Hip and Pelvis Fracture Surgery

The hip joint is the largest weight-bearing joint in the human body. It is also referred to as a ball and socket joint and is surrounded by muscles, ligaments and tendons. The thighbone or femur and the pelvis join to form the hip joint.

A hip fracture is a break that occurs near the hip in the upper part of the femur. A pelvic fracture is a condition that arises due to the breakage of the pelvic bone. It may damage the internal organs, nerves and blood vessels associated with the pelvic region.

Based on the damage to the pelvic ring and associated structures, hip and pelvic fractures can be categorized as:

• Stable fractures: Single point breakage and broken bones remain in position. Associated with less bleeding
• Unstable pelvic fractures: Breakage at two or more points. Associated with severe internal bleeding and damage to the internal organs. May cause shock, requiring immediate medical care followed by long-term physical therapy and rehabilitation

Causes

The common causes of pelvic fractures include:

• Sports injuries or trauma
• Abrupt muscle contraction
• Conditions such as osteoporosis, especially in the elderly
• Accidental injury or fall from a great height

Symptoms

The common symptoms associated with hip and pelvic fractures are:

• Swelling and tenderness
• Discomfort while rotating the hip
• Shortening of the injured leg
• Outward or inward turning of the foot and knee of the injured leg
• Pain and swelling in the groin or hip region that may worsen with ambulation
• Abdominal pain
• Bleeding through the urethra or vagina and the rectum
• Problems in urination
• Inability to stand or walk

Diagnosis

Your doctor will diagnose a fracture with a thorough physical examination that would include an examination of the functionality of the various organs present in the pelvic region. Imaging techniques such as X-rays, CT and MRI scans may also be ordered to confirm the fracture. In some cases, additional contrast studies with a radioactive dye may be recommended to evaluate the structural and functional activity of organs such as the urethra, bladder and the pelvic blood vessels.

Treatment

The treatment of a pelvic fracture depends upon the severity of the injury and your condition. Minor or stable fractures can be treated with conservative methods such as rest, medications, use of crutches, physical therapy and if required, minor surgery. These methods may take 8–12 months for complete healing.

The treatment of unstable fractures includes the management of bleeding and injuries to the internal organs, blood vessels and nerves. Surgical intervention may be employed for fixation of the fractured pelvic bones using screws and plates. Fixation provides stability to the pelvic bone and promotes natural healing of the fracture.