They can go undetected. Osteoporotic pelvic fractures, often following one or more relatively trivial traumatic incident, is relatively common among persons over age 60 .
You may walk with a limp for several months if damage has occurred to the muscles around your pelvis. These muscles may take up to 1 year to become strong again. Future problems, such as pain, reduced mobility, and sexual dysfunction, may result from damage to nerves and organs that is related to the pelvic fracture.
Symptoms of a hip or pelvic fracture include significant, sharp pain in the hip or groin and swelling, bruising, and tenderness in the skin at the site of the injury. Depending on the severity of the fracture, a broken bone may prevent you from putting any weight on the affected hip.
Severe injuries to the pelvis that involve several breaks can be life-threatening. After a pelvic fracture, there may be injuries to organs within the pelvic ring such as the intestines, kidneys, bladder or genitals. A minor fracture is usually treated with bed rest and medication.
Most pelvic fractures cause considerable pain, even when people are sitting or lying down. Severe pelvic fractures can result in life-threatening bleeding and may be accompanied by serious injuries to other organs. X-rays can show most pelvic fractures, but computed tomography is usually also done.
Bruising and swelling over the pelvic bones. Numbness or tingling in the genital area or in the upper thighs. Pain which may also be present on sitting and when having a bowel movement.
Pelvic fractures may be recognised by tenderness, pain, bruising, swelling and crepitus of the pubis, iliac bones, hips and sacrum. Other presenting factors are: haematuria, rectal bleeding, haematoma and neurological and vascular abnormalities in the legs.
All pelvic fractures require X-rays in order to be diagnosed. Your healthcare provider may have you undergo other imaging tests to learn more about your injury.
A force between 2,000 and 10,000 newtons is required to disrupt an adult pelvic ring [1]. Such high forces are generated in traffic accidents, crush traumas, and falls from great heights. Very often, soft tissues inside the small pelvis and around the pelvic ring are also disrupted [2].
Pelvic fractures usually start to heal about four weeks after the fracture. Some patients may notice less pain as soon as a few days after a fracture, depending on the severity of the fracture, but most patients take pain medication for four to six weeks after the injury.
Minor pelvic fractures in older adults involve either low energy mechanisms or repetitive stresses in osteoporotic bone (insufficiency fractures). These fractures may be either displaced or nondisplaced and generally involve both anterior and posterior elements of the pelvis.
With a broken pelvis you cannot walk, sit or move well without pain. The pelvis protects the bladder, intestines and many important blood vessels. Many of the important leg muscles and abdominal muscles attach to the pelvis and allow for body motion and function.
You can sleep in which ever position you find most comfortable but may prefer to place a pillow in between your knees when sleeping on your side. Avoid sitting on low chairs or for prolonged periods of time. Use your hands on the arms of the chair to help gently lower yourself.
Pelvic fracture recovery may involve surgery, prolonged immobilization, or long periods of relative inactivity. Athletes should avoid all sport activities until their pain has resolved.
A pelvic fracture involves damage to the hip bones, sacrum, or coccyx - the bony structures forming the pelvic ring. Due to the inherent structural and mechanical integrity of this ring, the pelvis is a highly stable structure.
Blunt traumatic injuries secondary to motor vehicle crashes (cars and motorcycles), pedestrian and bicycle-hits by vehicles, and falls from height are the main mechanisms of pelvic injuries. Usually, young men are more susceptible to the high-energy traumatic injuries [3].
Action Points. Explain to patients that x-rays in the emergency room often provides inaccurate information about suspected hip and pelvic fractures and may sometimes indicate fractures where none exist.
When a patient with blunt trauma is admitted to an emergency department, a CT scan is usually ordered. However, if emergency physicians suspect that a patient has a fractured pelvis or acetabulum, and it is not identified by CT, a pelvic x-ray exam should be ordered.
In severe pelvic fractures (Abbreviated Injury Scale [AIS]4), the incidence of associated intraabdominal injuries was 30.7%, and the most commonly injured organs were the bladder and urethra (14.6%).
Tips for Sitting Comfortably with a Fractured Pelvis
Use a cushion: Sitting on a cushion can help relieve pressure on the pelvic bones and make sitting more comfortable. Look for a cushion that is made of a soft, supportive material and has a cut-out design to reduce pressure on the coccyx.
There appears a current consensus for type C fractures to be touch to partial weight-bearing for 8–9 weeks, and for type B injuries partial weight-bearing for the same period of time; it is possible, however, for all pelvic fracture types to be managed with full weight-bearing as tolerated, given adequate stability.
The biggest long term complication of a broken pelvis is the development of arthritis. The main reason doctors operate on these fractures is that they know from past experience that if they leave the fractures in a poor position, although they will often heal, arthritis may follow within five years.