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. Severe fractures often require extensive surgery.
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%).
Severe and unstable pelvic fractures that are caused by high-impact events such as car accidents could result in complications such as severe bleeding and organ and/or nerve damage. If these related injuries are treated successfully, the pelvic fracture usually heals well.
The majority of pelvic fractures result from motor vehicle collisions (MVCs), falls from height, or a pedestrian or cyclist struck by a vehicle. [4][5] There is, however, a high rate of associated injuries, occurring in 12% to 62% of patients with pelvic fractures.
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).
Anatomic causes and changes in the anatomy of the hip and pelvis can lead to progressive pain, disability and even arthritis of the hips. These include femoral-acetabular impingement (FAI), hip developmental dysplasia, labral tears and detachments around the acetabulum.
High-energy injuries that result in pelvic-ring disruption are more likely to be accompanied by severe injuries to the central nervous system (CNS), abdomen, and chest.
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.
However, hip rotator and adductor muscles such as obturator internus, obturator externus and adductor brevis were commonly injured in cases with pelvic fracture, indicating indirect force mediated by these muscles may be associated with pelvic fracture.
The ribs form a cage that shelters the heart and lungs, and the pelvis helps protect the bladder, part of the intestines, and in women, the reproductive organs.
The liver is the most frequently injured abdominal organ.
Bladder Injury
Pelvic fracture is the most common injury associated with bladder rupture, which can be present in up to 29% of patients with pelvic fracture and related gross hematuria [25]. Delay in diagnosing bladder injury is associated with an increased mortality rate [26].
The late sequel of pelvic fracture treatment can cause gait and postural disturbances, chronic pain, genitourinary dysfunction, persistent neurological deficits, and rectal dysfunction.
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.
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.
The former comprised retention of urine in 41 patients (33.0%; 15.6% of all pelvic fractures), haematuria in 29 patients (33.0%; 15.6% of all pelvic fractures), and oliguria in three (3.4%; 1.6% of all pelvic fractures).
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.
In our study, we found that arterial injuries occurred in 10 patients: four cases of internal iliac artery, four cases of external iliac artery, one case of obturator artery proper, and one case of aberrant obturator artery.
Bowel entrapment within a pelvic fracture is rare, but can be fatal. This important diagnosis is difficult to make, even with current imaging methods.
If you break your pelvis, it can be painful and hard to move, but a broken pelvis isn't nearly as dangerous or as common as a hip fracture. The pelvis is the ring of bones that sits below your belly button and above your legs. You usually won't need surgery to fix a break unless it's a severe one.
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.
Most pelvic fractures heal on their own. The local tissues in the area of the fracture frequently keep the fracture pieces in order and the bones heal with a little rest and good nutrition.
Risk factors — Risk factors for these injuries are similar to those for osteoporosis: advanced age, prior pelvic fracture, glucocorticoid therapy, low body weight, smoking, and excess alcohol intake.
The bladder, due to its anatomical position, is prone to rupture in pelvic fractures. The majority of urinary bladder injuries are either extraperitoneal or intraperitoneal.
The intestines were most commonly impacted by penetrating trauma (70.1% of cases), followed by the liver and spleen (19.4% and 17.9%, respectively).