If you have a broken pelvis, you need immediate medical help. It can be a serious injury because the pelvis houses vital nerves, organs, and blood vessels.
A pelvic fracture may result from a car or motorcycle crash or a fall in fragile older people.
At UPMC, our trauma teams offer surgical and nonsurgical treatments for mild and severe pelvic fractures.
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What Is a Pelvic Fracture?
Doctors define a pelvic fracture as a break in any of the pelvic bones — the ring-like structure at the base of the spine. Each side of the pelvis houses one hip joint.
The pelvic bones include:
- The sacrum (the large triangular bone at the base of the spine).
- The hip bones (ilium, acetabulum, ischium, and pubis).
- The coccyx (tailbone, attached to the base of the sacrum).
These bones serve as an anchor for the muscles of the abdomen, hips, and thighs, allowing you to walk and stand. They bear your weight when sitting and serve as a transition between your upper and lower body.
The pelvic bones also surround major blood vessels and organs, protecting them from injury.
These organs include the:
- Bladder.
- Lower part of the digestive system.
- Reproductive organs.
Pelvic fractures typically happen during a high-impact accident like a car crash or a fall from a great height. But milder breaks sometimes happen to older people with osteoporosis as a result of a simple fall.
A pelvic fracture can be very serious, especially if other organs or systems of the body are damaged. Serious fractures occur from high-energy injuries, such as car crashes and falls from great heights.
What are the types of pelvic fractures?
The two main types of pelvic fractures are:
Stable fractures
In a stable fracture, the broken pieces don’t move apart, so the pelvis keeps a normal or near-normal shape. The broken bones line up well, making it easier to treat. Low-impact fractures, such as those in older people with osteoporosis, are typically stable fractures. Even though there is some pain, oftentimes people can walk on stable pelvic fractures.
Unstable fractures
In an unstable fracture, there are usually two or more breaks somewhere in the pelvic ring. The ends of the broken bones don’t line up evenly. Overall, the pelvis has changed its shape. People cannot walk on these fractures.
This type of fracture is more likely to occur after a high-impact accident, a fall, or a crush injury. It is much more serious and difficult to treat than a stable fracture.
One type of unstable fracture is the “open book" pelvic fracture. It’s a severe injury in which the pubic bone separates, and the ligaments holding the halves of the pelvis get torn. This type of injury requires urgent, life-saving medical attention.
Health care providers also classify pelvic fractures as:
Closed fractures
In closed fractures, the skin is not broken.
Open fractures
In open fractures, bone fragments break through the skin. These are much more serious injuries than closed fractures. That’s because as soon as the skin gets broken, infection can set into the wound and the exposed bone.
Avulsion fractures
Avulsions are relatively rare pelvic breaks. They occur when a ligament pulls away a piece of the lower hip bone without injuring internal organs. It’s most common in young athletes who haven’t finished growing.
How common are pelvic fractures?
Pelvic fractures are relatively uncommon. According to the American Academy of Orthopedic Surgeons, they account for about 3% of all fractures in adults.
What causes pelvic fractures?
A pelvic bone fracture typically happens when the lower part of your body gets crushed.
Typical causes of a broken pelvis include:
- A car or motorcycle crash.
- A crush injury that involves being squeezed between two heavy objects.
- A fall from a ladder or rooftop.
- A mild fall or injury in an older person with osteoporosis.
Pelvic fracture risk factors
Risk factors for a pelvic fracture include:
- Advanced age.
- Driving dangerously or at high speeds.
- Not wearing a seat belt.
- Unsafe work habits or environments.
- Osteoporosis or low bone density.
- Playing high-contact sports.
Complications of pelvic fractures
Unstable pelvic fractures are at greater risk for complications than stable pelvic fractures. Some unstable pelvic fractures can be life-threatening, and other serious injuries may be caused by the same event that caused the pelvic fracture.
Without urgent treatment, immediate complications may include:
- Infection.
- Internal organ damage.
- Severe bleeding.
Long-term complications from a fractured pelvis may include:
- A limp.
- A noticeable difference in leg length.
- Complications when delivering a baby.
- Incontinence.
- Pain, especially in the lower back.
- Reduced mobility.
- Sexual problems.
How can I reduce my risk of a pelvic fracture?
You may not be able to prevent a broken pelvis if you are in a high-impact accident.
But some ways you can reduce your risks of injury are:
- Always wear a seat belt and follow traffic laws.
- Follow workplace safety guidelines.
- Get plenty of vitamin D and calcium in your diet to keep your bones strong.
- Keep your bones healthy with weight-bearing exercise.
- Limit alcoholic drinks.
- Quit smoking.
- Remove tripping hazards, such as loose rugs, from your home.
- Seek treatment for osteoporosis.
What Are the Signs and Symptoms of Pelvic Fractures?
Fractured pelvis symptoms include:
- Bruising or swelling around the hip.
- Having to keep your knee or hip bent in a certain position to avoid pain.
- Intense pain when you move your legs.
- Numbness or tingling in your legs or groin.
- Pain in your belly, hip, groin, or back.
- Pain that makes it difficult to walk or stand.
When should I see a doctor about my pelvic fracture symptoms?
If you have a pelvic fracture, someone should take you to the nearest hospital emergency department (ED). If your injuries are severe, you may be transferred to the nearest trauma center. If you have already been treated by a doctor but your symptoms are getting worse, you should let your health care provider know.
How Do You Diagnose Pelvic Fractures?
Your doctors will first do a physical exam.
They will:
- Look at your hips, legs, and pelvis.
- Look carefully at the rest of your body to see if you have other visible injuries.
- Test for nerve injury — They’ll do this by asking you to move your ankles and toes. They’ll also check whether you have sensation at the bottoms of your feet.
Tests to diagnose pelvic fractures
After the physical exam, your doctor will likely order some imaging tests. These will give them a better idea about the location and extent of your pelvic fracture.
The tests include:
- CT scans — Provide a detailed, cross-sectional view of the pelvis. It helps your doctor see the extent of the injury and if there are other problems. The images can help them plan for surgery if it’s needed.
- MRI scans — Check for fractures that may not show up on CT scans or x-rays.
- X-rays — Show images of bones. Your doctor may take x-rays from several angles to see if bones have shifted out of place.
Pelvic fracture outlook
How well you recover from a pelvic fracture depends on your age, your overall health, and the extent of the fracture. It also depends on whether you had other critical injuries.
When you’re first recovering, daily activities may be difficult. Even sitting and sleeping can be challenging, because it’s hard to get in a comfortable position. Using a pillow between your legs can help keep your hips straight and avoid twisting your pelvis.
Severe pelvic fractures or those that occur in older people can affect you for the rest of your life. You may have complications or need a walker or other device to get around.
However, most people with a stable pelvic fracture eventually return to living a normal life.
How Do You Treat Pelvic Fractures?
The first goal of treatment is to stabilize any critical injuries that may have occurred at the same time as the pelvic fracture. The trauma team will want to care for airway, breathing, and blood flow problems before treating your pelvic fracture. Significant blood loss, for instance, could lead to shock.
After you are stable, the next goal is to treat the pelvic fracture and any other major injuries.
Pelvic bone break treatments include:
Nonsurgical treatments for pelvic fractures
If you have a stable pelvic fracture, your treatment may include:
- Medications — Your doctor may prescribe acetaminophen or ibuprofen to manage pain and inflammation. They may also recommend blood thinners to prevent blood clots in your legs and pelvis. Ice packs can help relieve pain and swelling.
- Walking aids — You may not be able to put weight on one or both legs right away. Your doctor may prescribe crutches or a walker for up to three months, or until your bones are fully healed. If you can’t use both legs, you may need a wheelchair for a while.
Surgery for pelvic fractures
If you have an unstable pelvic fracture, you’re more likely to need surgery. You may need more than one procedure, depending on the extent of your injuries.
Types of surgery include:
- Binders or wrapping sheets — A special belt or well-folded sheet can be wrapped around the pelvis. This helps temporarily hold the pelvic fracture still. This is done in the emergency room to help control the pelvic fracture, while doctors treat other injuries. Though not surgery, pelvic binders are often placed on a pelvis that will need surgery for the fractures.
- External fixation — uses metal pins or screws inserted into the pelvic bones. They extend through the skin and attach to a carbon fiber frame outside the body. This acts as a frame to hold the broken bones in the right place.
- Open reduction and internal fixation — Doctors reposition bone fragments into their original place. Screws or metal plates are attached to the outer surfaces of the bones to hold them together.
How effective is treatment?
How well treatment works will depend on the extent of your injuries. Stable pelvic fractures usually heal well, with fewer complications than unstable fractures.
How long does it take to recover after treatment for a pelvic fracture?
What is the fastest way to heal a broken pelvis? There’s not one single answer. Treatment and healing time will depend on the extent of the injury, your overall health, and whether you have had any other injuries.
In general, recovery from a broken pelvis can take anywhere from eight to 12 weeks. If you had multiple injuries or complications, it may take up to a year to fully heal.
If you had nerve or organ damage, you may have some long-lasting complications, like reduced mobility and incontinence.
But with regular follow-up care, you can greatly improve your quality of life after a pelvic fracture.
Why Choose UPMC for Pelvic Fracture Care?
At UPMC, you’ll receive world-class care for your pelvic fracture. UPMC has one of the most comprehensive trauma systems in the country.
Here are some of the reasons to choose UPMC for your care.
- A wide range of specialists — No matter what kind of injury you have, we have an expert to treat it, day or night. We offer specialized emergency care for complex fractures.
- Close to home — UPMC has Level I and Level II trauma centers — the highest levels — throughout Pennsylvania and nearby states.
- Decades of experience — For more than 30 years, the trauma program at UPMC has provided state-of-the-art emergency care.
- High volume of critical injuries — Each year, we treat thousands of adults and children with life-threatening, traumatic injuries.
