CHECK-UP:The pelvis comprises a number of bones and the seriousness of a fracture depends on how many are broken, writes MARION KERR
MY FRIEND – a lively 70 year old – fell and fractured his pelvis at home. Can you tell me how serious this type of fracture usually is?
The pelvis is a ring-like structure of bones at the lower end of the trunk, comprising three separate bones on each side – the ilium, ischium and the pubic bone, which fuse together as we age. Strong ligaments join the pelvis to the large triangular bone called the sacrum at the base of the spine.
The entire structure forms a bowl-like cavity below the rib cage where many digestive and reproductive organs are located. A hollow cup (the acetabulum) on each side of the pelvis acts as the socket for the hip joint.
In addition, the muscles that move the legs are attached to the pelvis and the large nerves and blood vessels that serve the lower limbs also run through it. Older people with osteoporosis are at higher risk of sustaining this type of fracture which can occur as a result of a simple fall or slip.
If the force of the fall results in the fracture of an individual bone then the structural integrity of the pelvic ring may remain intact.
More extensive fractures of the pelvis usually occur as a result of high energy force, the type experienced in a car crash. Depending on the degree of force and extent of the injuries, this type of fracture can be life threatening and requires surgical intervention.
He was given a walker to use but is reluctant to do so. Does he really need it, particularly around the house?
A fracture of the pelvis can usually be detected on X-ray or CT scan. Treatment of a stable fracture is usually conservative rather than surgical.
Crutches or a walking frame will be required to avoid weight bearing through the leg on the side of the fracture for a period of up to three months or until the bones have healed.
Most stable pelvic fractures heal well but if your friend continues to bear weight, it may slow the rate of bone and muscle repair and he may be left with impaired mobility as a result. As mobility will be restricted for several months, blood-thinning medication may be prescribed to reduce the risk of blood clots forming in the leg veins.