I'm 56-years-old, a cowboy by profession and laid up with a pelvic fracture from a green horse I was breaking to the saddle. Damn thing bucked me off like I was a green horn. I've had surgery to clamp and screw my two pelvic bones back together. I fully intend to get back to work, including riding. How long do these kinds of fractures take to heal?

Any bone fracture takes a minimum of six to eight weeks to heal -- sometimes longer if there are health issues such as heart disease, diabetes, obesity, and so on. If it's of any help, there has been a recent report on the diagnosis, treatment, and prognosis of a particular kind of pelvic fracture known as saddle-horn injury. From your description, this may be the type of injury you suffered. The experiences of these patients (all men) may help encourage you.

All but one man in the study had surgery to repair the damage. A few patients had other injuries such as rib fractures and bladder rupture, but the majority had diastasis (separation) of the pubis symphysis (where the pubic bones come together). Clamps, plates, and screws were used to bring the two bones back together and hold them in place.

Eighty per cent of the men (18 out of 20) were back to work and back in the saddle within a year of the injury. Some were working and riding at the level they were before the injury. But 14 of the 20 said that their ability to ride was limited compared to before the injury.

The major problem after it was all said and done was with erectile dysfunction (ED). ED is the inability to develop or maintain an erection of the penis. ED can lead to an inability to ejaculate during sexual activity. The patients did not have this problem before the injury, so it was concluded that it occurred as a result of the musculoskeletal damage from the injury. Upon further questioning, it turns out that one-third of the affected group also had urinary dysfunction with incontinence (dribbling urine) and urinary urgency (sudden need to urinate).

Although erectile dysfunction is a serious impairment, saddle-horn injuries don't usually result in a poor outcome such as internal hemorrhaging, death, or permanent physical disability. The surgery seems to be successful in holding the bones together nicely. X-rays show good alignment of the pubic bones and pelvic ring formed by the pubic bones. Second surgeries are rarely needed. Mild groin and/or perineal pain with activity is a common report.

Based on the results of this small study, it looks like saddle-horn injuries have a good prognosis. Return to work and riding horses is possible and even likely. Male patients should be aware about the potential for sexual dysfunction and see their physician if this happens to them.