Pelvic Fractures: Anatomy, Symptoms, and Management

The pelvis is made up of two Pelvic Bones or two Hemipelves (Two Innominate Bones), each formed by three different bones: Ilium, the largest bone located at the top; Pubis, the pelvic bone located at the front; and the Ischium, the lower pelvic bone located at the back. Each Hemipelvis is joined anteriorly by the Pubic Symphysis and posteriorly to the Sacrum by the Sacroiliac Joint. In the case of younger people, severe fractures involving the entire pelvis are mainly caused by high-speed automobile accidents or falls from great heights. Older people with Osteoporosis are highly prone to this type of injury.

Pelvic fracture

Symptoms:

A pelvic fracture causes a great deal of pain in the groin and the waist in general, regardless of the patient's position. They are of high complexity as they can cause life-threatening hemorrhages and injuries to other internal pelvic organs such as the Bladder and the Rectum.
Bruising on the skin around the waist is frequent, and if other structures were injured, blood may appear in the urine, along with incontinence and bleeding from the rectum or vagina.

Management:

Depending on the type of fracture presented, the following treatment is recommended:

Stable fractures or in areas without compromise of the stability of the pelvic ring, with a patient without imminent compromise of their life: No surgical intervention is performed, analgesics are prescribed, and walking with the help of support elements is recommended, seeking to maintain muscular activity during the time the fracture consolidates, during which time the pain will progressively decrease.

Unstable fractures, patient with evidence of imminent compromise of their life: An External Fixator is installed to immobilize the pelvis until the patient's conditions are optimal and surgery can be performed to reduce or align the bone fragments and be fixed with implants like plates and screws.

After surgery, the patient should start walking as soon as possible to speed up the healing process and gait rehabilitation.
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