The pelvis is a group of bones forming a large ring just beneath the spine. In adults, each half of the pelvis consists of three fused bones: the pubis, ilium and ischium bones. Both halves are held together by ligaments in the front of the body and are attached to the end of the spine at the back.
Fractures of the pelvis are not common and varies in severity. Pelvic rings often break in more than one place. A mild fracture may heal in several weeks without surgery. However, a serious pelvic fracture can be life threatening and may involve damage to the organs and blood vessels the pelvis protects. This type of fracture often needs emergency medical care and lengthy physical therapy and rehabilitation.
Pelvic fractures can be classified as:
- Stable, in which the pelvis has one break point in the pelvic ring, limited bleeding and the bones are held in place.
- Unstable, in which there are two or more breaks in the pelvic ring making the bone fragments unstable and leading to moderate to severe bleeding.
Both types of pelvic fractures can also be divided into open fractures, in which the skin has been broken by the break, or closed fractures, where the skin is not broken.
A pelvic fracture is usually diagnosed by the presence of bone tenderness, difficulty walking or doing other movements and any loss of nerve function in the lower part of the body. There may be injuries to organs within the pelvic ring such as the intestines, kidneys, bladder or genitals.
Although X-ray will show the fracture, a computed tomography (CT) scan is usually required in complicated cases to get a better picture of the fractures. Depending on how bad the fracture is, other imaging procedures may be needed. This may include contrasting studies where a radioactive dye is injected to create pictures to evaluate organs and structures in the pelvic area, such as the urethra, bladder and blood vessels.
Conservative treatment (non-surgical):
Treatment depends on the severity of the injury is. With a minor fractures, the most common treatment is bed rest, nonsteroidal anti-inflammatory medications or prescription painkillers. Physical therapy, the use of crutches may be recomended. Healing can take eight to 12 weeks.
Severe pelvic fractures are often life-threatening injuries due to the extensive bleeding. In these cases, doctors may use an external fixator to stabilize the pelvic area. Later, when the condition of the patient becomes stable, the surgeon may choose to fix the fractures using internal devices e.g. plates and screws.