Fracture of the pelvis: treatment, consequences

Content

  • 1Treatment and consequences of pelvic fractures
    • 1.1Types of damage
    • 1.2Causes
    • 1.3Symptomatic of damage
    • 1.4Emergency medical care
    • 1.5Diagnostics
    • 1.6Therapeutic tactics
    • 1.7Development of various complications
  • 2Fracture of pelvic bones
    • 2.1Causes of development of trauma
    • 2.2Anatomical features of the pelvis
    • 2.3Classification of pelvic fractures
    • 2.4Clinical manifestations
    • 2.5Consequences and complications of trauma
    • 2.6Diagnosis of pathology
    • 2.7Methods of treatment of pelvic bone fractures
  • 3Fracture of the hip: treatment, consequences, classification
    • 3.1Anatomical features
    • 3.2Classification of pelvic fractures
    • 3.3Associated Damage
    • 3.4Clinical manifestations
    • 3.5Diagnosis of pathology
    • 3.6Methods of treatment of pelvic bone fractures
    • 3.7First aid
    • 3.8Pain relief syndrome
    • 3.9Replenishment of lost blood
    • 3.10Immobilization
    • 3.11Conservative therapy
    • 3.12Surgery
    • 3.13Consequences and complications of trauma
    • 3.14Rehabilitation
  • 4Fracture of the pelvis: is there a danger to life?
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    • 4.1Anatomical features
    • 4.2Causes
    • 4.3Types of fractures
    • 4.4Local manifestations
    • 4.5General symptoms

Treatment and consequences of pelvic fractures

Pelvic bones are a combination of paired bones and sacrum in a certain closed ring, inside of which there are organs of the uterus, prostate gland, appendages and bladder.

At a time when a person makes different movements, the pelvic bone is given a huge load, so if it is damaged, human performance is significantly deteriorating.

Fracture of the pelvis is a very common and unfortunate trauma, which is often accompanied by unpleasant complications.

The most frequent cases are fractures of the pelvic bones in the elderly, as the strength of bones over time is very deteriorating.

Types of damage

There is a classification of pelvic fractures:

  • trauma of the hip ring without damage to its continuity;
  • fractures in the place of the pelvic ring with the presence of damage to its continuity;
  • fracture of Malgens, which is characterized by a double vertical violation of the pelvic bone tissue;
  • trauma in the place of the acetabulum;
  • violation of the integrity of the pelvic bones together with damage to his internal organs.

By the nature of injury distinguish:

  1. stable - damage to the pelvic bones that do not affect the pelvic ring. Such fractures are called isolated and marginal;
  2. unstable - as a result of such injuries, the pelvic ring is damaged;
  3. damage to the bottom and edges of the acetabulum (often accompanied by a dislocation of the femur);
  4. fractures of the pelvic bones - fractures of the pelvic bones, combined with dislocations.

There is an open (with violation of the integrity of soft tissues) and closed fracture (only the integrity of the bone is broken). The first signs of a pelvic fracture may differ from each other, depending on its type.

Causes

A fracture of the pelvic bones can occur as a result of:

  • increased traumatic impact in this area;
  • road accident;
  • falling from different heights;
  • weather conditions;
  • sports activities;
  • non-observance of safety rules at work and at home;
  • catastrophes of natural or mechanical origin;
  • extreme rest;
  • gunshot wounds.

Fracture of pelvic bones can also be caused by advanced age or various diseases that significantly worsen the usual strength of bone tissue:

  1. osteoporosis;
  2. osteomyelitis;
  3. arthrosis;
  4. oncological disease of bone tissue;
  5. tuberculosis of bones;
  6. infection with syphilis.

Symptomatic of damage

There are a number of symptoms that are characteristic of a fracture of the pelvic bones:

  • the development of extensive bruising and bruising in the area of ​​trauma;
  • edema of soft tissue;
  • Intensive pain, which is enhanced by palpation or attempted movement;
  • visual change of injured bone;
  • internal or external hemorrhage;
  • development of pain shock;
  • impossibility to make movements;
  • shortening of the limb of the injured party;
  • impossibility to bend a limb.

Sometimes, pelvic fractures occur simultaneously with trauma to the nearest internal organs of a person. With such fractures of the pelvic bones the following signs are observed:

  1. violation of the urinary function or its stasis (trauma of the urethra);
  2. the appearance of hematuria (with damage to the bladder);
  3. acute stomach syndrome;
  4. constipation or inability to curb the process of defecation;
  5. hemorrhage from the urethral cavity or perineum.

There are signs that are characteristic precisely at a fracture in a certain place of the pelvis, thanks to them it becomes easier to diagnose:

  • the intense pain that the victim feels in the place of the wing of the ilium means that the upper section of the acetabulum has been damaged;
  • trauma of the tailbone or sacrum can be diagnosed in the event that the victim is difficult to perform the process of defecation, restrain urination and with increased pressure on the sacrum there are strong pain. Read more about the symptoms of a coccygeal fracture;
  • if the pelvic ring is affected, the appearance of pain syndromes in the crotch or pubic region (in dependence, where the injury occurred), also the pain becomes more intense with the procedure for feeling the pelvis and worsens the performance of the lower limbs;
  • in the case of Malgen's fracture, the position of the pelvis becomes asymmetric, and the motor function of the lower extremity on the part of the injury significantly worsens;
  • if the rear half ring is injured, then the performance of the limb is severely limited and strong pain sensations are observed in its area;
  • damage to the integrity of the acetabulum is determined by the pain that intensifies during effleurage at the site of the thigh and axial load on it, as well as the motor functions of the femoral sutsava.

Emergency medical care

In the event that such a trauma occurred, the victim must immediately provide first aid, otherwise, the risk of complications is significantly increased.

First of all, when providing first aid, it is necessary to remove pain from the victim in order to avoid painful shock. To do this, use all kinds of painkillers from your medicine cabinet.

If there is an open fracture of the pelvic bones, the next stage of medical care is to stop bleeding and disinfection of the wound.

In order to stop the hemorrhage, you need to use a special tourniquet or make it from improvised rags, bandages and ropes.

With the harness firmly rewound area below the injury and on the fabric is written the exact time of the beginning of its use. After stopping bleeding, the wounded area is treated with antibacterial agents.

Then the fixation (immobilization at a fracture) of the victim in one position is carried out with the help of a strong board and ropes.

The position in which the patient is transported should resemble the "frog pose for This under the knees of the injured lay rollers, pillows, crumpled blankets or other similar subjects.

An ambulance crew should transport the emergency, but if the pelvic fracture occurred in a remote or inaccessible doctors place, then when carrying the victim you need to carefully monitor its immobility and correct position on the stretchers.

Diagnostics

Upon arrival at the medical facility, a pelvic fracture is confirmed by diagnosis. Treatment appoints a qualified specialist, based on the results of the survey.

Diagnosis with a pelvic fracture is performed by an experienced traumatologist immediately upon arrival at the nearest hospital.

The first step is to interview the victim to determine the cause of the injury and determine the first symptoms.

Next, the doctor performs the procedure of palpation to understand what kind of fracture, and in which place the bone is damaged.

After this, the patient is referred for radiography, which will accurately confirm the presence of the injury and its type.

Further, in order to confirm or exclude damage to nerve endings, vessels and the nearest organs, a computer and magnetic resonance imaging examination is performed.

Therapeutic tactics

Since fractures of the pelvic bones - this is quite severe damage, the first thing doctors do anti-shock therapy, inject the patient with an analgesic and restore the amount of blood lost in organism. Further, depending on the degree of injury, a qualified doctor selects the necessary tactics for further treatment.There are three methods of treating this fracture:

  1. conservative;
  2. operational;
  3. surgical traction.

Treatment of pelvic fracture in a conservative way is recommended in case of easy, uncomplicated injury. It consists only in prolonged immobilization of the patient.

Within three or four months the patient must make a minimum of movements and almost all the time is immobilized on a bed with a hard surface.

Under the knees, the patient is placed special rollers for the proper fusion of bones and the most suitable, in this case, position of the body. During immobilization, the injured person is prescribed developing physical training, physiotherapy and massage.

If a fracture with a displacement of bone fragments was diagnosed during the examination of the patient, surgical traction is prescribed.

This method of treatment is concluded in that the specialized needle is guided through the damaged bone of the patient and fixed in the necessary position.

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Fixing is carried out with the help of a device designed for this purpose with a suspended weight.

Surgical intervention is intended for severe fractures.

These can be traumas with a significant displacement of bone fragments, damage to vital organs, as well as splinter or multi-lobe fractures.

The task of doctors in this case is to firmly fix the injured bones using special metal structures (plates, pins, screws, etc.).

The period of treatment, and accordingly the length of stay in the hospital, is determined by the attending physician, based on the results of the examination, the nature and severity of the injury.

As with this damage, the regeneration of bone tissue takes a very long time, after a long period of immobility, the habitual motor functions of a person deteriorate significantly.

To fully restore the habitual performance of the limbs, rehabilitation after a fracture of the pelvis is necessary. Rehabilitation procedures and their frequency are selected by an experienced physician individually for each patient.

Methods of recovery can be:

  • physiotherapy;
  • developing a massage;
  • physiotherapeutic procedures;
  • special exercises;
  • proper nutrition.

The duration of the rehabilitation period is also appointed by the attending physician.

Development of various complications

In case of untimely treatment or incorrect approach to rehabilitation procedures, such consequences of a pelvic fracture can develop:

  1. atrophy of the muscles of the legs;
  2. there is chronic pain in the injured place;
  3. the appearance of lameness or change in the gait of a person;
  4. deterioration of the hip joint;
  5. the appearance of radiculitis or osteomyelitis;
  6. violation of the function of the urinary function;
  7. persistent problems with defecation;
  8. infection;
  9. complete or partial paralysis.

A source: https://PerelomaNet.ru/perelomy/kostej-taza-perelom.html

Fracture of pelvic bones

Fracture of the pelvic bones is one of the most complex and dangerous injuries, often accompanied by massive bleeding, damage to internal organs and leading to persistent disability, and in many cases, disability rights. In some cases, pelvic injuries cause death, which can result in blood loss, pelvic trauma or pain shock.

According to medical statistics, pelvic injuries are found in 5-7 people out of 100 diagnosed injuries of the musculoskeletal system.

In a quarter of cases there are injuries to the pelvic organs, and in 30%, traumatic and painful shock. Lethal outcome for such injuries occurs in 6 cases out of 100.

Most often, young and middle-aged people, mostly men, suffer from pelvic fractures, often traumas of this kind are found in adolescents.

Causes of development of trauma

To fractures of pelvic bones can lead:

  • pressure on the pelvis during road accidents, with natural (landslides, avalanches) and man-made disasters (destruction of buildings, wrecks), as a result of industrial injuries;
  • sharp, strong blows to the pelvic region, caused during fights, trainings or speeches on power sports;
  • falling from a height - climbers, paratroopers, builders and people, who are fond of jumping, suffer more often;
  • a blow against the water with improper diving from the tower;
  • a sharp contraction of muscles with strong tension, more often such situations occur in athletes;
  • thinning and fragility of pelvic bones, developing with osteoporosis;
  • women in the process of childbirth may develop pubic symphysis.

In 75% of cases, the cause of injury to the pelvic bones becomes an accident, and pedestrians suffer more often than people who are in the car.

Anatomical features of the pelvis

The pelvis serves as a receptacle and protection for the organs of the genitourinary system and support for the entire skeleton.

It is formed by three twin bones - pubic, sciatic, iliac, connected with each other by thin bone seams, immovably connecting with each other and with the sacrum, form a closed circle - the pelvic ring.

All three bones are involved in the formation of the acetabulum, which is part of the hip joint. Any damage to the pelvis affects the condition of the entire body.

Classification of pelvic fractures

Traumatologists distinguish several groups of fractures of pelvic bones:

  1. Injuries, in which the integrity of the pelvic ring is not damaged, such fractures are called stable. These include the marginal and isolated fractures - the fracture of the sacrum (transverse), the coccyx, the wing and crest of the ilium, the branches of the pubic or ischium bones and the fracture of the bumps of the ischium.
  2. Unstable fractures, in which the integrity of the ring is broken, the following subgroups of unstable fractures are distinguished:
  3. unstable vertical front - one or two-sided lesions of the pubic or ischium bone;
  4. unstable vertical rear - trauma of the wing of the ilium, fracture of the sacrum in oblique or vertical direction;
  5. double unstable - simultaneous damage to the anterior and posterior half-rings of the pelvis; this subgroup includes Malenga fractures (vertical) and Niederle (horizontal);
  6. multiple pelvic fractures.
  7. Damage to the acetabulum - one or two-sided fractures of the edges or bottom, often such a trauma is accompanied by a dislocation of the hip joint.
  8. The last group includes fractures - a fracture of the pelvic bones accompanied by a dislocation of the lobate or sacroiliac joint.

Damage accompanying pelvic fracture

Related damages include:

  • Massive bleeding - blood loss with stable fractures can range from 300 to 500 ml of blood, and when unstable, it reaches 3000 ml.
  • Damage to internal organs - rupture of the bladder, urethra, vagina or rectum. In this case, the contents fall into the cavity of the small pelvis and can cause the development of an infectious inflammatory process.
  • Damage of large and small nerve trunks of the lumbar plexus, manifested by pronounced neurological changes.

Clinical manifestations

All clinical manifestations of fracture of pelvic bones are divided into local and general. Separately, you can identify the symptoms of a traumatic or painful shock.

Local symptoms of pelvic injuries

The symptomatology of the pathology depends on the localization and type of fracture and varies depending on the severity of the lesion. Local manifestations include:

  1. visually distinguishable bone deformation of the pelvic region;
  2. pronounced pain syndrome;
  3. development of hematomas in the pelvic region;
  4. edema of various localization and size;
  5. violation of motor functions of the lower limbs;
  6. with open trauma to local symptoms, bleeding also applies;
  7. at unstable fractures mobility and crunch of fragments can be observed;
  8. for some types of fractures, the length of the limb varies from the side of the lesion.

Local manifestations of individual types of fractures

No. Localization of the fracture Clinical manifestations of trauma
1 Upper pelvis and iliac bone The volume of movements in the hip joints is reduced, the localization of pain is the area of ​​the wing of the ilium. With a fracture of the wing or iliac bone, there is a characteristic symptom, called a symptom of the back stroke - it is easier for the patient to go forward with his back.
2 Coccyx The intensity of pain increases with pressure on the lower part of the sacrum.
3 Pelvic ring If the integrity of the pelvic ring is not broken, the pain is localized in the crotch or pubic region and is enhanced by palpation or attempts to perform movements with one leg. In violation of integrity - pain syndrome is observed in the pelvic and perineal regions, and movements with the legs make it stronger.
4 The branches of the pubic bone A person with such an injury occupies position e, which is called the "frog pose".
5 Pubic Symphysis The patient takes a forced position with slightly bent tightly connected legs, the breeding of the limbs causes severe pain.
6 Rear half ring Since the pain is localized from the side of the lesion, the patient is forced to lie on the healthy side. Bruising is located mainly in the crotch area in men, they are localized on the scrotum.
7 The acetabulum Trauma is often combined with hip dislocation and manifests itself with severe pain, forced position of the injured limb, impaired functioning of the hip joint.

General clinical manifestations of pelvic fractures

Such a serious trauma as a fracture of the pelvic bones is usually accompanied by a significant blood loss of which may indicate pallor of the skin and a sharp decrease in the values ​​of blood pressure (arterial pressure). In addition, traumatic shock and trauma to the urogenital and digestive system often develops.

Manifestations of traumatic shock

  • rapid change in the color of the skin (they become pale);
  • cold sweat;
  • increased heart rate;
  • a decrease in blood pressure;
  • a loss of consciousness is possible.

Symptomatic of pelvic lesions

  1. With the rupture of the urethra, urine retention develops, bleeding from the urethra is observed, a hematoma appears in the perineal region. The size of the bladder is increased, and it is difficult or impossible to insert a catheter.
  2. Damage to the walls of the bladder can be accompanied by the presence of blood in the urine (hematuria), while the contours of the bladder itself during palpation and percussion are not determined.
  3. A sign of rupture of the vagina or rectum is the development of bleeding from them, these injuries are determined by gynecological examination or finger examination of the rectum.
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A common symptom of damage to the pelvic organs is a marked swelling of the tissues in the lower abdomen.

Consequences and complications of trauma

During the injury and during its treatment, the following complications may occur in the victim:

  • impaired sensitivity due to damage to nerve trunks and compression of tissues;
  • trauma of muscle fibers, blood and lymphatic vessels, tendons;
  • damage to the pelvic organs;
  • development of infectious inflammatory process;
  • abnormal or delayed fracture fusion;
  • development of osteomyelitis;
  • tissue hypotrophy;
  • the formation of contractures that limit the motor activity and functionality of the lower limbs.

Diagnosis of pathology

Pelvic fractures are diagnosed by a traumatologist after examination and radiography. Associated lesions require additional survey methods, which include:

  1. laparoscopy is performed with internal injuries;
  2. when the patient is in serious condition laparocentesis or even laparotomy may be used;
  3. if a bladder is suspected, ultrasound is required;
  4. trauma of the urethra is diagnosed by urethrography.

Methods of treatment of pelvic bone fractures

In case of pelvic fractures, it is very important that the victim be taken to the hospital as soon as possible.

Quickly initiated adequate treatment can save a person's life with a pelvic injury. Therefore, if you suspect this kind of injury, you should immediately call an ambulance.

It is very good if first aid is provided to the victim prior to her arrival.

Basics of first aid for pelvic fractures

In the presence of open fractures, it is necessary to stop bleeding and to treat the edges of the wound with an antiseptic. To relieve the pain, it is necessary to inject analgesics intramuscularly or give them to the affected person in a tablet form.

It is necessary to lay the injured person correctly, for which a tightly rolled blanket, clothing or roller is placed under the knees, and the upper part of the trunk is lifted (place a rigid pillow under it). It is desirable that in this position the knees of the patient do not disperse, if possible, they are fixed in one position.

If there is a symptom of a traumatic shock, you should loosen the straps, collar and buttons, ensure the flow of cool clean air, use ammonia.

It should be remembered that it is strictly forbidden to relocate a person with suspicion of a pelvic fracture. To transport such a patient, special tools are necessary. Therefore, do not try to deliver it to the hospital on your own.

Basic methods of treatment of pelvic bone fractures

The treatment of pelvic fractures is performed by a traumatologist or surgeon, depending on the severity of the damage, sometimes requires consultation and treatment with specialists of other specialization (resuscitator, urologist, gynecologist, proctologist). First of all, a complex of anti-shock measures is carried out, which includes the following components:

  1. Conducting adequate anesthesia - intracutular or intraosseous analgesia with novocaine or lidocaine, with certain types of fractures and with multiple combined injuries, it is preferable to use a common anesthesia. The question of the type of anesthesia is solved individually.
  2. Reimbursement of the volume of lost blood - with a small blood loss, the patient is given a transfusion and intravenous injection of replacement solutions on the second day. Massive bleeding requires the immediate commencement of recovery of blood loss. When non-stop profuse bleeding is necessary surgical intervention, consisting in the ligation of the arteries, after which blood substitution therapy is prescribed.
  3. Immobilization of the fracture - the type of immobilization and its duration depend on the localization of the fracture and its appearance. With stable fractures, it is possible to lay the patient on the shield, while a roller is placed under his knees or Beller's tires are used. Unstable fractures are a direct indication for the use of skeletal traction.

In some types of fractures, surgical intervention is prescribed, during which the fragments will be connected by metal plates or spokes (osteosynthesis). After the complete fusion of the bones, a repeated operation is necessary to remove the fixation elements.

The duration of treatment depends on the severity of the fracture and can take quite a long time. After the fusion of the bones, a rehabilitation period is required during which the patient returns to his habitual lifestyle.

During this whole period a person is under medical supervision and undergoes physiotherapeutic procedures and sessions massage, engaged in physical therapy, taking drugs that strengthen bone tissue and accelerate them accretion.

A source: http://www.knigamedika.ru/travmy-i-otravleniya/bedro/perelom-kostej-taza.html

Fracture of the hip: treatment, consequences, classification

Injuries to the musculoskeletal system in the pelvic area are the result of accidents, accidents, compression under the influence of mechanical force.

Over 75% of injuries are violations of the integrity of the pubic symphysis, joints connecting the lower spine with The pelvic girdle (including a pathological condition such as a fracture of the ilium); about 20% - acetabular deformities cavities.

All of them are accompanied by severe pain, they represent a danger to life (in severe forms they can terminate lethal), require urgent medical attention.

Anatomical features

The structure of the complex includes:

  • sacrum;
  • fixed, jointed bone seams 3 paired bones (ischial, pubic, iliac).

The latter, holding together in the outer-lateral part, form the acetabulum (BB) - a composite element of the hip joint.

Long bones, closing in front, form a pubic symphysis.

Continuity of the system is provided by the sacroiliac joints, through which the iliac bones are connected to the sacrum.

Classification of pelvic fractures

In addition to one- and two-sided injuries, pelvic injuries are also systematized by the type of localization.According to descriptive-pathoanatomical characteristics, there are:

  1. Fractures of Malgens (rear, front half-ring), BB and other elements of the link.
  2. Marginal, or isolated, deformations.
  3. Fractures in violation of the integrity of the system.
  4. The above pathological condition characterized by preservation of the continuity of the complex.

Modern medicine classifies injuries into three types: stable (group A), rotationally unstable (B), unstable, accompanied by complete rupture of the joints of the sacrum with iliac bones (C). Among the latter - vertical rear, front. An additional type is fracture.

Associated Damage

Any types of injuries are accompanied by bleeding, aggravating the patient's condition. Edge fractures cause relatively small hemorrhage (up to 500 ml). Deformations of group C of the vertical type are characterized by losses of more than 3 liters of liquid body fluids in a short time.

A number of pathological conditions is characterized by the appearance of neurological disorders due to compression of nerve endings in the lumbar region.

Clinical manifestations

The main signs of the presence of fractures are: deformation of the musculoskeletal system and pain in the area under consideration, edema and subcutaneous hematomas, traumatic shock. The latter is accompanied by symptoms, including:

  • pallor of the skin;
  • a sharp decrease in blood pressure;
  • cardiopalmus;
  • cold sweat;
  • loss of consciousness.

Trauma of the tissues, hemorrhage into the abdominal cavity can be determined by the manifestation of the clinical picture of the "acute abdomen" and pronounced puffiness.

With damage to the rectum, urethra, vagina, bleeding from these areas is observed.

Deformations of the bladder are detected by the presence of blood in urine.

Local symptoms that accompany various types of fractures are listed in the table below.

Type of damage Symptoms
Deformation of the coccyx Intense painful sensations, intensifying when pressed on the sacrum. Violated (difficult) defecation. With a rupture of nerves, urinary incontinence is observed.
Fracture of the awn or wing of the ilium Shortening of the limb (change in length is due to the displacement of the fragments). The patient can move mainly with his back forward.
Pathologies accompanied by destruction of the integrity of the pelvic ring The appearance of a sharp discomfort in the area between the coccyx and pubic bones.
Fractures with continuity of the system Pain localized in the pubic region, perineum, increasing with limb movement, during palpation.
Fracture of upper thigh end The symptom of the "stitched heel" is the lack of the ability to raise the leg; possibly the presence of bruises, a distinctly distinct crunch.
Injuries of pubic symphysis A pronounced discomfort in the dilution of the limbs. The victim has to be in an unnatural position (with slightly bent, tightly shifted legs).
Fracture of BB, complicated by hip dislocation Violation of the functions of the joint.
Fracture of Malgens Asymmetry of the pelvis; hematomas in the perineum (in male patients - in the scrotum area).

The severity of the symptoms described above is determined by the severity of the damage received.

Diagnosis of pathology

When contacting the clinic, the primary diagnosis is made by the doctor after the interview and examination of the victim. Additional surveys include:

  • radiography;
  • computed tomography;
  • MRI;
  • urethrography;
  • Ultrasound of the organs of the secretion system.

In complex cases (in the presence of signs of an "acute abdomen") diagnostic laparotomy, laparoscopy is carried out.

Scheme therapy, including the taking of drugs, a set of surgical procedures and physiotherapy procedures, is appointed by the attending physician at the end of all necessary studies.

Methods of treatment of pelvic bone fractures

The causes of fractures are many factors - car accidents, the fall of a person from a height, being in a zone of emergency situations (landslides, earthquakes, explosions, etc.).

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Often deformations occur due to awkward movements, shocks, excessive stresses. If you suspect a pelvic bone injury, you need to call an ambulance and try to alleviate the condition of the victim.

Therapy can be prescribed only by a specialist (trauma surgeon).

First aid

After injury, you should carefully examine the person.

Relaxation of the pain syndrome contributes to the adoption of the right position (under the knees is put tightly folded clothing, blanket, and under the body - a rigid pillow), oral use of analgesics (in the presence of medical knowledge, intramuscular administration of medicinal means).

If the damage is accompanied by bleeding, it is necessary to stop the blood (apply bandages indicating the time of fastening the tourniquet), treat the skin with an antiseptic.

When providing first aid, one should not forget the importance of sedatives. Tincture of valerian, Corvalol will help the patient relax and calm down.

Pain relief syndrome

Anesthetics are administered only by a doctor. Anti-shock therapy is carried out by using promedola, morphine and other narcotic analgesics.

The doctor can stop the pain syndrome according to the method of Shkolnikov-Selivanov (a solution of novocaine in a certain concentration is injected into the ileum muscles).

Symptoms of Malengya's fracture are suppressed by the use of medical anesthesia.

Replenishment of lost blood

A small blood loss is compensated by transfusion, the introduction of replacement solutions on average 24 hours after the injury. With massive bleeding, an immediate replacement of the lost quantity of the liquid medium is shown.

Operative interventions are performed for the purpose of ligation of the arteries; at the end of manipulation, the doctor prescribes blood replacement therapy.

Immobilization

The task of immobilization is to prevent the displacement of fragments and possible injury to internal organs. Duration, type of procedure are determined by the type of injury and the place of its localization.

Isolated fractures require fixation of patients on the shields, in special hammocks (under the knees, rollers are often placed).

Conservative therapy

Involvement of conservative therapy occurs in the presence of uncomplicated types of injuries and provides for a prolonged (in excess of 3 months) immobilization of the victim.

The basic principles of treatment of fractures of pelvic bones, not accompanied by dislocations, tissue ruptures and other pathologies, are in such methods as:

  • minimization of movements;
  • being on a hard surface.

Parallel to the main scheme are appointed massages, physiotherapy procedures.

Surgery

Surgical interventions are indicated for severe fractures and no effect from the involved conservative therapy, with deformations accompanied by the displacement of fragments, divergence of pubic bones, ruptures bodies.

Fixation occurs with the help of special metal structures (screws, spokes, plates, etc.), conducted under anesthesia.

Consequences and complications of trauma

Among the consequences of untimely treatment of pelvic fractures and refusal to apply to the doctor:

  • appearance of bone growths, chronic pain, sciatica;
  • amyotrophy;
  • sexual dysfunction;
  • a significant decrease in efficiency;
  • problems with urination, defecation;
  • paresthesia;
  • development of infectious pathologies.

Possible amputation and death (according to statistical data, mortality from late complications reaches 5% of the total number of patients).

Rehabilitation

An obligatory condition for preventing the development of the consequences of injuries is the passage of a course of restorative procedures. Among the activities included in the rehabilitation complex:

  1. Exercise therapy that maintains muscle tone;
  2. physiotherapy;
  3. therapeutic massages;
  4. the use of medications and liniments.

Of great importance is the adherence to a special diet (eating foods enriched with calcium - fish, greens, milk, nuts), hiking (with a gradual increase in their duration).

Fractures of the hip bones refer to severe types of injuries. Complete recovery of the patient is possible only with timely access to the clinic and following the advice of the attending physician.

A source: http://NogiNashi.ru/travmy/lechenie-i-posledstviya-perelomov-tazovyx-kostej.html

Fracture of the pelvis: is there a danger to life?

Fracture of the pelvis is not just a damage to the integrity of the bones, but a life-threatening condition.Inside the pelvic ring are internal organs, vessels, nerves.

In fracture, fragments can injure soft tissues, which leads to massive blood loss, which can be up to 3 liters. Damage to nerve endings causes painful shock until loss of consciousness.

Emergency care should be provided as soon as possible, because with every minute the risk of complications, death is increasing.

Anatomical features

The pelvis is not just one bone, as many might have thought. It consists of three parts, firmly connected to each other. The structure of the pelvis is taken into account in the diagnosis, the type of fracture, because only one bone is often damaged.

The pelvic ring consists of three pairs of bones:

  • pubic;
  • iliac;
  • sciatic.

Causes

Fractures of the pelvic bones occur due to the action of great strength. The athletes who are involved in weightlifting, elderly people with a violation of the mineral metabolism, diseases of the thyroid gland, adrenal glands are at risk.

The immediate reasons for a pelvic fracture include:

  1. Pressure on the pelvic ring with a heavy object (in road accidents, earthquakes, house collapses, natural disasters).
  2. Strong blow to the pelvis during fights, trainings.
  3. Athletes may have a fracture of the pelvic bone by the type of crack. When lifting the bar with a lot of weight, the gluteal muscles and the hamstrings are working. Most of them are attached to the ischium. With sudden movements, muscle fibers contract, which leads to cracks.
  4. When falling from a height, the entire impact force is often on the pelvis. Especially in cases where the fall in the horizontal position.
  5. Osteoporosis (decreased bone density); hereditary or acquired disorders of mineral metabolism increase the risk of fractures.
  6. In women, fused fractures of the pelvic bones may in the future complicate the process of childbirth. A large fruit, high water, a narrow pelvis leads to the appearance of cracks, damage to bones. This is, rather, an exception than the rule. Timely diagnosis during pregnancy will help avoid complications.

Types of fractures

The signs of a pelvic fracture depend on the type of damage, the presence of complications.

If the pelvic ring is broken, which is the plane of the entrance to the small pelvis, the patient's condition deteriorates sharply, the movements of the lower limbs are almost impossible, stability is lost.

The risk of blood loss in this type of fracture is high. Emergency assistance should be provided as soon as possible.

Damage of the same bone is not so dangerous for life, but it is not worth negligently treating it. Immobilization, transportation is carried out slowly, so as not to damage the vessels, internal organs, not to worsen the situation.

There are the following types of pelvic fractures:

  • isolated - fractures of the pubic, sciatic or iliac bones, as a rule, called stable. Under the influence of the traumatic force, a fracture of the most prominent parts occurs: crests or wings of the ilium, sciatic tubercles, pubic branches;
  • Unstable fractures are accompanied by disorders of the pelvic ring. In most cases, internal organs are injured. Depending on the location of the lesion, vertically unstable fractures are distinguished when the displacement occurs in the vertical plane. Rotational fractures are characterized by a horizontal displacement of the fragments;
  • damage to the swivel cavity. Fracture of the hip bones occurs due to a violation of the integrity of the bottom or edges of the articular surface of the cavity.
  • combined trauma: fractures of the pelvic bones are accompanied by dislocations in the lonely or sacro-subacute articulation.

Local manifestations

Despite some differences in the clinical picture, there are common signs of a fracture of the pelvic bones. These symptoms indicate the presence of damage, the need for emergency care.

  1. The pain syndrome is expressed as much as possible. When you try to touch the pelvis, the patient starts screaming, trying to pull away.
  2. There is a deformation of the bones, an unnatural position of the limbs.
  3. Hematomas, hemorrhages under the skin - the characteristic symptoms of fractures. Under the influence of a traumatic factor, the blood vessels burst, which leads to bruising.
  4. In severe cases, bleeding occurs.
  5. When the fragments are displaced, one can hear crepitation (crunching) in the damaged area.
  6. Violation of blood circulation, increase in permeability of blood vessels leads to edema.
  7. Fracture of the hip is accompanied by a restriction of mobility of the lower extremities. To raise or move the leg is impossible because of the growing pain (a symptom of the stitched heel).

General symptoms

In addition to local changes, with fractures of the pelvis there is a pronounced general symptomatology.Violation of the integrity of bones, pain syndrome, blood loss leads to traumatic shock.

As a rule, the patient immediately after the injury is excited, does not feel pain. Within a few minutes the condition begins to deteriorate. There is pale skin, cold, sticky sweat.

The pressure drops sharply, which is due to the presence of bleeding from the vessels and the pelvic bones themselves, having a spongy structure.

A source: https://travms.ru/perelom-taza.html