The pelvis is the structure responsible for connecting the spine to the lower body. The pelvis protects the bladder, intestines, and many important blood vessels. Many of the important leg muscles and abdominal muscles attach to the pelvis and allow for body and function.
Pelvic fractures are uncommon and range widely from mild to severe. Pelvic rings often break in more than one place. A mild fracture may heal in several weeks without the need for surgery. However, a serious pelvic fracture can be life-threatening and may involve damage to the organs that the pelvis protects. This type of fracture often needs emergency medical care, lengthy physiotherapy, and rehabilitation.
Pelvic fractures are classified as either ‘stable’ or ‘unstable’, as described below:
- Stable – in which the pelvis has one breakpoint in the pelvic ring, limited bleeding, and the bones are staying in place.
- Unstable – in which there are two or more breaks in the pelvic ring with moderate to severe bleeding.
Causes & Symptoms
Most fractures of the pelvis cause considerable pain in the groin, even when people are lying down or sitting. The pain worsens at a higher level when patients try to walk, increasing the severity of the fracture. Additionally, the area is often swollen and bruised, therefore some individuals may try to keep the hip or knee bent in a specific position in order to avoid making the pain worse.
If pelvic fractures are severe and unstable, the ability to walk becomes very difficult to do. However, some minor fractures can be less painful when walking. If other structures are injured, patients may begin to experience other kinds of symptoms associated with the fracture. These symptoms may include having blood in their urine, difficulty urinating, uncontrollable loss of urine, or bleeding from the rectum or vagina. In some cases, if the socket of the hip joint has been damaged, there is a chance the patient can be permanently disabled.
Other signs of symptoms of a pelvic fracture include:
- Pain, tenderness, bruising, or swelling in your pelvic bone area.
- Numbness or tingling in your groin or upper thighs.
- Sudden discomfort or pain when you sit, stand, walk, or have a bowel movement.
- Leg or thigh bone turns outward.
- Legs are not the same length in comparison.
How Gets a Pelvic Fracture?
A pelvic fracture can result from low-impact or high-impact events. Low-impact pelvic fractures most commonly occur in two age groups; adolescents and the elderly. Adolescents typically experience fractures of the ilium resulting from an athletic injury (for example, football, hockey, skiing) or an activity, such as jogging. Pelvic fractures also can occur from repetitive impact activities, such as ballet or gymnastics. Elderly people can experience pelvic fractures after minor falls if they have osteoporosis, or simply because their bones have weakened. Spontaneous fractures can occur in people with weakened bones; cancer also can weaken the pelvic bones and lead to a fracture. Elderly patients frequently have fractures of the thicker part of the pelvic bones. These pelvic ring fractures result from falling onto the side of the hip. These types of falls can be caused by balance problems, vision problems, medication side effects, general frailty, or by encountering unintended obstacles such as slippery floors.
High-impact pelvic fractures commonly result from major incidents such as a motor vehicle accident, a pedestrian being struck by a vehicle, or a fall from a high place. These pelvic fractures can be life-threatening, require emergency care, surgery, and extensive physiotherapy.
How Does It Affect You? How Serious Is It?
Complications may occur with any surgery, no matter how small. Some of the most common risks associated with pelvic fracture surgery include:
These are a much bigger risk for larger and more contaminated traumatic wounds. A dose of antibiotics given prior to surgery helps to make this risk as small as possible.
Injury to blood vessels or nerves
This can occur after pelvic fracture surgery. This can be reduced by having an experienced surgeon in your care.
These can develop in the legs following surgery. If not treated, the blood clots can break off and go into the lungs. This can cause serious bleeding problems and even death. Non-compliance with blood-thinning medication can have fatal consequences. It is always possible that the bone may not heal, and additional surgery will be required. This is usually associated with patient non-compliance, diabetes, or the use of nicotine like smoking or chewing tobacco.
This is a complication of pelvic fracture surgery due to the nature of these injuries. 30% of patients experience some form of sexual dysfunction such as erectile problems in males. It is important to mention these symptoms to your surgeon so appropriate referral and treatments can be arranged.
Recommended Treatment & Rehabilitation
A pelvic fracture is normally 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. An X-ray will show the fracture. A computed tomography (CT) scan will be used in cases to get a better image of the fractures. Depending on how severe the fracture is, other imaging procedures may be needed. This can include contrasting studies where a radioactive dye is injected to create pictures to evaluate organs and structures in the pelvic area, such as the bladder and blood vessels.
Physiotherapists can help you recover from a pelvic fracture by improving the following:
- Pain level
- Speed of healing
- Hip, spine, and leg motion
When you are cleared by your physician to begin physiotherapy, your physiotherapist will design a specific treatment program to speed your recovery, including exercises and treatments you can do at home.
Exercises for a fractured pelvis usually involve the low-intensity movements used in rehabilitation. Most of them are done lying down and can help strengthen the muscles around your hips. Here are some exercises for you to try:
Knee flexion and extension
First, lie on your back on the floor with your legs out straight. Then, slide your left foot toward your butt along the floor. Plant your left foot flat on the floor with your knee bent. Kick the foot back out until your leg is straight. Repeated this exercise 10 times per leg and complete three sets.
Lie on your back on the floor with your legs out straight. Slide your left leg to the left along the floor as far as you can. Afterwards, slide the leg back into the center. Repeat for 10 repetitions on each leg 3 sets a day.
Roll up a towel to place under your leg. Secondly, lie on your back with both legs straight. Place the towel underneath one knee and bend the other knee by planting your foot on the floor. Lift the shin of the leg on the towel until your knee is straight. Finally, lower the foot back down to the floor, then repeat 10 repetitions with 3 sets a day.
Lie on your back on the floor. Plant your feet flat on the floor and bend your knees. Lift your hips as high as you can, driving through your heels. Next, pause at the top for five seconds, then come back down. It is recommended to perform 12 bridges for 3 sets a day.
Sit or lie down with your legs straight out. Press your toes down and squeeze your calf muscle. Then, point your toes up as high as you can. Lastly, move your foot back and forth quickly. Repeat 10-15 times every hour to keep the blood moving.
Treatment depends on how bad the injury is – with a minor fracture, the most common treatment is bed rest, non-steroidal anti-inflammatory drugs (NSAIDs), or prescription painkillers. Physiotherapy, the use of crutches, and, in rare cases, surgery may be required.
Pelvic fracture recovery may involve surgery, prolonged immobilization, or long periods of relative inactivity. Athletes should avoid all sports activities until their pain has resolved. During these periods of rest, which usually last for weeks to months, an individual often loses strength, flexibility, endurance, and balance abilities.
Severe injuries to the pelvis that involve several breaks can be life-threatening. Shock, extensive internal bleeding, and internal organ damage may be involved. The immediate goal is to control bleeding and help stabilize the injured patient’s condition. These injuries often require extensive surgery as well as lengthy rehabilitation. During the surgical treatment, an orthopedic surgeon will put pelvic bones back together and hold them in place with an internal device, such as the following:
Pins (or surgical screws)
These are used if the break is where the thighbone (femur) joins the pelvis and you are younger and more active, or if the broken bone has not moved much out of place. If you are older and less active, you may need a high-strength metal device that fits into your hip socket, replacing the head of your femur.
Compression screws and side plate
This is used for a type of hip fracture to hold the broken bone in place while it lets the head of your femur move normally in your hip socket.
Plates and screws
Following surgical cleaning of the fracture and reposition of fracture fragments. This is performed when the hip socket has fractured.
Most patients with 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 typically fairly comfortable. However, they cannot be released to full activities such as manual labor, skiing, and motocross until four months have progressed. Aggressive return to activities too early can result in re-fracture and / or hardware breakage. In these cases, revision surgery is heavily required. Patients can develop pain from the hardware placed in surgery. Some of these screws can be removed 6-12 months after surgery.
Alternative & Homeopathic Treatment
Your treatment may depend on how severe the pelvic fracture is and the other injuries you may have. This is often decided after you have tests. Here are some alternative & homeopathic treatments you can try, such as the following:
- Walking aids – 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. If you have injuries on both legs, you may need to use a wheelchair for a period of time so that you can avoid bearing weight on either leg.
- Hot bath – Taking a warm bath can be soothing and can also alleviate pain symptoms from pelvic injuries. Warm water increases blood circulation throughout the body, decreasing pain symptoms from numbness.
- Medications – Your doctor may recommend non-steroidal anti-inflammatory medications in order to reduce any swelling and inflammation in the affected pelvic area.
- Essential oils – Some essential oils can help increase circulation in the body. They also have pain-relieving and anti-inflammatory properties that could boost healing.