What is a pelvic fracture?
The pelvis is comparable to a very rigid ring, like a bracelet. This bony structure forms what is called the pelvic ring. It has three components: the sacrum at the back , which connects the pelvis to the spine, and the two iliac bones, or hip bones, on the sides, which meet at the front at the pubic symphysis. “When it breaks, it has to break in two places. A pelvic fracture is generally associated with an injury at the front and an injury at the back, especially in older people,” explains Dr. Pomme Jouffroy.
When the fracture is located at the front of the pelvic ring, it may be a fracture of the pubic symphysis or, more frequently in the elderly, a fracture of the obturator foramen, which corresponds to the anteroinferior portion of the hip bone. At the back, fractures most often involve the sacrum, and more rarely the sacroiliac joints.
There are also fractures that do not directly affect the pelvic ring but the acetabulum, that is, the joint cavity into which the head of the femur fits to form the hip. These fractures involve the joint itself and require specific treatment.
Pelvic fracture in the elderly: what are the causes?
Pelvic fractures can occur after high-energy trauma, such as a bicycle or car accident, even in physically fit older adults. “In this case, the pelvis is often significantly displaced,” explains Dr. Jouffroy. They can also result from low-energy trauma, such as a fall from standing height. These fractures, much more common in frail older adults, are generally minimally displaced and often affect bones weakened by osteoporosis , such as the sacrum or pubic rami. This explains why pelvic fractures are more frequent in women, who are more susceptible to this bone fragility.
Pelvic fracture: what are the symptoms and how is it diagnosed?
The most common signs of a pelvic fracture are pain localized in the groin, buttocks, or lower back, which worsens when standing or walking, as well as difficulty standing or taking a few steps. Pain may also be present when pressure is applied to the pubic bone or sacrum. “In cases of obturator foramen fractures, some fractures extend into the joint cavity. The fracture bleeds, there is blood in the joint, and the pain when weight-bearing is then more intense,” explains the doctor. In some cases, swelling or bruising may appear. “The pelvis may move slightly; it is somewhat mobile,” adds Dr. Pomme Jouffroy.
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