The pelvis is a structure of bones – coccyx, hip bones and sacrum located between the base of the spine and legs. The hip bones are further divided into the pubis, ilium and the ischium. The pelvis forms a bowl-like cavity which contains as well as protects the reproductive organs, bladder and bowels. A break or crack in any of these bones is termed as Pelvic Fracture. The injury is often accompanied by damage to the ligaments as well. It can be classified as follows.
Stable Fracture – Fractures or cracks in the pelvis ring caused by a low energy force which does not disrupt the positioning of the bones
Unstable Fracture – High impact fractures which may lead to displacement of the bone pieces and often involve multiple breakages
Causes
- Vehicular collision
- A sudden fall on the hip or back
- Direct trauma to the joint
- Sports injuries which may lead to the separation of the ischium bone from the adjoining muscles
- Missing a step while climbing or descending the stairs
- Loss of bone calcium
Symptoms
- Dull or severe pain
- Bone piece may pierce out of the skin, in severe cases
- Inability to bear body weight
- Instability in the back and lower limbs
- Stiffness
- Swelling
- Numbness in the legs or groin
- Bruising and tenderness
- Difficulty walking or standing
- Pain is aggravated by movement
- Rectal or vaginal bleeding
- Hematoma
Diagnosis
- Detailed physical examination of the injured area, hips and lower limbs
- The doctor may check for loss of sensation due to nerve damage
- Evaluation of the patient’s symptoms, medical history and mode of injury
- X-ray imaging may be done to assess the level of damage and bone displacement
- A cross-sectional image of the pelvis may be obtained through CT scan
- MRI scan to assess soft tissue, ligament, blood vessel injuries
- Ultrasound may be suggested to check internal bleeding
Treatment
- In case of low impact injury, use of a walker, cane or crutches may be recommended to avoid bearing weight on the leg
- Pain killers and anti-inflammatory medicines may be prescribed to relieve pain
- Anticoagulants may be prescribed to reduce the risk of clotting
- Pins and screws may be fixed externally to keep the pelvic bones in place
- Skeletal traction may be helpful to realign the bones
- Surgery may be required to reposition and hold together the broken bone fragments with the help of metal plates or screws
- Physical therapy may be required to boost recovery and regain mobility of the hip
Updated 5/14/19