Recovering from a pelvic fracture

How good is recovery after pelvic fracture?

A stable pelvic fracture may heal in several weeks without surgery, particularly if you are young and fit and don't have other illnesses which can affect your healing time.

Avulsion fractures usually heal by themselves, with rest, over a period of 6-8 weeks.

Stress fractures normally heal over 4-6 weeks with rest, although medication can speed up healing and prevent recurrence, and review of running technique by a sports physiotherapist may be helpful in preventing further injury.

What are the possible complications of a pelvic fracture?

The risk of complications depends on the severity of the injury. The pelvic bones themselves generally heal well and full mobility usually returns after healing has occurred, although there are some exceptions to this.

Early complications

Severe pelvic fractures are life-threatening injuries. The greatest risk is due to immediate blood loss, particularly in the period before emergency care begins. Other possible early complications (within the first few days to weeks) include infection, wound healing problems, blood clots, further bleeding, and damage to internal organs.

These complications can occur in a lesser extent in more serious but stable fractures. They are not associated with avulsion fractures or stress fractures.

Later complications

The medium- to long-term complications of pelvic fractures are mainly seen after complex, unstable fractures. They include:

• Ongoing pain. Pain is a natural part of the healing process. However, chronic pain can occasionally develop and may need specialist management.

• Limp: you may walk with a limp for several months, particularly if the muscles around your pelvis were damaged. These muscles may take a whole year to become strong again.

• The nerves and blood vessels involved in sexual pleasure are inside the pelvis. If these are damaged this can lead to erectile problems in men and to problems with arousal and orgasm in women.

• Where there is nerve damage at the time of pelvic fracture, some nerve damage will remain and may affect your long-term mobility. The severity will vary depending on precisely what has happened. Long-term physiotherapy and rehabilitation with walking aids may help things improve slowly.

• When the fracture runs through the hip socket this can leave the hip joint working less well. This can affect mobility too, and further surgery might be needed.

Healing after any injury is generally better for those who are younger and fitter. Elderly patients who have reduced muscle strength and fitness, and who then become immobile after stable pelvic fractures, are generally less likely to return to full fitness after a long period of being 'off their feet'. This is particularly the case if they have previously existing problems with balance, or other health issues.

Elderly people who have maintained their fitness with regular exercise have almost the same chance of full recovery as younger patients.

How are pelvic fractures prevented?

You can reduce the chance of this type of injury through use of safety devices when travelling at speed, including seat belts and impact protection systems (airbags) - and also by driving at a safe speed for the conditions.

Any safety procedure that reduces risk of falls from high levels, including site safety on construction sites, will reduce the risk of major trauma.

Horse riders should be aware of the risk of a horse falling and rolling, particularly when involved in jumping or racing. It is difficult to protect against this other than by throwing yourself away from the horse as it falls, or rolling away as soon as you fall. This will not often be possible, even for experienced riders.

Treatments to improve bone density will make fractures less likely in those with osteoporosis. In patients with balance problems (who are at risk of falls) physiotherapy and occupational therapy can help core stability, balance, fitness and strength, and can make the environment safer.