The treatment approach for a pelvic fracture may differ for older adults due to the type of fracture, its cause, and a person’s overall health and mobility. It can involve a compression device, medication, surgery, or other methods.
In this article, we describe what pelvic fractures are and why they are common in older adults. We also outline some of the treatments for pelvic fracture and provide insight into how doctors determine the best treatment.
Finally, we discuss the outlook for older adults who have sustained pelvic fractures.
A pelvic fracture is any type of break in one or more bones of the pelvic ring, which consists of
- the sacrum, which is a triangular-shaped bone at the base of the spine
- the two hip bones, each consisting of an ischium, ilium, and pubic bone connected by three joints:
- two sacroiliac (SI) joints between the sacral bone and the iliac wings
- the pubic symphysis, which connects the two pubic rami
The pelvis is a very stable structure, as it has to
The American Association of Orthopedic Surgeons (AAOS) notes that medical professionals classify pelvic fractures as either “stable” or “unstable.”
Stable fractures are those that often result from low impact trauma. They are more common in older adults. These injuries involve damage to only one bone of the pelvic ring, and the two broken sections of the bone line up adequately.
By contrast, unstable fractures are often the result of high impact trauma. They are more common in younger adults. These injuries involve multiple breaks to the pelvic ring, and the broken ends of the bones do not line up adequately.
Older people with weaker bones can develop a pelvic fracture from low impact trauma, such as a fall.
The treatment options for a pelvic fracture depend partly on whether the fracture is due to high impact or low impact trauma.
Treating fractures from high impact trauma
The AAOS notes that the pelvic ring is close in proximity to major blood vessels and organs, and a fracture here has the potential to cause excessive bleeding.
According to a
- An external compression device: This device fits over the pelvic area to keep the bones in alignment and prevent internal bleeding.
- A skeletal traction device: This device consists of an external system of pulleys, weights, and counterweights that are attached to pins inside the pelvis. The system helps position the bones for optimal healing.
- An external skeletal fixation device: This device screws into the bones above and below the fracture and attaches to a device outside the skin. The device allows surgeons to adjust the tightness of the screws in order to realign the bones as they heal.
Treating fractures from low impact trauma
Pelvic fractures from low impact trauma primarily affect older adults.
Some older individuals may require surgery to treat a pelvic fracture. However, the risks of surgery
Older adults must begin moving again as soon as they are able, as a lack of mobility causes the most severe side effects. These may include:
- Osteopenia: a reduction in the protein and mineral content of the bones
- Pulmonary infection: an infection in one or both lungs
- Blood clots: blockages that can occur in the veins or arteries
Doctors may recommend prescription analgesics, such as a narcotic or tramadol.
Osteoporosis is a common cause of pelvic fracture and other types of bone fracture in older adults.
When considering the best course of treatment, a doctor will assess the type of fracture, its cause, and any underlying physiological features that may influence recovery.
If the injury is unstable, with impact toward the back of the pelvic ring, a person may
When considering treatment options for pelvic fractures in older adults, doctors will take into account the
- whether the person has any preexisting health conditions
- whether the person is taking any medications
- whether the person can safely undergo anesthesia
- the person’s level of mobility before the accident
- the person’s cognitive and nutritional status
Compared with younger adults with pelvic fractures, older adults with this injury are at increased
People may find that their quality of life decreases after a pelvic fracture. This is particularly true when other bone injuries develop due to pelvic fracture. This can cause disability and can affect mental and social well-being.
Certain severe complications are also more likely to affect older adults during recovery. These
- bony fragments of the pelvis piercing the bladder
- injury to the obturator nerve, which innervates the thigh
Although severe, most of the complications listed above are uncommon.
Pelvic fractures are uncommon, as the pelvic ring is a very stable structure. Nonetheless, this type of injury can occur at any age.
Most pelvic fractures in younger people are due to high impact trauma, while most of these injuries in older people are due to low impact trauma. This is because older people tend to have weaker bones that are more susceptible to fracture.
The treatment for pelvic fractures can differ for older adults, usually because of differences in the type of fracture and its cause. When considering treatment approaches, doctors will also take into consideration the person’s overall health and mobility status prior to the injury.