: Single point of breakage. The broken bones are not displaced and is associated with less bleeding.
• Unstable pelvic fractures: Breakage occurs at two or more points, followed by severe bleeding. Unstable pelvic fractures may cause shock, extensive internal bleeding and damage to the internal organs. It requires immediate medical care followed by long-term physical therapy and rehabilitation.

Causes

The common causes of pelvic fractures include:

• Sports injuries or trauma
• Abrupt muscle contraction
• Conditions such as osteoporosis, especially in elderly people
• Accidental injury or fall from a great height

Symptoms

The common symptoms associated with pelvic fractures are:

• Pain and swelling in the groin or hip region that may worsen with ambulation
• Abdominal pain
• Bleeding through the urethra or vagina, and the rectum
• Problems in urination
• Unable to stand or walk

Diagnosis

The diagnosis of pelvic fracture starts with physical examination. Imaging techniques such as X-rays, CT and MRI scans may also be ordered to confirm the exact condition or breakage of the pelvic bones. In some cases, additional contrasting studies using radioactive dye may be recommended to evaluate the structural and functional activity of organs such as the urethra, bladder and the pelvic blood vessels.

Treatment

Treatment of the pelvic fracture depends upon the severity of the injury and condition of the patient. Minor or stable fractures can be treated with conservative methods such as rest, medications, use of crutches, physical therapy, and if required, minor surgery. These methods may take 8–12 months for complete healing.

The treatment of unstable fractures includes management of the bleeding and injuries to the internal organs, blood vessels and nerves. Surgical intervention may be employed for fixation of the fractured pelvic bones using screws and plates. Pelvic bone fixation provides stability to the pelvic bone and promotes natural healing of the fracture.