Suffering a pelvic fracture is no fun, especially if you are older. A pelvic fracture is usually caused by a fall in the elderly and by a traffic accident or a fall from a great height in young people. Various treatments are available, depending on the severity and nature of the fracture. The doctor will determine which treatment is most suitable.
- What is the pelvis?
- What is a pelvic fracture?
- How is a pelvic fracture caused?
- What are the symptoms?
- Treatment of a pelvic fracture
What is the pelvis?
In the human body, the pelvis – pelvis in Latin – is a set of bones between the abdomen and the legs. The pelvis is composed of four bones: the right and left hip bones, the sacrum, and the coccyx. This set of bones forms a sturdy, cup-shaped ring, the pelvic ring , and connects the spine to the lower limbs. The pelvis has an important function in providing correct posture and movement of the body. It is located approximately in the middle of the skeleton and moves with the torso and also with the legs. It carries the entire weight of the upper body. Furthermore, the pelvis also forms a protective socket for internal organs. The upper part of the pelvis is called the greater pelvis or pelvis major and the lower part is called the lesser pelvis or pelvis minor . The large pelvis forms the lower border of the abdominal cavity; This is where the intestines are located. The genitals, rectum and bladder are located in the small pelvis. Because a woman must be able to give birth to a child, the woman’s pelvis is wider and has a more rounded pelvic entrance compared to the man’s pelvis.
What is a pelvic fracture?
One speaks of a broken pelvis or pelvic fracture when one or more bones or bone parts in the pelvis are broken. Pelvic fractures can be mild to severe. There are two categories of pelvic fractures:
- stable pelvic fracture: the pelvic ring is only broken at the front (at the level of the pubic bone) and the pelvis remains stable.
- unstable pelvic fracture: the pelvic ring is broken both at the front and at the back, causing the pelvis to lose its stability. Instability can also arise when the pelvis is broken at the front and at the same time there is an injury to the ligaments at the back, or on both sides.
Severe pelvic fractures can cause damage to organs and internal bleeding can occur as the broken bone fragments shift. In some cases, this damage is even life-threatening. Nerves can also be damaged by shifting broken bones.
How is a pelvic fracture caused?
Among the possible causes of a pelvic fracture, we must distinguish between a pelvic fracture in young people and a pelvic fracture in the elderly.
- In young people, the pelvis has a strong bone structure and it takes a lot of force to break the bones. A pelvic fracture in young people is often caused by a serious fall from a great height or by a traffic accident.
- Older people, on the other hand, often already have osteoporosis, reduced bone density. With them, the pelvis breaks much more quickly. A simple fall on an even surface is often enough to cause a fracture.
What are the symptoms?
- Pain is of course the most important symptom, after all it is a fracture. The person in question feels pain in the groin, hip and pelvic area. Walking is impossible because of the pain.
- Swelling may occur in the injured area.
- Numbness may occur in the legs because a nerve in the hip has been hit.
- Urination may be difficult and there may be blood in the urine because the bladder has been hit.
- If the pelvic ring is broken in several places, very heavy bleeding can occur because the veins in the inside of the pelvis are hit by shifting bone fragments. The blood loss can be so severe that the person goes into shock.
Treatment of a pelvic fracture
After a diagnosis has been made based on physical examination, X-ray and/or CT scan, the doctor determines which treatment should be applied.
Conservative treatment
When it concerns a stable pelvic fracture where the bone parts have not shifted, the treatment consists of bed rest and pain relief. It takes several weeks before the pain decreases and the pain relief can be reduced. Under the guidance of a physiotherapist, the patient can slowly start walking again. The physiotherapist will also give exercises to strengthen the muscles around the pelvis. It takes an average of six to twelve weeks for the fracture to heal.
Operative treatment
An unstable pelvic ring requires surgical intervention. The broken bone parts have shifted too much and internal fixation or external fixation must restore the stability of the pelvic ring. With internal fixation, the pelvis is stabilized internally with a plate and screws. With external fixation, the doctor places pins in the pelvic bone through small openings in the skin. These pins are connected to each other on the outside in a frame. In an acute phase, if there is severe blood loss, the doctor will immediately apply external fixation to make the pelvic ring stable again. Because the parts of the pelvis no longer move relative to each other, bleeding will decrease.
In both cases, when the patient is able to bear weight again, he or she will need a walker or crutches for some time. It takes an average of three to six months before the patient can walk pain-free again. With complicated fractures, recovery can take even longer. Sometimes the patient must be admitted to a rehabilitation center for some time.
