Introduction
An ischial fracture describes the fracture of the ischium (lat. Os ischii) in one or more places. The fractures are divided into upper and lower ischial fractures, as well as stable and unstable fractures. In the stable fracture, there is usually only a fracture at one location and there are no displaced fragments, in contrast to the unstable fracture. Like all fractures of the pelvic bone, the ischial bone fracture is a serious injury that should always be examined by a physician.
Causes
The ischium, like the entire human pelvis, is a very stable bone. Strong forces must be applied to it to cause it to break. One cause is traffic accidents at high speed, for example when a pedestrian is hit by a car.
A fall from a great height can also result in an ischial fracture. In sports, a muscle that originates from the ischium can tear out a piece of its bony anchoring under strong tension. However, this injury, known as an avulsion fracture, is rare and mainly affects young, still growing athletes.
There are also some diseases that weaken the bones and make them more susceptible to fractures. These include osteoporosis, which mostly affects older women, and various cancers, although these are much rarer. If a bone is weakened by a corresponding disease, even small forces in a so-called minor trauma are sufficient to lead to an ischial bone fracture.
Symptoms
The ischial fracture is often accompanied by severe pain that can radiate to the buttocks. In order to avoid the pain, a relieving posture is usually adopted in which the hip is bent and the affected side is relieved as much as possible. Every movement and load on the hip noticeably aggravates the pain.
Unstable fractures with moving bone parts can cause a feeling of bone rubbing. In the course of an accident, organs, blood vessels and nerves can also be damaged. Therefore, there may be bleeding from the anus, urethra or vagina or pain radiating into the abdomen.
If a nerve is damaged, parts of the skin above the hip or in the leg and foot may be numb or the corresponding muscles paralyzed or weak. Nerve injury can also lead to urinary incontinence. Bleeding can cause bruising behind the organs and cause pain in the lumbar spine.
If larger vessels, e.g. in the leg or pelvis, are injured, the high blood loss can also lead to dizziness and fainting. In principle, long-lasting pain must be expected after an ischial fracture. If such a stable bone is broken, it takes a correspondingly long time to heal, which causes the patient pain.
Accompanying injuries to nerves can also cause painful sensations or hypersensitivity to touch or high and low temperatures. How long one has to suffer from the pain varies from person to person and depends on the severity of the injury and other damaged structures. The type of therapy also has an influence on the duration of the pain.
However, it is possible that pain may still exist six to eight months after an ischial fracture. A complication that can generally occur with bony injuries is Complex Regional Pain Syndrome (CRPS). This is a disturbed wound healing of the injured tissue, which leads to chronic pain that is difficult to control. However, it is very rare.
