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Pelvic Fracture

Definition

A pelvic fracture is one or more breaks 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. Immediate care is important to prevent complications.

Pelvic Trauma
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Causes

Pelvic fractures are caused by hard impact traumas such as:

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

Risk Factors

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

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

Your doctor will ask about your symptoms and past health. A physical exam will be done.

Imaging tests of the area may be taken with one or more of the following:

Treatment

Proper treatment can prevent long-term complications. Treatment will depend on how serious the fracture is, but may include:

Initial Care

Life-threatening problems, such as bleeding or shock will need to be managed first. The bones will be stabilized until other issues are stable. Steps to repair the bone will depend on the amount of damage. Treatment options for the bone include:

  • Traction may be used realign and stabilize the fracture if surgery can't be done right away.
  • Stable fractures will heal without surgery.
  • Unstable fractures are treated with surgery.
    • Some fractures can be set with an external fixation device. Screws are placed through the bones to a frame on the outside of the body.
    • Others can be repaired with internal pins, screws, or plates.
  • Extra support may be needed to protect the pelvis while it heals. A walker or crutches may be needed to keep weight off the pelvis.

Medication

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

Rest and Recovery

Healing time varies by age and 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
    • Movement
    • Bladder function
    • Sexual function

Activities will need to be adjusted while your pelvic bone heals. Complete rest is rarely required.

Physical therapy or rehabilitation will be used to improve range of motion.

Prevention

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:

The American Pediatric Surgical Association
http://www.pediatricsurgerymd.org

Ortho Info—American Academy of Orthopedic Surgeons
http://orthoinfo.org

CANADIAN RESOURCES:

Canadian Orthopaedic Association
http://www.coa-aco.org

Women's Health Matters
http://www.womenshealthmatters.ca

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—emergency management. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T910561/Femoral-shaft-fracture-emergency-management. Accessed August 30, 2017.

Fracture management of unstable pelvic fractures. American Association of Orthopaedic Surgeons website. Available at: http://www.aaos.org/news/aaosnow/jul09/clinical8.asp. Accessed August 30, 2017.

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: http://orthoinfo.aaos.org/topic.cfm?topic=a00223. Updated February 2016. Accessed August 30, 2017.

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 February 2019 by EBSCO Medical Review Board Daniel A. Ostrovsky, MD  Last Updated: 2/12/2019