Pelvic Ring Fracture

What Is a Pelvic Ring Fracture and How Does It Occur?


A pelvic ring fracture is a fracture along any part of the bony pelvis.  The pelvis is made up of three bones: the two innominate bones and the sacrum. Typically, a pelvic ring fracture will occur when there is high trauma to the pelvis.  This may happen during a motor vehicle accident or a significant fall from greater than 15 feet.  It can also occur in an elderly, osteoporotic population from a ground level fall. Pelvic ring fractures are more common in men than in women.

A picture of the pelvis with visible fractures in the different areas of the pelvis a Pelvis Ring Fracture can occur.A Pelvic Ring Fracture can occur anywhere on the pelvis.

Read Bones in the Pelvis to learn more about the bones of the pelvis.

Pelvic Ring Fractures aren't the only issue you can have with your pelvis. Read Pelvic Dysfunction and Lower Back Pain to learn about other issues you can have relating to the pelvis.


What Are The Complications Associated With a Pelvic Ring Fracture?


The most serious complication is a life-threatening hemorrhage. This complication does not have well defined risk factors in that sometimes a high-grade pelvic ring fracture could present with minimal bleeding, while another low-grade pelvic ring fracture may present with severe bleeding.  One co-morbidity that could contribute to this is age.  Often with the aging process, there is increased atherosclerosis which can result in impaired vasoconstriction and somewhat loose periosteum, thus increasing the risk for hemorrhaging. A second noted complication of pelvic ring fracture is nerve injury.  This could result in what are very commonly seen problems within people of all ages and many different mechanisms of injury, sciatic nerve injury and bladder impairments.


Additionally, these types of patients are often immobilized, followed by a period of inactivity, therefore a third complication could be the development of a deep vein thrombosis (DVT) or a pulmonary embolism (PE). There are also known chronic complications that are associated with pelvic ring fractures, including chronic pain, painful gait and sexual dysfunction.  Typically, if a woman has sustained a pelvic ring fracture and then becomes pregnant, she will give birth via a cesarean.


How Do People Get Back to Moving Normally After a Pelvic Ring Fracture?


Once a patient has been cleared to begin their normal activities of daily living, they may find that they have increased pain, decreased range of motion, strength, balance impairments and a lack of endurance.  It will be important to seek out physical therapy in order to help to restore this normal movement.  A physical therapist can assist by offering techniques to decrease pain and restore movement, such as manual therapy interventions, appropriate stretches, taping, and electrical stimulation.  Additionally, an individualized strengthening program would be developed to assist the patient in getting back to their previous level of activities, including learning how to walk with a normally again and balance training.  These combined activities should be tailored to meet the individual needs of the patient and to prevent a fall or loss of balance which could cause problems down the road.


Can Someone Make a Full Recovery After a Pelvic Ring Fracture?


It is possible to make a full recovery after a pelvic ring fracture.  Typically, the healing time for a pelvic ring fracture with good alignment and with lower complications could take 8-12 weeks, however the more complicated fractures could take longer, up to 4-6 months.  Additionally, those individuals that are looking to resume to higher level activities such as manual labor, skiing, CrossFit, contact sports or motocross should not be released to full activity until the 4–6-month mark.  

If you have suffered from a Pelvic Ring Fracture and have been cleared to begin getting back your normal daily or recreational activities, Physical Therapy is imperative to make sure you get back to your prior level of function. JOI Rehab has experienced Physical Therapists that can help you get back to normal life!

To book a Physical Therapy appointment call 904-858-7045 or click on the button below.



By: Jenn Dieter, MPT


References
1.Flint L, Cryer HG. Pelvic fracture: the last 50 years. J Trauma. 2010 Sep. 69(3):483-8.
2.Kimbrell BJ, Velmahos GC, Chan LS, Demetriades D. Angiographic embolization for pelvic fractures in older patients. Arch Surg. 2004 Jul. 139(7):728-32; discussion 732-3.  
3.Pisquiy JJ, Toraih EA, Hussein MH, et al. Utility of 3-Dimensional Intraoperative Imaging in Pelvic and Acetabular Fractures: A Network Meta-Analysis. JBJS Rev. 2021 Jun 24. 9 (6).
4.Routt ML Jr, Nork SE, Mills WJ. High-energy pelvic ring disruptions. Orthop Clin North Am. 2002 Jan. 33(1):59-72, viii.

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