Orthopaedic Conditons & Treatments

Pelvis Fractures, Causes and Symptoms

Pelvis fractures occur when the pelvic bone structure, which includes the coccyx, hipbone and sacrum, is disrupted. The pelvic bone forms a ring around the sacrum, a large bone shaped like a triangle that joins the upper pelvic cavity, rear pelvic cavity and base of the spine right between the hipbones. The ilium (the largest and uppermost pelvic bone), ischium (rear and lower hip bone) and pubis (anterior and ventral of the pelvis) make up this vital and complex bone structure. Injuries to the pelvic region that disrupt these three components occur when a powerful force has been applied to the body, which may also affect the local organs. There are many precious internal organs held within the pelvis, so these injuries can cause a great deal of internal bleeding in more severe cases.

People of all ages may suffer from serious pelvic injuries after accidents involving bikes, cars, motorcycles and falls from elevated heights. Elderly people can often fracture their pelvic bone with just a mild fall. Pelvis fractures are now happening most frequently among 15-28-year-old males, although pelvis fractures in the 35+ age group happen more frequently among women. In the United States, there are believed to be approximately 37 cases of pelvis fracture per 100,000 people per year.

Anatomy of the Pelvis
The pelvic bone sits between the lower limbs and abdomen in humans, where it connects the spinal lumbar region to the femurs. The pelvis can be divided into the following parts:

  • Pelvic girdle (hip bones)
  • Pelvic spinal region (coccyx and sacrum)
  • Pelvic cavity (which is subdivided into the following parts):
    • Greater pelvis (above brim of pelvis)
    • True pelvis (below brim of pelvis)
    • Pelvis floor/diaphragm (below pelvic cavity)
    • Perineum (below floor/diaphragm)

The pelvis is made up of three large bones, in addition to three to five smaller bones in the coccyx. The sacrum and coccyx form the pelvis in the posterior dorsal, and the two hipbones form the lateral and anterior portion of the pelvis. The ilium, ischium and pubis remain separate from one another before a human hits puberty, and begin to fuse as one matures into adulthood.

Types of Pelvic Fracture
Whether pelvic fractures are mild or severe, they can generally be grouped into one of the two following categories:

  • Stable Fractures – When an individual suffers a mild pelvic injury with only one breaking point along the pelvic ring, limited or no disruption to the pelvic bone and limited internal or external bleeding, the fracture is considered “stable.” This denotes that the pelvis is still secure despite the injury, and that there is a good chance of a quick, successful and complete recovery.
  • Unstable Fractures – In more severe pelvis fractures in which two or more breaks along the pelvic ring have occurred, the injury is considered “unstable.” There may also be moderate to severe bleeding with this type of injury, and internal organs may be threatened.

Causes of Pelvis Fractures
The most common pelvis fracture causes are falls from considerable heights and accidents involving bikes or automobiles. Elderly people are often believed to be the most likely population to suffer this type of injury, but it can happen to anyone at any age when the thighbone takes a direct blow. Injuries in elderly individuals are often caused by moderate slips and falls. Here is a little bit more information about the most common pelvis fracture causes:

Intense Impacts – When individuals survive major traumas, such as car and motorcycle accidents or falls from great heights, it can seriously fracture the pelvis, regardless of age.
Sports Injuries – This is one of the less common pelvis fractures causes, but it can be very serious and painful when it does occur. Football, soccer and rugby players are the most likely to fracture their pelvis during falls ending in unnatural positions in contact sports games. There are also rare cases of pelvis fracture resulting from training injuries.
Moderate Falls – Elderly people and those suffering from osteoporosis and other bone-weakening diseases may fracture their pelvis after only a moderate fall, because their bone structure is so fragile. Elderly people are also more likely to fall because of poor balance, compromised vision and medication side effects, so this population is especially susceptible to fractures. Some people with extremely weakened bones may even fracture their pelvis spontaneously without falling.

Symptoms of Pelvis Fracture
Pelvis fracture symptoms will vary depending on whether the injury is mild or severe. All injuries to this region will cause severe pelvic pain, and more serious cases may also have consequences such as internal bleeding. If you have suffered an injury to your pelvic region and you are suffering from some or all of the following symptoms, you may have fractured your pelvis:

  • Abdominal bruising
  • Back pain
  • Coccyx pain
  • Heightened pain and difficulty while walking
  • Hip pain
  • Intense pelvic pain
  • Leg pain
  • Pelvic bruising
  • Pelvic swelling

More intense pelvis fractures may also cause the following symptoms:

  • Bloody urine
  • Dizziness
  • Fainting
  • Incontinence
  • Left, lower and/or right abdominal pain
  • Numb legs
  • Weak legs

Since pelvis fracture symptoms vary, diagnoses are typically based on a number of x-rays to pinpoint the nature of the injury. The x-ray images will show the physician what the bones and internal organs look like from several different angles, and a computer tomography (CT) scan may also be necessary to better understand the extent of the injuries. The physician may also perform various examinations to test for damage to the nerves and blood vessels in the legs. An injury to the pelvic bone itself does not typically cause serious damage and may even be able to heal without intervention, but if the internal organs are affected it can become life threatening and may require surgery.  

The multidisciplinary team of orthopaedic experts at North Shore-LIJ Orthopaedic Institute's Trauma Services in New York treats Pelvis Fractures as well as a broad range of conditions that affect the bones within the body.

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