A pelvic fracture refers to the breaking of any portion of the pelvis, which consists of the two Ilia bones, the Pubis, the Ischium, and the Sacrum.
Symptoms of a Pelvic Fracture
Symptoms of a pelvic fracture can vary significantly based on the severity, type of fracture, and possible complications.
- A minor avulsion fracture may resemble a pulled muscle but will be directly felt on the bone.
- More substantial fractures may cause immediate pain upon impact or at the time of trauma.
- Bruising may develop within 48 hours, sometimes appearing even sooner.
- Pain while moving the hip.
- The patient may adopt a specific leg position for comfort.
- Numbness, tingling, or cold, pale skin in the legs may indicate nerve or blood vessel damage.
- Grade C injuries often involve internal bleeding, leading to symptoms of shock such as nausea, light-headedness, a racing pulse, cold and clammy skin, and loss of consciousness.
Causes
The pelvis is a robust structure that typically requires significant force to fracture, except in cases of osteoporosis among the elderly, where bones may be weaker and more prone to fractures. Athletes may experience avulsion fractures, where a muscle pulls away from a small section of bone.
Pelvic fractures commonly result from high-energy impacts, such as car or motorbike accidents, or falls from great heights. The pelvis contains several internal organs, and injury to these organs, along with internal bleeding, can occur.
Classifications
Pelvic fractures can be categorized based on their severity and the level of stability exhibited:
Grade A: Fractures that are stable in nature, typically encompass minor fractures, including avulsion fractures like Rectus Femoris avulsion, and fractures of one of the Ilia.
Grade B: Fractures are characterized by rotational instability, often involving compression fractures, accompanied by separation of the pubic symphysis and widening of the SI joints.
Grade C: Fractures that are both vertically and rotationally unstable, resulting in complete disruption of the pelvic ring. These injuries are highly severe, frequently accompanied by multiple complications and a substantial fatality rate.
Treatment
Fractured pelvis treatment varies depending on the severity, with different approaches for each grade:
Grade A Injuries: Rest is key, typically requiring non-weight bearing and the use of crutches. Partial weight bearing may be introduced after two weeks, continuing up to three months until healing is complete. Avulsion fractures generally heal faster. Painkillers or anti-inflammatory medications may be advised.
Grade B Injuries: The need for surgery is determined by severity. Surgical approaches may include external fixation of the fractured segments, using an external cage until healing. Medications such as painkillers, anti-inflammatories, or even blood thinners may be necessary during recovery due to immobility.
Grade C Injuries: If extensive internal damage is present, the primary treatment focus shifts away from the fracture. Stabilizing the patient and treating internal injuries are prioritized before addressing the fracture sites.
Rehabilitation Program: Essential for all pelvic fractures, a rehab program aids in regaining mobility and strength. Early rehabilitation may be initiated even for minor injuries, featuring exercises like muscle contractions and leg movements. A physiotherapist or physical therapist will guide through suitable exercises for recovery.
