Broken pelvis

Overview

In younger patients, a broken pelvis usually results from an accident involving heavy external trauma. Older people (especially if they suffer from osteoporosis) can sometimes break their pelvis simply by falling down. A pelvic fracture causes pain in the hip area, a protective limp, and sometimes also misalignment and an inability to walk. Symptoms range from quite mild to life-threatening.

Symptoms

Main symptoms

• Pain, protective limp, possibly inability to walk
• Oblique pelvis and difference in leg length
• Complicated and multiple fractures: loss of stability and symptoms of additional injuries
  • Often accompanied by additional injuries to internal organs (intestines, bladder, diaphragm, blood vessels, nerves or other bone fractures)

Complications

• In serious accidents with high kinetic energy: entire body is affected (whole body trauma), risk of life-threatening bleeding
• Early arthritis of the hip joint is possible (for acetabular, i.e. hip socket, fractures)
• Possibility of permanent misalignment if not/insufficiently stabilised by surgery

Causes and treatment

Causes

• Weakened bones (osteoporosis, older people, bone metastases)
  • Can break relatively easily, e.g. falling at home
  • Spontaneous fractures (breaks without external trauma) are possible
• Stable, mostly young bones
  • A serious impact is required to cause a pelvic fracture (high-energy trauma, e.g. traffic accident, falling from a great height)

Further treatment by your doctor / in hospital

Possible tests

• General examination
• Imaging procedures:
  • X-ray
  • CT scan (computed tomography), standard for trauma
  • MRI (magnetic resonance imaging)
  • Ultrasound (sonography), exclusion of internal bleeding

Possible therapies

• Stable pelvic fractures with no displacement:
  • Conservative approach (i.e. no operation)
  • Mobilisation as soon as possible
• Displaced, unstable or open fractures, acetabular fractures and associated internal injuries:
  • Primary haemostasis
  • urgery (control of bleeding, prevention of sequelae)

What can I do myself?

A broken pelvis can't be diagnosed by sight. If a broken pelvis is suspected and the patient is unable to walk after an accident:

• Let patient lie in a relaxed position
• Only move the accident victim if this is necessary for applying immediate lifesaving measures
• If the patient is likely to go into shock because of blood loss: elevate the legs
• Organise speedy transport to a doctor or hospital

When to see a doctor?

• Severe pain in the hips (suddenly or after an accident)
• Misalignment, difference in leg length
• Feeling of instability, inability to walk
• Disorientation after a fall

Synonyms

Broken pelvis