Symptoms

What symptoms do pelvic fractures cause?

Serious pelvic fractures are sometimes not diagnosed at the time of the injury. The situation is often complicated by multiple injuries, unconsciousness of the patient, or the effects of drugs, alcohol or pain medication. Any symptoms that refer to the region of the pelvis should be carefully investigated.

As with all fractures the most common symptom of a pelvic fracture after an accident is pain in the pelvic region. In the common situation when an elderly person has fallen and sustained a pelvic fracture the pain may easily be mistaken for a hip fracture. If a hip fracture is not seen on x-ray the pelvis x-ray must be examined carefully to rule out a fracture of the pubic ramus. In younger people, pelvic fractures commonly occur in the setting of multiple trauma. The pain may not be evident in an unconscious patient or may be much less than the pain from other injuries.

The pain is felt in the area of the fracture. For example, in a fracture involving the pubic rami and the posterior sacroiliac complex, the pain is felt in both places. If there is pain or tenderness at the back, this region must be carefully evaluated by x-ray or computed tomography (CT) scan to identify the injury. The muscles that move the leg take origin from the pelvis so pain is made worse by movement. If the fracture involves the hip socket (acetabulum), movement of the hip joint will be especially painful or impossible. One leg may appear to be shorter than the other in acetabular fractures and unstable pelvic fractures.

Shock from blood loss may be seen when there is a pelvic fracture. If the patient needs on-going resuscitation and blood transfusion, the pelvis fracture may be responsible. Bleeding from a pelvic fracture often tracks down into the groin so swelling and purple discoloration of the scrotum or the labia are common and may last a long time. Swelling and bruising may also extend into the root of the thigh. Bleeding from the urethra is a sign of a potentially serious injury to the bladder or the urethra. Another symptom of a urogenital injury is the inability to pass urine or incontinence. Numbness or weakness in the leg or groin may be a sign of a nerve injury associated with a pelvic fracture.