Pelvic trauma is an extremely frequent injury to people of all ages. People that participate in sports activities are very likely to hit their pelvis. The same applies to elderly people who are also in high danger of pelvic trauma.
What exactly is the pelvis
Pelvis is an area of the body that is very often subject to injuries. It concerns patients of all ages and is the result of various types of injuries from simple falls to serious injuries due to falls from height or serious car crashes.
Pelvis connects the spine and the lower limbs. The pelvis consists of the sacrum, a triangular-shaped bone nested between the two innominate bones, which are connected anteriorly by the symphysis pubis. Each innominate bone articulates with the sacrum at the sacroiliac joint.
Who is more at risk of pelvic trauma?
Elderly people are more likely to get injured after a low-energy trauma such as ground-level falls. Patients’ various pathological problems such as sight and hearing difficulties, in combination with the difficulty to maintain their body balance, lead to frequent falls.
Usually, such injuries result in a hip fracture. Other times, it can lead to a pelvic fracture. Sometimes, we see a combination of a sacral fracture along with a fracture of one of the two innominate bones ( ischiopubic ramus). In their majority, those types of fractures have a relatively good healing probability.
Most often, we proceed with a conservative treatment for that kind of fracture due to the generally low functional requirements of the patients in combination with several health problems they might have. This includes bed rest for a few days with analgesics and then progressive mobilization with the aid of a walker and a physiotherapist.
In younger patients’ things are a little bit more complicated. The injury mechanism is always more significant, and also is the dynamic fracture. Often the sacral fracture at the posterior ring of the pelvis is combined with a fracture of the innominate bones or even a rupture of the pubic symphysis.
We can have a rupture also in the sacroiliac joints. The combination of those types of injuries in a relatively young and healthy patient, and the need for a complete recovery and return to the previous levels of sporting activities, leads the patients to surgery.
What is the goal of surgery?
The goal of the operation is to restore the high stability of the pelvic ring and early mobilization. On the contrary, the impact of extended bed rest on a patient can lead to thrombosis, loss of muscle mass, and creates difficulties in returning to the previous physical state.
Types of pelvic fractures
Acetabulum fracture is a special type of pelvic fracture. The head of the femur meets with the pelvis at the acetabulum, forming the hip joint. If the fracture is displaced, the healing can be defective and can lead to premature wearing out of the joint and the development of osteoarthritis.
A displaced acetabulum fracture is another reason to proceed to surgery. The reduction of the acetabulum fracture and osteosynthesis are crucial for the health of the hip joint.
Pelvic and acetabulum surgery requires a very specialized doctor that exceeds the capabilities of a General Orthopaedic. P. Bountogiannis, Orthopaedic surgeon has many years of experience in surgical procedures treating pelvic fractures at the Hull Royal Infirmary Hospital in Great Britain.