Pelvic Fractures - Symptoms

Authored by Dr Mary Lowth, 12 May 2017

Patient is a certified member of
The Information Standard

Reviewed by:
Dr John Cox, 12 May 2017

A stable pelvic fracture is almost always painful. Pain in the hip or groin is usual and is made worse by moving the hip or trying to walk - although walking may still be possible. Some patients find if they try to keep one hip or knee bent this can ease the pain.

Other symptoms will vary with the severity. They may include:

  • Pain and tenderness in the groin, hip, lower back, buttock or pelvis.
  • Bruising and swelling over the pelvic bones.
  • Numbness or tingling in the genital area or in the upper thighs.
  • Pain which may also be present on sitting and when having a bowel movement.

There may also be visible signs of bleeding. Bleeding can track out to the skin in several places, some of which are more likely to be visible than others. They include:

  • Bruising over the pelvic bones themselves.
  • Bruising or a tender lump in the groin or on the perineum.
  • Bruising in the small of the back.
  • Vaginal bleeding in women, and bruising to the scrotum in men.
  • Blood in the urine or coming from the back passage.
Note: after significant trauma, such as a road accident, serious pelvic fracture is quite likely, even in patients who are initially walking around. It is really important if assisting at the scene of an accident, therefore, to keep survivors still and warm until emergency services arrive. This will reduce risk of dangerous bleeding and may save lives.

Major and unstable pelvic fractures are likely to cause severe pain and shock. Pain may be in the pelvis, groin, back, tummy (abdomen), or down the legs.

The pelvic bones are large and have a rich blood supply, so when broken they will bleed heavily and the bleeding will not stop quickly. Whilst the blood may not be visible, because it is on the inside of your tummy, this level of blood loss will cause a sudden drop in your blood pressure. Affected people will be pale, clammy and seriously unwell, perhaps even unconscious.

It is sometimes possible to move around and attempt to walk immediately after a major unstable pelvic fracture - particularly after road accidents. This is because shock can initially prevent you from feeling pain. It means that anyone involved in major trauma should be kept still and warm until they can be fully assessed.

Pelvic avulsion fractures are mainly seen in young, active sportspeople who are still growing. Symptoms are usually of sudden pain during a sudden powerful movement. The pain is often in the bottom, in the crease of the buttock, or at the bony part on the front of the hip. Afterwards the athlete will feel weakness and pain when doing the movements which use the affected tendon and muscle. Bruising and swelling are likely.

Stress fractures - where there is a fine crack in the bone which does not extend all the way through - are one of the mildest sorts of stable fracture. Stress fractures of the pelvis are easy to miss as the pain may be quite hard to locate. Symptoms typically consist of a dull pain that is difficult to localise at first. This may get better as exercise continues but be worse afterwards.

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