Pelvic fracture

Pelvic fracture
Classification and external resources
ICD-10	S32.3, S32.4, S32.5, S32.8
ICD-9-CM	808
DiseasesDB	9739
eMedicine	emerg/203
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Pelvic fracture is a disruption of the bony structure of the pelvis, including the hip bone, sacrum and coccyx. The most common cause in the elderly is a fall, but the most significant fractures involve high-energy forces such as a motor vehicle crashes, cycling accidents, or a fall from significant height. Diagnosis is made on the basis of history, clinical features and special investigations usually including X-ray and CT. Because the pelvis cradles so many internal organs, pelvic fractures may produce significant internal bleeding which is invisible to the eye. Emergency treatment consists of advanced trauma life support management. After stabilisation, the pelvis may be surgically reconstructed.

The bony pelvis consists of the ilium (i.e., iliac wings), ischium, and pubis, which form an anatomic ring with the sacrum. Disruption of this ring requires significant energy. When it comes to the stability and the structure of the pelvis, or pelvic girdle, understanding its function as support for the trunk and legs helps to recognize the effect a pelvic fracture has on someone. The pubic bone, the ischium and the ilium make up the pelvic girdle, fused together as one unit. They attach to both sides of the spine and circle around to create a ring and sockets to place hip joints. Attachment to the spine is important to direct force into the trunk from the legs as movement occurs, extending to one’s back. This requires the pelvis to be strong enough to withstand pressure and energy. Various muscles play important roles in pelvic stability.Because of the forces involved, pelvic fractures frequently involve injury to organs contained within the bony pelvis. In addition, trauma to extra-pelvic organs is common. Pelvic fractures are often associated with severe hemorrhage due to the extensive blood supply to the region.

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