What causes a broken pelvis

Pelvic fracture

Treatment of a pelvic fracture can take a long time, depending on the extent of the injury. Here you can find out how a pelvic fracture develops, how it is treated and why subsequent rehab is so important.

What is a pelvic fracture?

The pelvis has two essential functions in our body: It supports the intestines and connects the spine with the legs. Specifically, it is one Pelvic ringwhich consists of several bones. A fracture can in different places on this ring occur or affect the acetabulum.

An overview of the various types of pelvic fracture

Doctors differentiate three forms of pelvic hernia:

  • At a Type A pelvic fracture there is an isolated fracture of the anterior pelvic ring or the pelvic rim. Since the pelvic ring is completely preserved, the expert also speaks of a stable pelvic fracture.
  • At a unstable fracture (pelvic fracture type B) the X-ray shows a complete break. Viewed vertically, the pelvis is stable, but rotationally unstable: the pelvic blades, which are actually immobile, can be opened outwards. There is a loss of stability and severe internal bleeding is possible.
  • One is even more serious Type C pelvic fracture, because here the pelvis is unstable both vertically and rotationally.

Possible consequences and complications

If it is a type B or C pelvic fracture, this often goes with one high blood losst that can be life-threatening - especially when veins are torn. Also Injuries to important organs, for example the bladder, are possible. They also exist with severe pelvic fractures the following risks:

  • thrombosis
  • Damage to the nerves
  • Impotence (with a fractured pubic bone)
  • arthrosis
  • Femoral head necrosis (death of the head of the thigh)

How does a pelvic fracture develop?

In most cases, a pelvic fracture occurs as a result of a Traffic accident or one Falling from a great height. In any case, great forces act on the pelvic area. In 60 percent of all cases, those affected not only suffer a pelvic fracture, but also other injuries. In this context, the doctor also speaks of a multiple trauma.

The Size of the acting force and the direction from which it comes, has a major impact on the type of fracture. If the force acts directly on the pelvis from the front, the pelvic blades are usually pushed apart. If a force is applied from the side, the pelvic ring will instead curve. Although the pelvis can break even with simple falls (e.g. when slipping on black ice), this is usually a pubic bone fracture. This pelvic injury is harmless compared to a pelvic fracture and takes a shorter healing time to complete.

Who is particularly at risk?

Older ones People over 70 are particularly at risk of having a pelvic fracture - especially if they are on osteoporosis Suffer. In osteoporosis, the bone density continues to decrease, so that the bones can break even with little force. Even people who have a Sport with a high risk of accidents and injuries pelvic injuries are more common than average.

Duration and course of illness

At a stable pelvic fracture there are usually no long-term consequences to fear. Also a unstable pelvic fracture heals completely with appropriate therapy - but it takes longer and the risk of consequential damage such as osteoarthritis is far greater.

Typical symptoms in the presence of a pelvic fracture

A broken pelvis goes along with it severe pain and swelling hand in hand. If the pelvic fracture is stable, however, the symptoms are less pronounced. The dependent body parts (such as the testicles, the labia or the perineum) point possibly bruising on. In the case of an unstable pelvic fracture, the pelvic bones can be shifted against each other, and in some cases the legs are even of different lengths. In extreme cases, the pool opens like a book (open book phenomenon). The affected person is then no longer able to walk.

How is a pelvic hernia diagnosed?

In the case of a severe pelvic fracture, those affected are usually admitted to the hospital emergency room. If there is a slight fracture of the pelvis with minor symptoms, the orthopedic surgeon is responsible. The doctor will ask the patient after exact course of the accident as well as after the previous medical history consult. Also the exact localization and severity of the pain (piercing, stabbing, etc.) is extremely important for the diagnosis.

There follows one physical examinationin which the doctor palpates the pelvis for irregularities and applies light pressure to the pelvic blade. In this way he can determine whether the pelvis is unstable. If necessary, he also feels the pubic symphysis and does a rectal examination to rule out bleeding. Checking the sensitivity and blood flow in the legs is also extremely important.

After the physical exam, a X-ray image made in order to be able to assess and localize the break precisely. If a posterior pelvic fracture, acetabulum fracture or sacrum fracture is suspected, the doctor will classify it CT (computed tomography) while sonography (ultrasound) is used to examine the internal organs.

In some cases, further examinations are required, such as the urinary tract (excretory urography) or the blood vessels (vascular x-ray).

Therapy options

Treatment of a pelvic fracture also depends on the severity of the injury and the patient's condition. In the event of a slight, stable break of type A, a conservative therapy usually sufficient. This consists of bed rest, the administration of painkillers and - after a period of a few days - physiotherapy and mobility exercises.

With a type B or C pelvic fracture, there is almost always one surgery required - in the case of a complex fracture with large blood loss, it may even be necessary to stay in the intensive care unit.

Indispensable: rehabilitation after a fractured pelvis

After a fractured pelvis is a orthopedic rehab Recommended, because it helps to avoid bad posture and incorrect strain. The patient is also given the opportunity to strengthen important muscle groups under professional guidance and thus ensure lasting healing success.

The rehab should start asapbecause the sooner the patient can move properly again, the better. Already in the sick bed they become light physiotherapeutic measures performed, followed by first attempts at walking with the walker and forearm rests. Walking aids are used until the fractures have healed well. However, the patient should not use them for too long either to avoid bad posture. From the eighth week - also under guidance - light weight training completed.

The rehabilitation measure takes place depending on the extent of the injuries outpatient or inpatient in a rehab clinic instead of. In any case, the measure takes several weeks in claim. If the rehab is considered medically necessary, the costs will be covered by the health insurance. This is usually the case after an operation. For minor pelvic fractures, however, the doctor usually only prescribes physiotherapy.

The Applying for rehab is carried out by the treating doctor or alternatively by the social services of the treating hospital. Alternatively, the patient can submit an application for rehab himself - but in any case he needs a certificate from the attending physician, which certifies the need for rehab. Application forms are available from the respective health insurance company.

Conclusion

A pelvic fracture is a significant injury that requires extensive therapy. If the patient adheres to the rules of conduct of the attending physician and if suitable rehab is initiated as soon as possible, the opportunities on a complete healing however very good.

Last changed on: 09/30/2019

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