Diagnosis | Ischial fracture

Diagnosis

Most ischial fractures show up in the X-ray image as fracture lines or displaced bone fragments. If there is a suspected injury to internal organs of the abdomen or pelvis, a CT or MRI scan may also be necessary to safely find and treat the injury. A urinalysis and cystoscopy are indicative of an injury to the urogenital tract, as is palpation of the male prostate. A gynaecological examination should also be performed, especially in pregnant women. In case of a slight fall of an elderly person, a disturbed pain sensation and the untypical accident mechanism can make it difficult to find the fracture.

Therapy

Depending on the type and severity of the injury, the therapy must be adapted accordingly. Abrasion fractures often only require immobilization and painkillers. Stable fractures can be treated with walking aids for relief.

A pain-adapted load should be applied in which the patient only performs movements that do not hurt him. Unstable fractures require surgical treatment.The bone pieces are brought into their correct position in an open surgery or with a system of weights from the outside and then fixed with wires, nails, screws or plates. In any case, physiotherapy as soon as possible is important and should be maintained for a comparatively long time after the accident.

A consistent pain therapy must be carried out. Depending on the severity of the pain, anti-inflammatory drugs such as ibuprofen or opioids may be necessary. Opioids are strong drugs and have quite high side effects and a high addiction potential, which is why they should not be given on a long-term basis.

During immobilization, drugs to thin the blood must be taken. In general, physiotherapy should start as early as possible with a pain-adapted load. Here, patients exercise under professional supervision as well as their position allows without pain.

This prevents excessive muscle loss and a malposition of the joints. The pain improves and there is effective protection against thrombosis and pneumonia, which can affect older, bedridden patients in particular. In addition, the risk of a permanently disturbed gait pattern or a chronic feeling of instability is reduced.