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.
Medical practitioners should carefully monitor the hemodynamic status of patients with pelvic fractures, as there is frequently concomitant blood loss, even in closed fractures.
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.
Arthritis. 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.
If you have a pelvis fracture that is treated without surgery, you may be able to walk with crutches or a walker right away. If you have a have a more severe pelvis injury that requires surgery, you may be asked to not put weight on one or both legs.
The pelvis can be broken into many pieces or just crack slightly depending on the quality of bone and the type of injury. Pelvic fractures are described according to where and how the bone breaks and they are classified into different types by injury pattern.
Activity Modification. After a hip or pelvic fracture, your doctor may advise you not to put any weight on the affected hip for six weeks or more. This allows the bone to heal.
Bed rest and pain medicine is the only treatment required. Stay in bed for the first 2 to 3 days to reduce pain with movement. During this time, you will need help with bathing, using the bathroom, and meals. A bedpan or bedside commode may be easier to use than getting up to use the bathroom.
In severe pelvic fractures (Abbreviated Injury Scale [AIS] > or =4), the incidence of associated intraabdominal injuries was 30.7%, and the most commonly injured organs were the bladder and urethra (14.6%).
Adjust your chair: Make sure your chair is adjusted to a comfortable height and angle. Keep your feet flat on the floor and use a footrest if necessary. If you have a desk job, consider using a standing desk or a leaning chair to reduce pressure on the pelvis.
Treatment for a pelvic stress fracture typically involves an initial period of rest from weight bearing activity. This may involve a period of reduced activity or the use of a walking stick or crutches for a number of weeks.
Major and unstable pelvic fractures are likely to cause severe pain and shock. Pain may be in the pelvis, groin, back, tummy (abdomen), or down the legs. The pelvic bones are large and have a rich blood supply, so when broken they will bleed heavily and the bleeding will not stop quickly.
Most hip and pelvic fractures require immediate medical care. Often, doctors perform surgery to set and stabilize the bone to prevent permanent damage. If you have been injured and feel pain in the hip or pelvis, our doctors recommend going to the nearest emergency room.
Signs & symptoms
The symptoms listed below are observed frequently: Pain in the lower back, the coccyx, the abdomen, along the side or rear of the thigh, in groin or the pubic bone. Problems with activities such as walking up or down steps, rolling over in bed, prolonged sitting, getting up from a chair or walking.
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].
Recovery and rehabilitation in the hospital
Most patients use crutches to assist their ambulation for six to twelve weeks. The first six weeks after operation is "quiet time" for most patients. Only gentle range of motion and light strengthening exercises are prescribed as the pelvic ring injury heals.
This includes sexual intercourse and douching. You should also avoid certain activities that may increase pelvic pressure such as lifting more than 10 pounds, squatting, performing certain lower-body exercises, and sometimes even orgasm is prohibited.
While your pelvis heals, you will need to keep weight off the hips. Once you are able to walk, a walker or crutches can help you get around. You can help your pelvis heal with care at home. Your doctor may prescribe medicine to relieve pain and prevent blood clots.
In people with surgical treatment, physical therapy starts after 1 or 2 days of bed rest. Physical therapy starts with non-weight bearing exercises. Only when the fracture is stable enough can weight bearing exercises be initiated.
When can I drive? For lower extremity injuries (pelvis and legs), you can drive once you can walk smoothly with a cane (with OUT a limp). This varies by person and injury. For upper extremity injuries (arms and clavicle), this can vary but usually you may start driving by six weeks.
Pain relievers can help you feel well enough to begin physical therapy, which is a vital part of recovery from a fractured hip or pelvis. Our doctors often recommend over-the-counter pain relievers, such as acetaminophen. If pain is more intense, your doctor can prescribe a stronger medication.
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.
If a person has a fractured pelvis, they should use crutches or a walker for some time until the fracture has healed. A doctor will often suggest avoiding full weight bearing activities for up to 12 weeks . This means someone should initially avoid: walking without crutches or a walker.