Exactly what is the pelvis? It is actually a group of bones that create a ring-like structure at the lower end of the upper body. Each of the two sides of the pelvis is comprised of three bones: the ilium, the ischium, and the pubis.
These bones grow together as one ages. Connective tissues, known as ligaments, join the pelvis to the sacrum, the large triangular bone, at the base of the spine. A bowl-like cavity is thus created, sitting just below the rib cage. A hollow cup rests to each side that provides the socket for the hip joint.
Within the pelvic region sit certain digestive and reproductive organs. Nerves and blood vessels that go to the legs pass through this area. The pelvis is an attachment point for the muscles that go both down into the legs and up into the upper body. If the pelvis is injured or becomes fractured, it can affect these vital structures and cause significant bleeding, nerve injury, and damage to the internal organs.
The elderly are at risk for pelvic fractures due to the incidence of osteoporosis. For example, the pelvis can be damaged when the patient slips and falls. Even teenagers are at risk, especially if they are active in sports. While many may complain of a “pulled muscle,” they, in fact, might be dealing with an undetected fracture. Sudden muscle contractions can cause these fractures, causing a small piece of bone from the area where the hamstrings attach to be torn away. Fortunately, this type of fracture does not affect internal organs or cause the pelvis to become unstable.
Many pelvic injuries are sustained through high-energy means, such as a significant fall, a car accident, or a crushing incident. Depending upon the severity of the impact, the resulting injuries can be life-threatening, and surgical intervention may be necessary.
Obviously, a broken pelvis is quite painful. It can also become bruised and swollen. If the fracture is caused by something as traumatic as a car accident, it can be accompanied by other bodily injuries. In these cases, significant bleeding may present which can lead to shock. Such injuries must be immediately stabilized and the patient should be taken directly to an emergency or trauma center for treatment.
As with any fracture, an X-ray is necessary to diagnose the type and the extent of fracture to the pelvic region. X-rays will most likely be taken from different angles to determine how far out of place the bones actually are. The doctor will also perform an examination of the blood vessels and nerves in that area.
Treatment options for stable fractures, those that commonly occur with sports injuries, usually heal without surgical means. The patient may need to use a supportive device, such as crutches or a walker, and should not put all of his or her weight on both legs for a couple of months or until the bones are properly healed. Pain medication may also be prescribed. These types of pelvic injuries usually heal well.
Pelvic fractures resulting from more traumatic circumstances that require surgery may necessitate the use of an external fixator to stabilize the pelvis. This device uses long screws inserted into the bones on each side, connected to a frame outside of the body.
As with any fracture, recovery time depends on a host of variables, from the severity of the injury to the patient’s overall health. As with any injury, it is best to seek medical advice to determine the best course of action.
(Information from this article was obtained at http://orthoinfo.aaos.org/topic.cfm?topic+A00223.
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Hi Ann - Pelvic fracture is indeed a very serious injury, and your comprehensive article is very helpful. Thank you for addressing this important topic.November 3, 2009 - 6:06pm
Take good care,