If a hip or pelvic fracture is nondisplaced, meaning the bone fragments remain in place, orthopedic specialists at NYU Langone may recommend noninvasive treatments to help speed healing. After a hip or pelvic fracture, your doctor may advise you not to put any weight on the affected hip for six weeks or more. This allows the bone to heal. Your doctor can provide crutches, a walker, a cane, or a wheelchair to help you get around. A lack of movement may also cause blood clots, called deep vein thrombosis , to form in the leg and block blood flow.
Your doctor may recommend stretching and range-of-motion exercises in muscles and joints aside from those in the affected hip to maintain strength and improve blood flow, which stimulates healing.
Your doctor may recommend a technique called bone stimulation to help speed bone healing. Bone stimulation uses a low electric current or low-intensity pulsed sound waves. If a fracture is slow to heal, your doctor may also recommend a portable unit that can be used daily at home. In electronic bone stimulation, a doctor places a small electrode or electrodes—flat discs that adhere to the skin and conduct electricity—onto the skin near the fractured hip or pelvic bone.
The electrodes are connected to a machine that sends a low electrical current to the affected bone. This technique jump-starts the healing process by stimulating your body to produce proteins that begin to repair cells at the site of the injury. Until help arrives a person with a suspected pelvic fracture should be covered with a blanket or jacket and should not be moved by non-trained personnel, especially if there is severe pain.
If you are at a serious road accident and a person is walking around, get them to sit still. Ask if there is any pain anywhere, particularly in their chest, tummy abdomen or hips. If there is pain anywhere near the pelvis they could have a major pelvic fracture, and you should assume they are seriously injured and keep them still and warm until emergency services arrive. It is well known that sometimes people walk around with severe pelvic fractures immediately after road accidents, as shock can prevent them from initially feeling much pain.
Reduction in bleeding from the pelvis is initially helped by keeping the pelvis as stable as possible. Initially this is done by binders and sheets, followed by stabilisation using external fixation see below.
This involves long screws inserted into the bones from the sides and a large external frame. It is done in the operating theatre, under anaesthetic. It helps prevent further blood loss by holding the bones together. The metal pins or screws are inserted into the bones through small incisions into the skin and muscle. They project out of the skin on both sides of the pelvis where they are attached to carbon fibre bars.
The external fixator acts as a stabilising frame to hold the bones in proper position. This involves a pulley system of external pins in the bones, with weights and counterweights. It helps line up the pieces of bone. Skeletal traction is sometimes used as a temporary treatment, and it often provides some pain relief. Occasionally, pelvic fractures are treated with skeletal traction alone but this is unusual.
A few patients require internal fixation to keep the bones in place. This is open surgery, performed under anaesthetic. The bone fragments are repositioned, then held together with screws or metal plates which are left permanently in place.
Getting the pelvis fixed and stable is very important both for pain control and for the long-term results of your treatment. It is more likely to be necessary if there are multiple fractures. Pain is managed using painkillers and by stabilising an unstable pelvis. Strong painkillers and local anaesthetics may initially be needed. You may at first have an epidural anaesthetic to help manage the initial pain. Doctors usually prescribe 'blood thinners' anticoagulants to reduce the risk of blood clots forming in the veins of your legs and pelvis.
Pelvic fractures are known to increase the risk of blood clots. Initial treatment is with pain relief and bed rest, followed by mobilisation. Doctors will want to get you moving as soon as possible, as this is better for your long-term recovery, and also reduces the risk of blood clots forming deep vein thrombosis.
However, you are likely to need to use crutches or a walker for around three months, or until your bones are fully healed.
If you have injuries above both legs, you may need to use a wheelchair for a period of time so that you can avoid putting any weight on either leg. You will be seen regularly by physiotherapists who will try to help you keep muscle strength and joint mobility whilst you are not able to weight bear.
Once you start to weight bear, physiotherapy will still be needed to strengthen your muscles and help you regain your balance, as you may find this is much less good when you first start walking again. Surgical treatment is not usually needed for stable fractures.
Crutches and walking aids are likely to be used as part of your recovery, and physiotherapy will be an essential part of your treatment. Treatment of pelvic avulsion fractures is with rest.
These fractures usually heal by themselves over weeks. Initially, applying ice can help pain and inflammation. Occasionally, surgery is needed to re-attach the bone and tendon to the pelvis; however, this is mainly reserved for unusually large avulsion fractures. Following the rest period, a gradual rehabilitation programme can be commenced which aims to regain full strength and movement at the hip. Pelvic stress fractures can cause lingering, worsening pain and may become full-thickness fractures, so rest from the activity which caused them is very important.
A gradual reintroduction to running can begin after a few weeks, once the athlete is pain-free. Some specialists now suggest treatment with an infusion of pamidronate , a drug more commonly used to treat 'thinning' of the bones osteoporosis. This treatment appears to be fairly effective in speeding the healing of stress fractures, even in patients without osteoporosis. Most people who experience pelvic fracture walk again after a few months. Recovery will be quicker if the fracture is less severe and if you are younger and fitter, or if you have healthy active muscles.
Sometimes, major pelvic fracture can affect your mobility in the long term. World J Emerg Surg. I'm worried about falling asleep. Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Egton Medical Information Systems Limited has used all reasonable care in compiling the information but make no warranty as to its accuracy.
Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions. In this series. In this series: Recovering from a Pelvic Fracture. You may be asked to be non-weight bearing through one leg or hip and so you will need to use crutches to mobilise.
A physiotherapist will teach you to do this. You may need to use crutches for a period of up to eight weeks or longer. If you have other injuries, your consultant may ask you to not weight bear at all on your legs whilst your injuries heal. In this case, you will need to use a wheelchair for a short period of time. Mobility is reviewed on an individual basis when you are seen in the outpatient clinic and have had an x-ray.
Click here for more information about pelvic surgery. The majority of patients resume a normal sex life once the pelvic fractures have healed, though remember the amount of weight you have been asked to restrict through your hip and leg also applies to any sexual position.
Please discuss this with your orthopaedic consultant so you can be correctly counselled. If you have experienced damage to your bladder, rectum or vagina at the time of your injury, you may have problems with sexual dysfunction.
Sometimes pelvic injury can cause pain during intercourse for women and erectile dysfunction in men. Your consultant will advise you of this and can refer you to the most appropriate team to help you. Click here for more information about related injuries and possible complications following pelvic surgery. Returning to work will depend on a number of factors; your occupation, your injuries and the surgery undertaken.
Most patients find they are able to start sports after four to six months once fully healed, but your consultant will advise you based on your specific injuries and surgery when you come back for your outpatient appointment. We use cookies to improve your experience of our site. Online Community: Sign In Register. Home Recovery Info What is Trauma?
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