Is a comminuted pelvic fracture serious?

For women, the pelvis can be said to be an important "armor" to protect the uterus. If you are hit by a heavy object or unfortunately fall and suffer a comminuted fracture of the pelvis, you should seek medical attention immediately to prevent the pelvic bone fragments from damaging the uterus. Generally speaking, comminuted pelvic fractures require surgical treatment. After treatment, the patient needs to rest in bed and perform rehabilitation exercises, and can only work after 3-5 months.

The pelvis is divided into two parts by an oblique boundary (starting from the sacral promontory at the back, passing through the iliac arcuate line, iliopectine protuberance, pubic pecten, pubic tubercle, pubic crest to the upper edge of the pubic symphysis): the part above the boundary is called the greater pelvis, also known as the false pelvis, and its bone cavity is the iliac fossa of the abdominal cavity; the greater pelvis participates in the formation of the abdominal cavity. The area below the boundary is called the small pelvis, also known as the true pelvis. Its inner cavity is the pelvic cavity. The anterior boundary is the pubic bone and pubic symphysis, the posterior boundary is the front of the sacrum and coccyx, the two sides are the inner surface of the hip bone, the obturator membrane and ligament, and there are greater and lesser sciatic foramina on the side walls. The pelvis refers to the small pelvic part below the boundary line, which includes the pelvic wall, pelvic diaphragm and pelvic organs. The upper opening of the pelvis is surrounded by the boundary line, and the lower opening is sealed by the pelvic diaphragm. The soft tissue below the pelvic diaphragm is called the perineum.

The pelvis is composed of the sacrum, coccyx, and two hip bones (formed by the fusion of the ilium, ischium, and pubis). The sacrum and ilium, and the sacrum and coccyx are supported and connected by strong ligaments to form joints, which are generally immobile. After pregnancy, under the influence of hormones, the ligaments relax slightly, and the joints become slightly loose, which is beneficial for delivery.

The dangers of pelvic comminuted fracture

1. Pelvic fractures may damage pelvic organs, especially the bladder and urethra. The repair situation and sequelae depend on the severity of the injury and the judgment of the urologist.

2. Since the nerves are not injured, urinary incontinence and other conditions generally will not occur, but urethral stenosis and other conditions may occur.

3. If the injury is minor, it should not have much impact on the condition of the uterus.

4. There are two main aspects of the impact of pelvic deformation: A. Impact on childbirth (this depends on the degree of deformation), but caesarean section can be used to solve this problem in the future. B. Due to the tilt of the pelvis, the lower limbs are of unequal length, which affects walking. But since the internal fixation surgery has been done, I believe there will be no dislocation at present, at least no obvious dislocation. So there is no need to worry too much about these two aspects.

5. Pelvic fractures usually cause heavy bleeding and can easily be life-threatening due to hemorrhagic shock. But I guess all these have passed now, and I just need to slowly recover and recuperate for some time. As for how many more surgeries will be needed, I think it may mainly depend on the situation of urology (that is, the recovery of the urethra and bladder).