Hemorrhage is considered the leading cause of death in patients with pelvic ring injuries [5, 19, 20].
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.
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.
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%).
Mortality rate was 37%. Pelvic fracture severity, shock and coma at presentation, and the presence of concurrent head and chest injuries were associated with increased mortality. Gender, other mechanisms of injury and other concomitant injuries were not associated with increased mortality.
Outlook after pelvis fracture
This can cause disability and can affect mental and social well-being. Certain severe complications are also more likely to affect older adults during recovery. These include : bony fragments of the pelvis piercing the bladder.
Most people with a broken pelvis take about 4-6 months to heal. If anatomic alignment was achieved at surgery and no complications occur, patients are able to return to prior activities and function. By six weeks, patients are fairly comfortable.
Mild and stable pelvic fractures can usually heal without medical intervention such as surgery. However, if you have a mild pelvic fracture, you must limit the amount of pressure you put on your pelvis and legs and get enough rest so your fracture can heal properly.
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.
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.
However, possible complications of pelvic fractures can affect a person's quality of life. These can include impaired mobility, ongoing pain, and sexual dysfunction.
Conclusions: Patients with open pelvic fractures often survive, need to be treated with massive blood transfusions, and often require a colostomy. They are frequently left with chronic pain and residual disabilities in physical functioning and physical roles, and many remain unemployed years after injury.
2, 12, 13 Studies report the 1-year mortality after pelvic fractures to be fairly considerable, ranging from 8% up to 27%.
Your doctor will provide specific guidance on when it's safe to start sitting after a fractured pelvis. In most cases, it's important to avoid sitting for long periods of time during the initial healing phase, which can last several 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.
APC Type III: APC III injuries are defined as the disruption of both the anterior and posterior sacroiliac ligaments, including the posterior sacroiliac complex, the strongest ligaments in the body. APC III injuries have the highest rate of mortality, blood loss, and need for transfusion of all pelvic ring injuries[9]
It is safe to fly with a broken bone if it is properly set and secured. However, it is best not to fly at least 48 hours after the plaster cast has been applied. If you fly before this time, the cast will most likely be split in half to avoid swelling, compartment syndrome, and deep vein thrombosis (DVT).
The difficulty of the rehabilitation will depend on the nature of your injury and your general health, but be aware that the complex structure of the pelvis can make this a complicated and often arduous process, taking anywhere from 6 months to 1 year.
Normally, driving should be avoided for the first 6 weeks and even travelling as a passenger is best avoided for the first three weeks (except for essential journeys), as getting in and out of a car can risk straining the hip and stretching the healing tissues. However, you should discuss this with your surgeon.
First, you may have to stay in the hospital for 24 hours or a few days after your reconstructive pelvic surgery. You can already go home if you walk to the toilet alone and your bladder empties properly. In other cases, you might need a catheter for about a week.
In some cases the nerves going to the bladder are damaged in the pelvic fracture. This leads to several problems in the bladder that generally result in incontinence (involuntary leakage of urine or accidents).
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.
Proximal femur fractures had the highest mortality rate among all fracture locations; 25% at 1 year with a corresponding SMR of 2.7, which is in accordance with previous studies (Vestergaard et al. 2007b. Increased mortality in patients with a hip fracture-effect of pre-morbid conditions and post-fracture complications ...
In unstable pelvic ring fractures a blood loss of approximately 9 to 15 units of blood has to be expected whereas total blood loss is mainly evaluated retrospectively and indirectly (3). The acute total blood loss and hemodynamic status of the patient can be assessed by clinical shock signs.