Symptoms of pelvic fracture, you have to read it!

Some female friends experience urethral bleeding, perineum swelling and other adverse symptoms for unknown reasons. In fact, these are typical symptoms of pelvic fracture. In addition, the posterior superior iliac spine may also increase, decrease or move upward.

1. Symptoms

1. The patient has a history of severe trauma, especially trauma involving pelvic compression.

2. The pain is widespread and worsens when moving the lower limbs or sitting. Local tenderness, congestion, rotation and shortening of the lower limbs, bleeding from the urethral orifice, and swelling of the perineum may be seen.

3. The umbilical spinous distance may be seen to increase (dissociated fracture) or decrease (compression fracture); the posterior superior iliac spine may be increased (compression fracture), decreased (dissociated fracture), or moved upward (vertical fracture).

4. The pelvic separation compression test, figure-of-four sign, and torsion test are positive, but are contraindicated in examining patients with severe fractures.

2. Diagnosis

1. The patient has a history of severe trauma, especially trauma involving pelvic compression.

2. The pain is widespread and worsens when moving the lower limbs or sitting. There is local swelling, subcutaneous ecchymosis and obvious tenderness in the perineum and pubic symphysis. The pelvic ring is squeezed inward or separated outward from the iliac crests on both sides, and pain occurs at the fracture site due to the involvement or squeezing (pelvic compression and separation test).

3. The affected limb is shortened, and the length from the navel to the medial malleolus is shortened. However, the length from the anterior superior iliac spine to the medial malleolus on the affected side is often not shortened with the exception of central dislocation of the femoral head. When the sacroiliac joint is dislocated, the posterior superior iliac spine on the affected side is more prominent than that on the healthy side, and the distance between the spine and the affected side is also shorter than that on the healthy side. It indicates that the posterior superior iliac spine is displaced posteriorly, superiorly, and toward the midline.

3. Prevention

There are no special preventive measures for this disease. The main thing is to pay attention to production and life safety and avoid trauma.

Functional exercise after surgery is more important for patients. The significance and methods of functional exercise should be introduced to patients and their families. The method of functional exercise varies according to the degree of fracture.

(1) Fractures that do not affect the integrity of the pelvic ring:

① For patients with a single fracture without associated injuries and without the need for reduction, they should rest in bed, alternating between supine and lateral lying (with the healthy side at the bottom), and do upper limb stretching exercises, lower limb muscle contractions, and ankle activities in bed in the early stages.

② One week after the injury, practice in semi-lying and sitting positions, and perform flexion and extension exercises of the hip and knee joints.

③ 2-3 weeks after the injury, if the general condition is good, you can get out of bed, stand and walk slowly, and gradually increase the amount of activity.

④ 3-4 weeks after injury, do not restrict activities and practice normal walking and squatting.

(2) Fractures that affect the integrity of the pelvic ring:

① For those without complications after injury, they should rest on a hard bed and perform upper limb activities.

②Starting from the second week after injury, perform lower limb muscle contraction exercises in a semi-sitting position, such as quadriceps contraction, ankle dorsiflexion and plantar flexion, toe flexion and extension, etc.

③In the third week after injury, perform hip and knee joint activities in bed, first passively and then actively.

④ 6-8 weeks after injury (i.e., clinical healing of the fracture), remove traction fixation and walk with the help of crutches.

⑤ Gradually exercise and abandon crutches and walk with weight in the 12th week after injury.