Pelvic fractures occur when the bony pelvis is disrupted, most often from high-energy trauma such as motor vehicle collisions or falls from height.
Pelvic fractures occur when the bony pelvis is disrupted, most often from high-energy trauma such as motor vehicle collisions or falls from height. These injuries range from stable, low-energy fractures to complex and unstable patterns that carry significant risks, including vascular, visceral, and genitourinary injury. Diagnosis is typically made with imaging such as X-ray and CT, while management depends on the fracture pattern in coordination with trauma and orthopedic surgeons.
The pelvis plays a vital role in protecting organs, supporting neurovascular structures, and transferring weight between the spine and lower limbs, making fractures particularly serious. Classification of pelvic fractures is based on the direction of force. Lateral compression injuries involve internal rotation of the hemipelvis, often producing fractures of the pubic rami and sacrum that are rotationally unstable but vertically stable.
Anterior-posterior compression injuries, also called “open book” fractures, result from external rotation of the hemipelvis and separation of the pubic symphysis or sacroiliac joint. Vertical shear injuries occur from cranial forces, such as falls from height, and cause vertical displacement of the hemipelvis, disrupting both anterior and posterior pelvic structures. These are highly unstable fractures, frequently associated with major vascular and organ injuries.
Pelvic fractures typically result from acute trauma, with patients presenting with hip and leg pain that may be accompanied by other injuries if multiple organ systems are involved. A thorough history, including prehospital details from EMS, is important. On physical exam, clinicians should inspect for deformity, swelling, bruising, abrasions, open wounds, or hematomas, with particular attention to the skin, urogenital, vaginal, and rectal areas.
Deformity or abnormal positioning of the lower extremity may indicate significant displacement. Palpation involves assessing pelvic stability and tenderness, though range of motion is usually deferred. A detailed neuro exam is critical, especially for sacral nerve function and lower extremity strength and sensation.
If you are experiencing symptoms that may be related to pelvic fractures, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
Connect with a doctor, physical therapist, or imaging center near you.
Find a Provider Near You →