Due to the location and function of the pelvis, a pelvic fracture is typically a serious injury, involving internal organ damage, nerve injury, and bleeding. Read on to learn more about the anatomy of the pelvic area, and the risk factors, causes, symptoms, diagnosis and treatment of a pelvic fracture.
Anatomy of the pelvis
The pelvis is a ringed structure composed of three bones—the ilium, ischium, and pubis—below the rib cage at the lower end of the trunk. These three bones, which grow together as a person ages, are joined to another bone—the sacrum—by strong connective tissues. Together, this whole structure serves to hold and protect numerous digestive and reproductive organs and nerves. The pelvis also connects to the hip joint and muscles and nerves that extend between the trunk and the lower extremities.
Because all of these organs and nerves dwell or pass through the pelvic area, a pelvic fracture can involve extensive injury to these systems, making pelvis fracture a potentially catastrophic injury.
Risk factors for pelvic fracture
Growing active teens and older individuals with weakened bones due to osteoporosis are at an increased risk for pelvic fracture.
Athletic teens may experience an avulsion fracture of the pelvis when they “pull” a muscle of the groin or pelvic area. In these cases, a sudden muscle contraction can cause a small piece of the ischium to fracture. Fortunately, this type of fracture is usually stable and does not cause injury to internal organs or nerves.
Older individuals with osteoporosis or another bone disease are also at greater risk for pelvic fracture. Even mild falls and other accidents can result in fracture to the pelvis or other bones. As with teen fractures, many of these types of accidents do not cause significant organ, nerve or other tissue damage.
Causes of Pelvic Fracture
Pelvic fractures that occur in major accidents do; however, commonly result in significant injury to internal organs, nerves, and other tissues. Motor vehicle accidents, crush accidents, and other incidents involving high-energy impact to the pelvis can cause serious damage to the pelvic structure and surrounding systems.
Depending on the nature of the accident, such injuries can be life threatening.
Symptoms of Pelvic Fracturecaninclude:
- Moderate to severe pain, swelling and bruising
- Pain that worsens considerably with movement
- Considerable bleeding
- Shock
- Symptoms of damage to internal organs
If a broken pelvis is suspected following a serious accident, immediate medical treatment should be sought.
Diagnosis of Pelvic fractures
To determine the location, type, and severity of pelvic fracture, a doctor will perform a physical examination and diagnostic imaging studies, such as x-ray, CT scan and MRI. The surrounding organs, blood vessels, nerves, and soft tissues will also be assessed to identify and evaluate injury to these systems.
A doctor will often classify the type of pelvic fracture and determine whether or not the fracture is stable.
Treatment of Pelvic Fractures
When a pelvic fracture is stable, as with avulsion fractures in young athletes, surgery will not usually be necessary. In such cases, crutches or a walker can be used for a few months while the fracture heals. Pain medication may be prescribed to manage discomfort. Physical therapy may also be utilized during the rehabilitation process.
Unstable fractures resulting from serious accidents often involve extensive bleeding and organ damage, which requires immediate medical treatment. During surgery, an orthopedic surgeon may begin by using an external fixator to stabilize the bones and gain better access to internal organs, blood vessels, and nerves that may require attention.
To stabilize the pelvic fracture, a doctor may need to perform traction and/or insert plates or screws in addition to or instead of using external fixation.
While stable pelvic fractures usually heal well, unstable fractures sustained in traumatic accidents are often accompanied by a host of complications including infection, internal organ damage, nerve damage, and bleeding. All of these complications can affect the ultimate outcome following a pelvis fracture.