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Pelvic Fracture

Definition

A pelvic fracture is defined as one or more breaks, also known as fractures, of the bones that make up the pelvis. Several organs, blood vessels, and nerves are located in this area. Because of this, a pelvic fracture is a serious injury that needs immediate care to prevent current and future complications.

Pelvic Trauma

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Causes    TOP

Pelvic fractures are caused by:

  • Car, motorcycle, or pedestrian collisions
  • Falls
  • High-impact sports injuries

Risk Factors    TOP

Factors that may increase your chance of a pelvic fracture include:

  • History of falls
  • Decreased bone mass—osteoporosis
  • Decreased muscle strength
  • History of trauma in young children and adolescents, especially during sports

Symptoms    TOP

A pelvic fracture may cause:

  • Pelvic pain
  • Pain upon walking, or inability to walk
  • Swelling and bruising
  • Feeling of a pulled muscle, especially in adolescents that participate in sports

Diagnosis    TOP

Your doctor will ask about your symptoms and medical history. A physical exam will be done to assess the extent of your injury. You may be referred to a doctor who is a trauma specialist and/or a doctor who is a bone specialist.

Tests may include:

  • Blood tests
  • Urine tests

Imaging tests can evaluate the pelvic region and surrounding structures. These may include:

Treatment    TOP

A pelvic fracture is a serious injury that may be complicated by injuries to other parts of your body. Proper treatment can prevent long-term complications. Treatment will depend on how serious the fracture is, but may include:

Intial Care

Initial treatment focuses on managing life-threatening problems, such as bleeding or shock. Your fracture may be held in place with a sheet wrap or an external fixation device. With an external fixation device, screws are inserted through the bones and connected to a frame on the outside of your body.

Traction may be used realign and stabilize the fracture if you can't have surgery right away.

Stable fractures will heal without surgery. Unstable fractures are treated with surgery. Some fractures can be set with an external fixation device. Others may require repair with internal pins, screws, or plates.

Extra support may be needed to protect, support, and keep your pelvic bone in line while it heals. Supportive steps using a walker or crutches to help you move around while keeping weight off your legs and pelvis.

Medication

Prescription or over-the-counter medications may be given to help reduce inflammation and pain. Blood thinners reduce the risk of blood clots.

Check with your doctor before taking nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or aspirin.

Rest and Recovery    TOP

Healing time varies by age and your overall health. Young people and those in better overall health heal faster. It may take several months for an unstable fracture to heal.

Complications of a pelvic fracture can be temporary or permanent. These include:

  • Pain
  • Nerve damage, which can affect
    • Mobility
    • Bladder function
    • Sexual function

You will need to adjust your activities while your pelvic bone heals, but complete rest is rarely required.

As you recover, you may be referred to physical therapy or rehabilitation to start range-of-motion and strengthening exercises. Do not return to activities or sports until your doctor gives you permission to do so.

Prevention    TOP

To help reduce your chance of a pelvic fracture:

  • Prevent falls by using a stool or stepladder to reach high places. Add handrails along stairways and place nonslip mats in your bathroom, shower, and under carpets.
  • Wear a seatbelt in any vehicle your drive or ride in.
  • Never drive if you have been drinking, or ride with anyone who has.
  • Use proper safety gear for any high-risk sports you participate in.
  • Maintain your muscle strength with regular exercise.

RESOURCES:

Ortho Info—American Academy of Orthopedic Surgeons
http://orthoinfo.org
The American Pediatric Surgical Association
http://www.pediatricsurgerymd.org

CANADIAN RESOURCES:

References:

Collinge C, Tornetta P III. Soft tissue injuries associated with pelvic fractures. Orthop Clin North Am. 2004;35(4):451-456.
Femoral shaft fracture. EBSCO DynaMed website. Available at:
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Updated August 25, 2014. Accessed August 29, 2014.
Fracture management of unstable pelvic fractures. American Association of Orthopaedic Surgeons website. Available at:
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Accessed August 29, 2014.
Frakes MA, Evans T. Major pelvic fractures. Crit Care Nurse. 2004 Apr;24(2):18-30.
Grotz MR, Allami MK, Harwood P, et al. Open pelvic fractures: epidemiology, current concepts of management and outcome. Injury. 2005;36(1):1-13.
McCormack R, Strauss EJ, et al. Diagnosis and management of pelvic fractures. Bull NYU Hosp Jt Dis. 2010;68(4):281-291.
Mohanty K, Musso D, Powell JN, Kortbeek JB, Kirkpatrick AW. Emergent management of pelvic ring injuries: an update. Can J Surg. 2005;48(1):49-56.
Pelvis Fractures. American Academy of Othopaedic Surgeons Ortho Info website. Available at:
...(Click grey area to select URL)
Updated September, 2007. Accessed August 29, 2014.
Quick TJ, Eastwood DM. Pediatric fractures and dislocations of the hip and pelvis. Clin Orthop Relat Res. 2005;(432):87-96.
Tornetta P III, Templeman DC. Expected outcomes after pelvic ring injury. Instr Course Lect. 2005;54:401-407.
Last reviewed August 2014 by Michael Woods, MD
Last Updated: 08/29/2014