Unstable Pelvic Injury: Information & Specialists

The adult pelvis has a ring-shaped structure. 

It consists of the following bones:

• Os sacrum (sacrum)
• Ilium (hip bone)
• Os ischium (ischium) and
• Os pubis (pubic bone)

In the event of a pelvic injury, this ring may be broken in one or more places. If the pelvic ring is fractured in multiple places, particularly the posterior pelvic ring, this is classified as an unstable pelvic fracture.

Anatomy of the Pelvis @ Henrie /AdobeStock

Unstable pelvic injuries are often the result of high-velocity trauma. This can be caused, for example, by sudden braking or acceleration, as well as impact events. They are frequently associated with other injuries.

Due to the severity of the injuries and the resulting blood loss, they can be life-threatening.

The primary management of unstable pelvic injuries involves rapid pelvic stabilization to improve the overall condition. 

Pelvic stabilization is primarily performed using an external fixator or a pelvic clamp. An external fixator is a rigid support frame outside the body that stabilizes the bone fragments during initial care.

Rapid, structured action, effective trauma center management, and a high level of expertise are essential for successful treatment. Therefore, treatment must be performed at centers with the appropriate infrastructure.

In addition to restoring a stable pelvic ring, reconstruction of the fractured hip joint is of great importance.

Both procedures are performed using state-of-the-art surgical techniques, such as:

• navigation procedures and
• Intraoperative 3D monitoring

In some cases, the procedure can also be performed using a minimally invasive approach. This eliminates the need for long incisions, allowing patients to recover more quickly from surgery and begin rehabilitation sooner.

Due to the complex geometry of the pelvis, treatment of acetabular and pelvic ring fractures should only be performed at specialized centers.

The prognosis for pelvic injuries has continued to improve thanks to modern techniques and treatment approaches. However, the prognosis still depends on the severity of the injury.

Close and long-term outpatient follow-up of patients is essential for postoperative care.