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Pelvic fractures often represent a serious injury, requiring immediate medical attention in order to avoid further complications. The highly skilled specialists and surgeons at Cedars-Sinai Marina del Rey Hospital provide multiple surgical and non-surgical treatment approaches for pelvic fractures, promptly evaluating and attending to this type of injury, offering postoperative advice and guidance as well.
The pelvis is a ring of bones that is located in the lower section of trunks. It is composed of a lot of bones some of the most important ones being: the sacrum, which is the large triangular bone at the base of our spines, the tailbone (also known as the coccyx) and the hip bones. The hip bones contain three bones: the ilium, ischium and pubis.
During our childhoods the three hip bones are separated but they fuse together as we grow older.
As these three bones meet they form the acetabulum, which is a hollow “cup” that acts like the socket of the ball-and-socket hip joint.
The pelvis is joined to the sacrum by bands of connective tissues known as ligaments and they form a bowl-like cavity bellow the ribcage. Blood vessels, nerves, parts of our bladder and reproductive organs all go through the pelvic ring, which protects them from injuries and which also serves as an anchor for the hip thigh and abdomen muscles. So when a pelvis fracture occurs (quite rarely accounting for only 3% of adult fractures) we can get in a lot of trouble.
Pelvic fractures, depending on their severity can be treated either surgically or non-surgically. Surgically they can be treated by the following methods:
External fixation: External fixation of the pelvis is one of the techniques used for stabilizing unstable pelvis ring injuries either permanently or temporarily. External fixation involves an X-ray machine so that the surgeons may view your pelvis at all times and use it as a guide as they will need to construct a rather large device (called a fixator) which they will need to insert into your bones.
Internal fixation: Internal fixation is a process, which involves two steps, firstly it involves an open reduction, which is a surgery that is used to set your bones and secondly the fixation itself which, by using either plates, screws, or a combination of both makes sure that the bones that the open reduction set will stick together.
Skeletal traction: While usually used immediately after an injury, skeletal traction can also treat some pelvic fractures alone (quite rarely though)
Skeletal traction involves pins implanted in either the thighbone or the shinbone to help with the leg's positioning. The pins have some weight attached to them, which will pull on the leg so that the broken bone pieces will stay in a “normal” position. It also provides some main relief for most patients.
Other therapies include:
Ice therapy: Ice decreases pain and swelling and helps prevent tissue damage.
Swimming and cycling: They are both low-impact exercises and are commonly used to help restore a full range of motion.
Any therapy that you want to take must be discussed with your doctor beforehand.
Pelvic fractures are most commonly classified using either the Tile system or the Young-Burgess system.
The Tile system classifies injuries in three categories:
The Young-Burgess system classifies fractures based on the mechanism of injury.
They can also be informally classified as:
Pelvic fractures are always associated with pain that is worsened by any movement of the hip. Often patients will try to keep their hip or knee bent in a patient-specific position so that they will not aggravate the pain.
Swelling and bruising in the hip area is also common as is numbness and tingling in either the genital area or your upper thighs. Defecating (bowel movements) can be painful.
A pelvic fracture can be diagnosed by imaging with the use of X-Rays for initial imaging, computed tomography scans (CT scans) so that your doctor may be able to study a more detailed image and better understand the pattern and size of your fracture, check for any injuries commonly associated with pelvic fractures and aid with preoperative planning, and, rarely, MRI scans in case a fracture cannot be observed on a radiography or a CT scan.
Risk factors include:
Pelvic fractures can be caused by minor falls (in people with low bone density such as elders), by car/motorcycle accidents, falls from significant heights and crush accidents.
The range of alternative medicine and treatments for pelvic fractures is limited to Vitamin supplements, especially Vitamin D due to its role in bone formation and consolidation. Calcium supplements can help strengthen newly forming bone tissue. Additional protein intake can help speed up the healing and strengthening of the muscles. Balance exercises can help with the fear of falling and re-injuring your pelvis.
Social activities that are not physically demanding and promote a state of wellbeing will help with reducing negative emotions that are associated with pelvic fractures and can help with the healing process. Supervised, long-term exercises show greater benefits than isolated resistance training or home exercise programs.
Pelvic fractures can be prevented using Vitamin D supplements as it helps strengthen your bones and, due to the fact that most pelvic fractures are caused because of falls, proper safety procedures must be always followed when working.
In the elderly physical therapy and occupational therapy help in maintaining home safety, core stability strength and general fitness.
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