Pelvic fracture is a condition that arises due to breakage of the pelvis bones. It may damage internal organs, nerves, and blood vessels associated with the pelvis region.
The pelvis is a round structure of bones located at the base of the spine, connected to the sacrum of the spine by strong ligaments. The pelvis is composed of three bones, namely ilium, ischium, and pubis that are fused together. The side of the pelvis is composed of a cup shape socket, known as acetabulum.
Various organs related to the digestive and reproductive systems lie within the pelvic ring. There are also, several large nerves and blood vessels supplying the lower limbs that pass through the pelvis. The pelvic ring also acts as point of attachment for muscles approaching from the upper and lower part of the body.
Based on the damage of the pelvic ring and associated structures, pelvic fractures can be categorized as:
- Stable pelvic fractures: usually have either a single point breakage in the pelvic ring with a ligament injury elsewhere, or breaks in two parts of the pelvic ring with the broken bones remaining in position; these are associated with less bleeding
- Unstable pelvic fractures: Have breakage at two or more points with significant displacement. These fractures are usually from high energy injuries and may be 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.
The common causes responsible for 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
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
The diagnosis of pelvic fracture starts with physical examination including checking the functional activity of the various body organs present in the pelvic region. Imaging techniques such as X-rays, CT (Contrast Tomography) and MRI (Magnetic Resonance Imaging) scan may also be used to confirm the exact condition or breakage of the pelvic bones. In some cases, additional contrasting studies using radio-opaque dye may be recommended to evaluate the structural and functional activity of organs such as the urethra, bladder, and the pelvic blood vessels.
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 of 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.