Pelvis fracture treatment
The pelvis is a set of bones in the shape of a ring that surrounds many vital organs, such as the bladder. Pelvis fracture is a complete or partial break in one of the three bones in the pelvic ring located in the trunk of the body. In as many as 25 percent of all pelvis fracture incidents, patients also have sustained injuries to their bladder as a result of the trauma. In 40 percent of all incidents, patients sustained injuries to their abdomen as well. Because of these additional injuries, as much as 55 percent of all pelvic fracture cases lead to death due to other injuries and complications with hemorrhaging. These high numbers show the need for proper diagnosis as soon as patients arrive for care.
The right treatment for your pelvis fracture is determined by a few important factors such as your age, present health, health history, the extent and location of the fracture and your history with other medications and treatments.
A pelvis fracture can be dangerous because it limits the ability of the pelvic bones to protect the internal organs they surround. If you have any reason to believe that you may have sustained this injury, it is important to receive immediate medical attention. To diagnose your condition, your doctor will start by asking you questions about your past medical history and your activity before seeking treatment. To locate the specific site of the fracture, the following techniques are used:
- X-ray (radiograph) – This is typically the first test performed. It is done by sending electromagnetic radiation through your body to produce images of your pelvis to find the exact location of the fracture. Bone stands out in an X-ray because it absorbs the radiation and can provide your doctor with images that will show the severity of the fracture.
- Computed tomography scan (CT or CAT scan) – A CAT scan uses X-ray technology combined with computer technology to enhance the image provided. This may be used in more complicated fractures.
- Ultrasound – An ultrasound uses sound waves to create images that can show any internal bleeding that may have occurred during the fracture.
- Urethrography – In some instances, the bladder or urethra becomes damaged. Depending on the location of the fracture, the doctor may inject dye into your urethra to look for any injuries.
- Arteriography – This is another common test to check for internal bleeding. It is similar to the urethrography in that dye is injected into the bloodstream to look for any areas where there may be internal bleeding due to the injury.
If the pelvis fracture is stable, which in many cases is difficult to determine, nonsurgical repair is possible. This is particularly true in the young and the elderly. You will likely be able to put full or partial weight on your feet while the fracture is healing. You will likely require the use of crutches or a walker to get around. Throughout this time, many patients use blood thinners to prevent blood clots.
In some cases, a pelvis fracture requires surgery. The goal of most pelvis fracture surgeries is to reconnect the broken ends of the bone and prevent them from moving as they heal, otherwise they could damage the vital organs. Most pelvis fractures are surgically treated in one of the following ways:
- External fixation – Pins are placed through the skin and into the pelvis. These pins are connected by carbon fiber rods to stabilize the fracture. This is done whenever there is significant trauma to the skin and tissue, which would increase the risk of infection if an incision were made.
- Metal plates and screws – In some cases, metal plates and screws may be placed directly on the bone to keep it more stable. This is done when there is little or no trauma to the surrounding tissues.
- Pins – In cases where the fracture occurs close to the thighbone, pins may be used to hold the joint in place. These pins are usually used on younger patients whose bones are still growing and do not require the strong stability of plates and screws, which can limit proper growth.
The multidisciplinary team of trauma and fracture experts at Northwell Health Orthopaedic Institute performs pelvis fracture surgery as well as a broad range of nonsurgical and surgical treatments for conditions that affect the bones.
Much of the research surrounding pelvis fractures has to do with how they are diagnosed. Because the pelvis surrounds such important organs, a fracture can lead to multiple complications, such as hemorrhaging. This makes it very important to diagnose each injury appropriately.
As research on diagnosis and treatment is ongoing, it is a good idea for your conversation about it with your doctor to be ongoing as well.