Unstable Pelvic Fracture

Summary about Disease


An unstable pelvic fracture involves a break in the pelvic ring with displacement. This displacement indicates significant injury to the bony structures and supporting ligaments of the pelvis. Due to the extensive force required to cause such a fracture, these injuries are often associated with significant internal bleeding and damage to other organs. They are considered orthopedic emergencies.

Symptoms


Severe pain in the groin, hip, or back

Inability to bear weight

Deformity of the pelvis or legs

Numbness or tingling in the groin or legs

Bleeding from the urethra, vagina, or rectum

Blood in the urine

Signs of shock (rapid heart rate, low blood pressure, pale skin, confusion)

Causes


High-energy trauma such as motor vehicle accidents, motorcycle crashes, falls from significant heights, or crush injuries.

Medicine Used


Pain Management: Opioids (morphine, fentanyl), NSAIDs (if appropriate and bleeding is controlled).

Antibiotics: Prophylactic antibiotics to prevent infection, especially if open fracture is present.

Anticoagulants: To prevent blood clots (DVT/PE) after surgery.

Blood Products: Transfusions for blood loss.

Is Communicable


No. Unstable pelvic fractures are not communicable. They are caused by physical trauma.

Precautions


Prevention: Safe driving practices, fall prevention measures, workplace safety protocols.

Post-Treatment: Strict adherence to rehabilitation programs, weight-bearing restrictions as directed by the surgeon, monitoring for complications such as infection, blood clots, or nerve damage.

How long does an outbreak last?


Unstable pelvic fractures do not occur in outbreaks. They are isolated traumatic events.

How is it diagnosed?


Physical Examination: Assessment of pain, range of motion, and neurological function.

X-rays: To visualize the fracture pattern.

CT Scan: Provides detailed images of the pelvis, including bony structures and soft tissues. Useful for assessing the extent of the injury and planning surgical intervention.

Angiography: If vascular injury is suspected.

Timeline of Symptoms


Immediate: Severe pain, inability to bear weight, possible deformity.

Within Hours: Development of swelling, bruising, and potential signs of shock.

Days/Weeks: Pain gradually improves with treatment and rehabilitation, but can persist for several months. Potential complications such as infection or blood clots can arise.

Important Considerations


Unstable pelvic fractures are life-threatening injuries due to the risk of severe bleeding and associated injuries.

Rapid assessment and stabilization are crucial.

Treatment often involves surgical fixation to restore pelvic stability.

Rehabilitation is a lengthy process requiring a multidisciplinary approach.

Long-term complications such as chronic pain, arthritis, and functional limitations are possible.