Pelvic fracture fixation is an operation to stabilise broken bones in the pelvis using plates, screws, or an external fixator. It is performed for unstable pelvic fractures that cannot be managed safely without surgery.
The approach depends on the fracture pattern. Anterior fractures are approached through an incision in the lower abdomen or groin. Posterior fractures may be fixed with screws placed under X-ray guidance through small incisions (percutaneous fixation) or through a larger incision. External fixation involves pins placed through the skin into the pelvic bones, connected by an external frame. Surgery may take two to four hours depending on complexity.
Surgery is recommended for unstable pelvic ring injuries where the pelvis has been disrupted in two or more places, acetabular (hip socket) fractures with displacement, and pelvic fractures with associated injuries to blood vessels, nerves, or internal organs.
Stable pelvic fractures (such as isolated pubic rami fractures in elderly patients) are managed with pain relief and mobilisation. These fractures heal without surgery. Unstable fractures require surgical stabilisation to prevent ongoing pain, deformity, and difficulty walking.
Pelvic fractures are often high-energy injuries with associated injuries. Resuscitation and stabilisation take priority. Surgery may be performed urgently or planned within days. CT scanning is essential for surgical planning.
The aim is to restore pelvic stability, relieve pain, and allow mobilisation. Successful fixation enables most patients to return to walking, though recovery is prolonged. Outcomes depend heavily on the severity of the initial injury and associated injuries.
Pelvic fractures are major injuries. Full recovery typically takes six to twelve months or longer.
Hip and lower back stiffness are common.
High risk with pelvic injuries despite preventive measures.
The sciatic nerve and lumbosacral plexus are at risk, particularly with posterior fractures. Damage can cause leg weakness or numbness.
The pelvis may heal in a slightly asymmetric position, potentially causing leg-length discrepancy.
Particularly with open fractures or external fixation pin sites.
Pelvic fractures may be associated with injuries to pelvic organs.
Unwanted bone formation around the hip that may limit movement.
Nerve and vascular injuries associated with pelvic fractures can affect these functions.
General anaesthesia. Significant blood loss may occur, and transfusion facilities must be available.
Weight-bearing restrictions typically apply for six to twelve weeks. Physiotherapy is essential and begins in hospital. Many patients need a walking frame or crutches for several months. Return to work depends on the severity of injury and type of employment. Full recovery takes six to twelve months.
Regular follow-up with X-rays at six weeks, three months, and six months. Physiotherapy throughout. Long-term follow-up may be needed for complex injuries.
Most patients with successfully treated pelvic fractures return to walking. Some may have a limp or ongoing discomfort, depending on the severity of the original injury.
Usually at three to six months, depending on the fracture and recovery. Your surgeon will advise.
Usually not. Removal is only considered if the metalwork causes specific problems.