Pelvic Fracture

Overview

A pelvic fracture is a break in one or more of the bones that make up the pelvis, the sturdy ring of bone at the base of the spine that supports the upper body and protects organs such as the bladder, bowel, and major blood vessels. Pelvic fractures range widely in severity. A minor, stable fracture, such as a small crack from a fall in an older adult, may heal with rest. A severe, unstable fracture from a high-impact crash can be life-threatening because of internal bleeding and organ injury.

Because the pelvis surrounds important blood vessels and organs, serious pelvic fractures are treated as emergencies. Even stable fractures need proper evaluation to confirm the bones are not displaced and to guide healing. Treatment depends on the type of break, how stable it is, and whether other injuries are present.

Symptoms

The most common symptom is pain in the pelvis, hip, or groin that worsens with movement.

• Pain in the groin, hip, lower back, or buttocks
• Pain that increases when walking, standing, or moving the legs
• Difficulty or inability to bear weight or walk
• Swelling, bruising, or tenderness over the pelvis
• Numbness or tingling in the groin or legs in some cases

Signs of a severe fracture with internal bleeding include feeling faint or dizzy, a rapid heartbeat, pale clammy skin, and trouble passing urine or blood in the urine. These require emergency care immediately.

Causes

Pelvic fractures are caused by force applied to the bones of the pelvis. Common causes include:

• High-energy trauma: motor vehicle crashes, motorcycle accidents, or falls from a height, which often cause severe, unstable fractures.
• Low-energy falls: a simple fall, especially in older adults with weaker bones, can cause a stable fracture.
• Sports injuries: sudden forceful muscle pulls can break off a small piece of bone (avulsion fracture), more common in young athletes.
• Weakened bone: osteoporosis or bone disease can make fractures occur with less force.

Risk Factors

• Older age with thinning bones
• Osteoporosis or other conditions that weaken bone
• High-risk activities such as motorcycling or contact sports
• Previous fractures
• Conditions that increase fall risk, such as poor balance

Diagnosis

Doctors diagnose pelvic fractures using imaging and a careful exam:

• X-rays: the first test to look for breaks and how the bones line up.
• CT scan: gives detailed images of complex fractures and helps assess stability and nearby injuries.
• Physical exam: checking for tenderness, deformity, and pelvic stability, along with nearby organs.
• Additional tests: blood tests, urine tests, and scans to look for bleeding or injury to the bladder, bowel, or blood vessels in severe cases.

Treatment

Treatment depends on the type and severity of the fracture.

• Stable fractures: often managed without surgery, using pain control, rest, and a gradual return to walking, sometimes with a walker or crutches.
• Unstable or displaced fractures: may need surgery with plates, screws, or rods to hold the bones in place while they heal.
• Emergency stabilization: severe fractures with bleeding may require a pelvic binder, blood transfusion, and procedures to stop bleeding.
• Rehabilitation: physical therapy helps restore strength, movement, and walking after healing.

Recovery time varies from several weeks for minor fractures to months for severe injuries.

Prevention

• Keep bones strong with adequate calcium, vitamin D, and weight-bearing exercise
• Get screened and treated for osteoporosis if you are at risk
• Reduce fall hazards at home, such as loose rugs and poor lighting
• Use seat belts and proper protective gear during high-risk activities
• Address balance and vision problems that raise fall risk

When to See a Doctor

See a doctor for pelvic or groin pain after a fall or injury, especially if you cannot walk comfortably. Call emergency services right away after a high-impact injury or if you have:

• Severe pelvic, hip, or groin pain
• Inability to move the legs or bear weight
• Feeling faint, dizzy, or a rapid heartbeat
• Blood in the urine or trouble urinating
• Significant swelling or bruising of the pelvis

Severe pelvic fractures can cause dangerous internal bleeding and need urgent treatment.

Related Topics

Frequently Asked Questions

References

1. American Academy of Orthopaedic Surgeons (AAOS). Pelvic fractures.
2. Mayo Clinic. Broken bones.
3. MedlinePlus, U.S. National Library of Medicine. Pelvic fractures.
4. National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). Osteoporosis.