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Our young son is in surgery. I have nothing to do but worry. Can you please help me understand something? He was involved in a car accident and may have a spinal cord injury. There's also some indication of internal bleeding from a fracture of the pelvis. I understand how the spinal cord can get pressed on or cut if the spinal bone breaks. How does having a pelvic fracture cause bleeding?
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A little refresher of pelvic anatomy may help. The pelvis is made up of your two hip bones (the ones you rest your hands on just below the waist). Each one of these bones on either side is called the ilium. At the bottom of each ilium is the place you bear weight when sitting. This is called the ischium. The place where the two pelvic bones meet in the front is called the pubis or pubic bone.
Before puberty (which means before the bones stop growing and before skeletal maturity), these three bones (ilium, ischium, pubis) are separate and have not yet fused together like in adults. Sandwiched between the two hip bones is the wedge- or pie-shaped sacrum. The place where the ilium meets the sacrum posteriorly (from the back) on both sides is called the sacroiliac joint.
High-energy trauma from car accidents can cause severe pelvic fractures -- severe enough to break and separate the bones in one or more places. Such a fracture can occur through the ilium above the hip joint causing a hip dislocation in addition to the fracture. Sometimes the pelvis is fractured in more than one place.
The jagged edges of the separated bone can cut into soft tissues, blood vessels, nerves, and even organs in the pelvic cavity. Trauma teams know that such an injury can cause more problems from internal bleeding than even spinal cord or head injuries. Every effort is made to stabilize the fracture to keep the bones from shifting and causing further damage while the surgeon works on the spinal cord injury.
The danger comes when all eyes and attention are on the other bodily injury or injuries and no one realizes the pelvis is fractured and potentially unstable. The fact that your trauma team recognizes the presence of a pelvic fracture and possible hemorrhaging is actually a very positive thing. Careful attention to all injuries right from the start help assure the best results possible.
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*Disclaimer:*The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. |
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