The pelvis is the sturdy ring structure located at the lower end of the trunk. The pelvic bones include the large triangular bone at the base of the spine (sacrum), the tailbone (coccyx), and the hip bones. The hip bones meet to form the hollow cup that serves as the socket for the hip joint, this is called the acetabulum.
Fractures of the pelvis and acetabulum are not very common. They generally occur as a result of a traumatic event such as a car collision or fall from a significant height. Because major nerves, blood vessels, and several organs pass through the pelvis, pelvic fractures may require urgent treatment. The care of patients with these injuries require a multidisciplinary approach. Doctors must address airway, breathing, and circulatory problems before addressing the fracture.
A fractured pelvis or acetabulum causes pain and an inability to bear weight. Sometimes there is also bruising, lacerations, hematomas, or swelling in the hip area.
Diagnosis and Treatment
Your orthopedic surgeon will examine your pelvis, hips, and legs. He or she will test for stability by applying gentle compression. X-rays will be taken to determine how displaced the bones are. A CT scan is also used to provide a more detailed image, it helps assess for asymmetry and rotation.
If the fracture is stable and the bones are not displaced, your doctor may recommend nonsurgical treatment. In order for displacement to occur, the pelvic ring has to be injured in at least two places. Crutches or a walker can be used to avoid bearing weight. Medication may be prescribed to relieve pain and avoid blood clots.
For unstable fractures, there are multiple fracture types and your surgeon will determine the best course of treatment. Your doctor may use external fixation to stabilize the pelvic region. This involves metal screws and pins being inserted into the bones and attached to a carbon fiber bar outside of the body to hold the bones in proper position until they heal. Internal fixation is a surgery where the displaced bone fragments are repositioned into their normal alignment. They are held together with screws or metal plates inside the body.
After hip surgery, your orthopedic surgeon will recommend you use crutches or a walker for a period of time to avoid bearing weight. Physical therapy is usually prescribed to regain flexibility, strength, and range of motion. Stable pelvic fractures tend to heal well. Unstable fractures may require multiple surgeries and may include other complications from additional injuries.