Definition
A pelvic fracture describes a fracture of the bony parts of the pelvis. The bony pelvis is formed by the hip bone and the lowest part of the spine, the sacrum. The hip bone in turn consists of three bony parts: the ilium, the pubic bone and the ischium, which are separate parts during the first 15 years of life and only after that do they fuse together completely to form the hip bone.
Looking at the pelvis from above, you can actually see a ring shape, hence the name pelvic ring. The pelvis serves functionally to transfer force from the spine to the lower extremity. At the same time, it protects the organs located within it, such as the bladder, uterus and intestines.
Pelvic fractures are rare, but when they do occur, they are usually serious injuries. The main causes of pelvic fractures are serious accidents with a high level of violence, such as a traffic accident or a fall from a great height. In younger adults such a fracture occurs mainly in the context of so-called polytraumas.
A polytrauma is a severe accident in which several regions of the body or organs are injured simultaneously and at least one injury of these or a combination of both is life-threatening. About one in five polytrauma patients has a pelvic injury. At an advanced age, especially from the age of 70 years, even minor injuries with little force occasionally cause a pelvic fracture.
Minor accidents, such as a fall over a carpet at home or a fall on black ice, can cause dangerous fractures of the pelvis in old age. In advanced age, women are particularly affected, as they often suffer from “bone loss” (osteoporosis). A fracture of the pelvis often occurs in combination with other injuries.
In older people, for example, a pelvic fracture often occurs in combination with a fracture of the neck of the femur, so it is important to remember this. Often the acetabulum is also involved. The hip joint is then directly affected by this fracture/ injury.
How long does the healing take?
The duration of the healing process depends largely on the type or severity of the pelvic fracture. If it is a stable pelvic fracture, the average healing time is four to eight weeks. During this time the pelvis should not be stressed.
Beyond these eight weeks, however, the load is still limited at first and pain may still occur, but the worst is over. An unstable pelvic fracture is usually operated on and healing can take longer. After the operation, the patient must remain in bed for about four weeks.
After that the patient can gradually return to everyday activities. Nevertheless, it is important that the patient is passively physiotherapeutically mobilised during the prescribed periods of bed rest in order to avoid muscle loss. In the case of a complicated multiple fracture, patients often have to remain in bed as far as possible for months. Physiotherapy plays an important role in the healing process.
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