Our 14-year old son has an avulsion fracture of the pelvis. The doctor says no surgery is needed. He can walk with crutches as much as his pain level will allow. Does this seem right?

Most pediatric pelvic fractures heal quickly and quite nicely without medical intervention. Unless there is internal bleeding, nerve damage, or other trauma, nonoperative treatment is best.

X-rays or other imaging tests give the physician an idea of where the fracture is located and what type it is. If the bone and structures are stable, then weight-bearing as tolerated is advised. Pain is the patient's guide.

After a couple of weeks, the doctor may suggest some simple range of motion exercises to regain motion. Strengthening exercises are gradually added. By the end of eight weeks, the child is often back to normal activity when there are no further complications.

More advanced or complicated fractures may be treated with bed rest or decreased activity. Weight-bearing may have to be avoided until the fracture heals. if the fracture doesn't heal (called a nonunion fracture) or if the fracture is unstable, then surgery may be needed.

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