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Pelvic Fracture

What is a Pelvic Fracture?

Fracture in pelvis is common with elderly people usually caused by a fall from standing. The fracture results to a disruption or discontinuity in the pelvic bone including the sacral, coccyx and hip bone. Vehicular accident and high energy force significantly contribute to pelvic fraction. Internal bleeding is highly possible owing to the fact of pelvis holding many internal organs of the body. Internal bleeding is often associated with pelvic fracture which visible to the eye and surgical reconstruction is recommended after stabilizing the health condition of the patient.


Types

Pelvic fracture is classified in to two types according to the point of break in the pelvic ring including other injuries associated with it.

  1. Stable fracture – fracture defined as breaking in one point of pelvic ring only with minor bleeding and no bone dislocation recognized.
  2. Unstable fracture – fracture defined as breaking in multiple point of the pelvic ring accompanied with mild to severe bleeding.

Pelvic fracture is described using either of the two classification system based on the integrity of the sacroiliac complex and the mechanism of injury. These classifications are known as:

  1. Tile Classification System – describes the fracture based on the injury to the pelvic ring and the force of mechanism. It is the common system use in describing the fracture of a patient in different types whereas; Type A described as rotationally and vertically stable; Type B described as unstable rotationally yet stable vertically; Type C described as unstable both rotationally and vertically.
  2. Young and Burgess Classification System – expanded the Tile classification by adding combined mechanism of injury and forces. The system also predict associated injury pattern as presented by pelvic ring deformity. The injury is described on grade system of Grade I, II and III.

Pelvic Fracture Symptoms

Pelvic fracture is common to elderly people who are at the age of suffering osteoporosis. It can also happen to young adults in the form of high force such as vehicular accident and other rough activities that young adults are engaged in. The pelvic fracture is visibly seen but the injuries are manifested through the signs and symptoms such as:

  • Pelvic pain that may be described as bearable or severe often due to the force of mechanism of fall or impact of the mechanism.
  • Haematuria is experienced as a result of bleeding internal organs as an effect of the injury.
  • Bladder function is uncontrollable as a result of the injury which destabilized the internal organ of the reproductive system.
  • Inability of an individual to move in rotation or bending and even in standing up and walking.
  • Bowel incontinence is also experienced.
  • Pain in the groin is the most significant of pelvic fracture symptom.

Pelvic Fracture Causes

An individual can suffer pelvic fracture though it is more common to elderly people. Children and young adults can also suffer from this fracture but the degree or level of recovering is entirely different from that of elderly people as young adults especially children as bone development and strength have not been maximized. The possible cause of pelvic fractured could be due to the following:

  • Elderly people with osteoporosis are high risk for pelvic fracture as the bone tissues are thinning and bone density is loss.
  • Vehicular and motor accidents are high-energy force accidents that can give the worst fracture in the pelvic bone due to major impact.
  • Fall from standing up which is common to happen to elderly people.
  • Fall from heights may cause worst fracture due to impact of high-energy force.
  • Decreased muscle strength may cause one to fall landing on the pelvic region may cause fracture.

Pelvic Fracture Treatment

Treating pelvic fracture varies depending on the stability of the patient including the severity and type of fracture the patient suffered. The first goal of treatment is patient comfort by alleviating the pain and bleeding if there is any. Immobilizing the patient is as important as alleviating the pain to prevent further damage and complication. A mild injury will only require recovery for a short period of time. Treating a pelvic fracture victim includes:

Stable Fracture Treatment

  • Conservative approach of treatment is recommended for mild injury brought by pelvic fracture. Immobilization accompanied with bed rest for 6 weeks while the damaged bone is healing on its own.
  • Pain medication through oral or intravenous infusion to alleviate pain from the injury.

Unstable Fracture Treatment

  • Stabilization and immobilization of the patient is the first priority for patient who endured high-energy force fracture. Immediate goal is to control bleeding of the patient to prevent shock due to severe trauma. Immobilizing the patient to avoid further damage or injury and complication.
  • Bone reconstruction is prescribed which can only be done surgically.

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