Complications of pelvic fractures

Many people do not know what pelvic fracture is. In fact, it cannot be said to be a disease, it is a situation or a phenomenon. Pelvic fractures are mainly caused by external force. The force of this external force is enormous, and it mainly occurs in some traffic accidents and landslides. Because the disease is easily misdiagnosed, the mortality rate is very high.

If pelvic fractures are not treated promptly or are treated incorrectly, it can easily cause pelvic fracture complications. This complication is very scary for many people. If you don’t believe it, you can look at the following.

Pelvic fracture is a serious trauma, mostly caused by direct and violent pelvic compression. It is common in traffic accidents and landslides. In wartime, it is caused by firearms. More than half of pelvic fracture traumas are accompanied by complications or multiple injuries. The most serious is traumatic hemorrhagic shock and combined injuries to pelvic organs, which have a high mortality rate if not properly treated.

Disease Overview

Pelvic fracture is a common fracture with a high incidence rate. Pelvic fractures account for nearly 3% of all skeletal injuries. The main causes of pelvic fractures in adults include: motor vehicle collisions accounting for 57%, pedestrians being hit by vehicles accounting for 18%, motorcycle collisions accounting for 9%, falls from heights accounting for 9%, and crush injuries accounting for 5%. The incidence of pelvic fractures in adolescent patients is relatively low, at approximately 0.5%-7%. The most common causes are motor vehicle accidents, pedestrians being hit by vehicles, and falls from heights. With the development of society, the increase in accidental injuries such as traffic accidents and work-related injuries has significantly increased the incidence of pelvic fractures caused by high-energy injuries, among which unstable pelvic fractures account for about 7%-20%, seriously threatening the lives of patients. The mortality rate for patients with pelvic fractures ranges from 5% to 30%.

1. Retrocutaneous hematoma. The bones of the pelvis are mainly cancellous bones, the pelvic wall is rich in muscles, and there are many arterial and venous plexuses nearby, with rich blood supply. The gap between the pelvic cavity and the posterior skin membrane is composed of loose connective tissue, and there is a huge space to accommodate bleeding, so fractures can cause extensive bleeding. Huge retrocutaneous hematomas may extend to the renal area, subdiaphragmatic area, or mesentery. Patients often suffer from shock and may have symptoms of peritoneal irritation such as abdominal pain, abdominal distension, decreased bowel sounds, and abdominal muscle tension. In order to differentiate it from intra-abdominal bleeding, diagnostic abdominal puncture can be performed, but the puncture should not be too deep to avoid entering the retroperitoneal hematoma and being mistaken for intra-abdominal bleeding. Therefore, close and careful observation and repeated inspection are necessary.

2. Injury to the urethra or bladder. The possibility of lower urinary tract injury should always be considered in patients with pelvic fractures, as urethral injuries are far more common than bladder injuries. Patients may experience difficulty urinating and bleeding from the urethra. The incidence of membranous urethra injury is higher in cases of bilateral pubic ramus fractures and pubic symphysis separation.

3. Rectal injury. Unless the pelvic fracture is accompanied by an open injury to the genitals, rectal injury is not a common complication. If rectal rupture occurs above the peritoneal reflection, it can cause diffuse peritonitis; if it occurs below the reflection, perirectal infection may occur, often with anaerobic bacteria.

4. Nerve damage. It often occurs when the sacrum is fractured. S1 and S2, which make up the lumbar sacral nerve trunk, are most vulnerable to injury. The gluteal muscles, hamstrings and calf gastrocnemius muscles may become weak, and there may be loss of sensation in the posterior calf and lateral part of the foot. When the sacral nerve is severely injured, the Achilles tendon reflex may disappear, but sphincter dysfunction rarely occurs. The prognosis is related to the degree of nerve injury. Mild injuries have a good prognosis and can generally be expected to recover within a year.

The above is an introduction to the complications of pelvic fractures. I believe that everyone will understand this complication clearly after reading it. If something unexpected happens to your body, you must know how to deal with it and know what happened. Combined with the doctor's advice and treatment, you can recover better.