The Fractures of the Pelvis
The pelvis is the sturdy ring of bones located at the base of the spine. Fractures of the pelvis are uncommon—accounting for only about 3% of all adult fractures.
Most pelvic fractures are caused by some type of traumatic, high-energy event, such as a car collision. Because the pelvis is in proximity to major blood vessels and organs, pelvic fractures may cause extensive bleeding and other injuries that require urgent treatment. In some cases, a lower-impact event—such as a minor fall—may be enough to cause a pelvic fracture in an older person who has weaker bones.
Clinical features
A fractured pelvis is almost always painful. This pain is aggravated by moving the hip or attempting to walk. Often, the patient will try to keep his or her hip or knee bent in a specific position to avoid aggravating the pain. Some patients may experience swelling or bruising in the hip area.
Nonsurgical Treatment
Can be recommended for stable fractures in which the bones are nondisplaced or minimally displaced which may include:
To avoid bearing weight on your leg, your doctor may recommend that you use crutches or a walker for up to three months or until your bones are fully healed. Medications will be prescribed to relieve pain, as well as an anti-coagulant, or blood thinner, to reduce the risk of blood clots forming in the veins of your legs and pelvis due to immobilisation.
Surgical treatment
Skeletal traction is a pulley system of weights and counterweights that helps realign the pieces of bone. Skeletal traction is often used immediately after an injury and removed after surgery. Occasionally, certain pelvic fractures can be treated with skeletal traction alone.
This helps in stabilizing the pelvic bone. In this surgery, metal pins or screws are inserted into the bones through small incisions into the skin and muscle. The pins and screws project out of the skin on both sides of the pelvis where they are attached to bars outside the skin. The external fixator acts as a stabilizing frame to hold the broken bones in proper position.
In some cases, an external fixator is used to stabilize the bones until healing is complete. In patients who are unable to tolerate a lengthy, more complicated procedure, an external fixator may be used as a temporary treatment until another procedure can be performed.
During this operation, the displaced bone fragments are first repositioned (reduced) into their normal alignment. They are then held together with screws or metal plates attached to the outer surface of the bone.
OUTCOME
