Complete information on hip & hip fractures (pelvic fractures)

Fractures or fractures can occur in any area of ​​the bone, including the hands, feet, wrists, and ankles. However, apart from these common bone locations, fractures can also occur in the hip and pelvic area (pelvic fractures). To find out more about these types of fractures, here is complete information about pelvic fractures that you need to know.

What is a pelvic fracture?

Pelvic fractures are fractures that occur in one or more of the bones that make up the pelvis. The pelvis is a group of bones at the end of the torso, between the spine and the legs. Its function is to help bind muscles and protect organs in the lower abdomen, such as the bladder, intestines and rectum.

The pelvis covers the sacrum (the large triangular shaped bone at the base of the spine), coccyx (coccyx), and hip bones. The hip bones, both on the right and left, consist of three bones called the ilium, pubis, and ischium.

These three bones separate during childhood, but then fuse with age. The meeting of these three bones also forms the acetabulum, which is the part of the pelvis that is shaped like a hollow cup and functions as a socket for the hip / hip joint. The acetabulum joins the pelvis with the thighbone (femur).

Pelvic fractures are a rare type of fracture. OrthoInfo said, the number of hip fracture cases only occurs about 3% of all types of fractures in adults. There are more common types of fractures, such as wrist fractures, ankle fractures, and collar or shoulder fractures.

Although rare, serious hip fractures can be life threatening. This is because the pelvis is close to large blood vessels and organs, so a broken bone at this location can cause organ damage and bleeding. Therefore, this type of fracture often requires emergency medical care.

Pelvic fracture signs and symptoms

Common signs and symptoms of a pelvic fracture or hip and hip fracture are:

• Pain in the groin, hips, or lower back.
• Unable to get up or stand up, especially after a fall.
• Unable to lift, move, or rotate the leg.
• Difficulty walking.
• Swelling and bruising in the pelvic area and around it.
• Numbness or tingling in the groin or legs.
• Unequal leg length, usually the leg on the injured hip side is shorter than the other side.
• The leg on the side of the injured hip is pointed outward.

In severe cases, a hip fracture can cause symptoms, such as bleeding from the vagina, urethra (the tube that carries urine from the bladder out of the body), or rectum (a space that contains solid waste from the large intestine to be discharged outside the body), or difficulty urinating. If you have one or more of these symptoms you should immediately consult a doctor.

Causes & risk factors for pelvic fracture

A common cause of pelvic fractures or hip and hip fractures is a violent impact to the area of ​​the bone, such as a high-speed car or motorbike accident or a fall from a height. In this condition, pelvic fractures can occur in people of any age who are still healthy.

However, fractures in the pelvis and hips can also be caused by weakened bone conditions, such as osteoporosis. In people with this condition, even a slight impact to the pelvis can fracture that area of ​​the bone. The cause of this pelvic fracture generally occurs in the elderly due to aging factors that cause osteoporosis.

In rare cases, hip fractures can also occur due to high athletic activity, causing the ischium to tear from the muscle attached to the bone. This condition is also known as a type of avulsion fracture. The avulsion fracture in the pelvis usually occurs in young athletes.

In addition to the causes above, there are several factors that increase a person's risk of developing a fracture in the pelvis or pelvis and hips, namely:

• Female gender, especially after entering menopause, which can cause loss of bone density faster than men.
• Increasing age. The older you are, the more prone to hip and hip fractures you become.
• Family history, in which if your parents had a hip fracture, you are at high risk for the same.
• Not getting enough calcium and vitamin D. Both of these nutrients are important for strengthening bones.
• Lack of exercise, such as walking, causes bones and muscles to weaken and is more likely to fall and fracture your hip.
• Smoking habits and excessive alcohol consumption.
• Medical conditions that affect the brain and nervous system, which increase the risk of falling, such as stroke, dementia, Parkinson's disease, and peripheral neuropathy.
• Other chronic medical conditions, such as endocrine disorders that cause brittle bones, intestinal disorders that reduce calcium and vitamin D absorption, and having low blood sugar and low blood pressure that increase the risk of falling.
• Long-term consumption of certain drugs, such as steroids.

Pelvic fracture diagnosis

To diagnose a fracture or pelvic fracture, your doctor will examine the physical symptoms of your pelvis and hips. Then, imaging tests will be done to confirm the diagnosis and check the severity of your fracture. Tests that may be done such as:

• X-rays, can show a broken bone.
• A CT scan can show more detailed areas of the bone, especially for more complicated cases of pelvic fractures.
• MRI, which shows more detailed images of the bone and surrounding tissue, especially to examine possible stress fractures.
• Urethrography, which can show images of the urethra to see if there is damage from a fracture.
• Angiography, which can show images of the blood vessels around the pelvis.

Hip and hip fracture treatment

Treatment for pelvic fractures varies from patient to patient. This will depend on the pattern of the fracture, how much bone has shifted, the condition of the injury, and the patient's overall condition.

In a non-severe hip fracture, where the bone has not shifted or has only shifted slightly, non-surgical treatment is sufficient to treat the condition. However, this type of fracture does not require a cast like the fracture of the hand and foot.

In this condition, you may only need to use a walker, such as crutches (cane) or a wheelchair, for at least three months until your bones heal. You will also receive pain relievers, non-steroidal anti-inflammatory drugs (NSAIDs), or anticoagulants to reduce the risk of blood clots in the pelvis and legs.

However, in severe hip fractures, surgery is the most effective treatment for this condition. However, before surgery, the doctor will first treat shock, internal bleeding, and organ damage that may occur. The aim is to control bleeding and stabilize the condition of the injured patient.

During surgery, you may undergo one or more types of fracture surgery. Here are some types of surgery for pelvic fractures that are commonly performed:

• Internal pen fixing operation

In this type of fracture surgery, the bones are aligned to their normal position and then held together using a screw-shaped pen or metal plate on the surface of the bone. This pen serves to hold the bone in position until it heals.

• External pen fixing operation

As well as internally, the doctor may use a fixation or pen that is placed externally on the outside of your skin or body. In this type of surgery, screws are inserted into the bone through small incisions in the skin and muscles. Then the screws are made to protrude from the skin on either side of the pelvis.

From these protruding screws a carbon fiber rod is attached to the outside of the skin, which serves to hold the broken bone in the right position. In some cases, this can be used externally until the bone heals. However, in patients who cannot use this device for long periods of time, external fixation is only applied until other treatment procedures can be performed.

• Hip replacement surgery

Especially for the hip area, especially in the acetabulum, hip replacement surgery is often recommended. This type of surgery is performed if your hip fracture has interfered with the blood supply to the ball part of the hip joint.

These injuries are common in older people with fractures femoral neckor the neck of the femur which tends not to heal properly. As for the pen insertion surgery alone is not sufficient to repair and stabilize the bone.

This type of surgery can be done totally or partially. In total hip replacement surgery, the upper femur (thigh) bone and socket in the pelvis are replaced with a prosthesis or artificial bone made of metal.

The partial hip replacement surgery is performed by removing the head and neck of the fractured femur and replacing it with a metal artificial bone. This type of surgery is usually performed when a broken bone tip is displaced or damaged and is generally recommended for adults who have other health conditions or cognitive impairments that are unable to live independently.

• Skeletal traction

Skeletal traction is a device consisting of a pulley, strings, weights and a metal frame that is fixed over the bed. This load pulley system is used to help realign the pieces of bone to the correct position.

In hip and hip fractures, skeletal traction is often used after injury and released after surgery. Sometimes, a fracture in the acetabulum can be treated with skeletal traction alone. However, this decision is very rare.

In skeletal traction, metal pins are implanted in the femur and shin to help position the legs. Then weights will be placed on the pin to pull the leg and keep the fracture in the right position.

Recovery period after pelvic fracture treatment

After undergoing the above treatments, you will generally enter a period of rehabilitation or recovery. During this period, you generally need physical therapy to strengthen your muscles and bones, so they can help you move.

You may also take occupational therapy to help you with your daily activities, such as bathing, dressing, and cooking. In occupational therapy too, the therapist determines whether you need a walker or wheelchair for activities.

During the recovery period, don't forget to always meet the nutritional needs needed, by eating the recommended foods for fractures. Consult a doctor for more information.