Can you walk with a broken pelvis? (explanation and advice)

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La pelvic fracture ou pelvic fracture is a fairly rare pathology. This is one of the most serious fractures, so nearly a third of victims have sequelae after treatment. In this article, we will focus on the ability to walk again after a pelvic fracture.

Definition and anatomy

Le basin is the part of the human body that supports the abdomen and protects the pelvic veins, internal genitalia, bladder and part of the intestine.

It takes the form of a funnel and consists of two lateral coxal bones, the coccyx and the sacrum behind. The coxal bones are structured according to the fusion of three bones: the ilium, the ischium and the pubis. The wings of the ilium form the hip and join the sacrum behind. The ischium is the bone that supports us in a seated position. As for the pubis, it is located above the sex. These bones are placed at the base of the trunk and serve as attachments for the lower limbs at the coxo-femoral joint.

Le basin has two regions: big pool which is the upper part formed by the wings of the ilium, and the small pool under the wings. These two regions connect at the level of a cavity called the upper strait, flattened from front to back. The lower strait designates a diamond-shaped opening of the pelvis, limited behind by the top of the coccyx.

A fracture of the pelvis results in the rupture of the bones that constitute it. It can be either minimal or intense and in this case cause serious bleeding. There are many forms of fracture. We can cite :

  • non-articular fracture which results in stable lesions;
  • partially stable fracture;
  • the unstable fracture.

For more explanation on the subject, you can click here.

Pelvic fracture: causes and symptoms

The stable fractures of the pelvis are manifested by lesions at the level of the crest, the pubic ramus or the iliac spines. These types of fractures do not interrupt the continuity of the ring of the pelvis although pain is felt in the affected regions.

Several situations can cause the stable fracture of the pelvis, including a fall, sports trauma or trauma following a road accident.

As regards the unstable fractures, they affect the pelvic ring, the symphysis or the acetabulum. This often results in loss of mobility in one or both lower limbs as well as damage to organs such as the spleen, intestine, liver or nerves.

The causes of such a fracture are for the majority of cases a traffic accident or a false movement during an excessive transfer of force from the thigh to the acetabulum. It can also occur in pregnant women, especially near childbirth. The normal preparation of the female body for birth causes an extension of the symphyseal zone which can lead to the explosion of the symphysis.

In both cases, the main symptom of pelvic fracture the pain remains. It can irradiate the entire pelvic region or be localized only on the pubis, groin or buttock.

Can you walk with this type of fracture?

An individual diagnosed with a stable fracture has no difficulty walking. However, it is important to avoid weight bearing on the pelvis until bone consolidation is complete. This can last one to two weeks with support in physiotherapy (physiotherapy).

For the case of an unstable fracture, emergency care relies on treatments with plates, screws and a temporary external fixator to compress the affected area. During this time, in order not to aggravate the fracture, it is contraindicated to exert weight on the lower extremities.

Once the pelvis is stabilized, the fracture begins the healing process over several weeks. The return to walking is then carried out gradually according to the recommendations of the surgeon or the attending physician. The latter also prescribe rehabilitation exercises to prevent muscle deficits following a long period of rest.

Possible complications after a pelvic fracture

Pelvic fractures show a high mortality rate of 15% to 50%. Complications are related to the associated lesions and not to the fracture of the bone per se.

Indeed, the crashing of the pelvic ring can lead to lesions of the iliac veins. This results in an open and significant external hemorrhage which is observed at the posterior level of the pelvis. Hemorrhagic shock can also occur and prove to be life-saving.

In the event of damage to the peripheral nerves or the nerve sciatica, neurological complications appear. They cause loss of sensation and reflexes in the lower limbs, incontinence or anuria.

Finally, there are the surgical complications. They mainly concern the acetabular fracture. For this type of fracture, the operation consists of restoring the surface to be joined without any difference in height. An uneven level of the bones will later lead to premature wear of the joints or osteoarthritis.

Return to walking following a fracture of the pelvis

After the immobilization period, the rehabilitation after a pelvic fracture can last between 3 and 6 months. It is initiated exclusively under the prescription of the attending physician.

Rehabilitation aims to ensure that the patient can regain all his walking abilities and to minimize lameness. It is based in particular on muscle strengthening as well as work on stability, flexibility and proprioception.

Normally, the sessions are carried out under the supervision of a physiotherapist or a physiotherapist.

In any case, the patient must learn to listen to his pain and avoid excess with the exercises.

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References

https://www.msdmanuals.com/fr/professional/blessures-empoisonnement/fractures/fracture-du-bassin

https://www.institut-kinesitherapie.paris/actualites/fracture-bassin/

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