What are the sequelae of iliac fracture

If you touch your hips, you will feel two protruding bones on both sides, which are the ilium. We all know that this part of our body has our endocrine system, the kidneys which are crucial for metabolism and detoxification, and for women, the uterus. Therefore, it is very important to protect this part. If a fracture occurs in this area, it may cause blood vessel rupture or even heavy bleeding, affecting our physical health.

complication

1. Hemorrhagic shock: Bleeding from the fracture ends and damage to the posterior structure leading to rupture of the anterior sacral venous plexus is the main cause of shock, and rupture of large blood vessels is less common. Other causes include open wounds, hemothorax, intra-abdominal hemorrhage, long bone fractures, etc.

2. Retroperitoneal hematoma: The bones of the pelvis are mainly cancellous bones, the pelvic wall has many muscles, and there are many arterial and venous plexuses nearby, with rich blood supply. The gap between the pelvic cavity and the posterior tunic is composed of loose connective tissue, and there is a huge space to accommodate bleeding. Therefore, fractures can cause extensive bleeding. Large retroperitoneal hematomas may extend to the renal area, below the diaphragm, or to the mesentery. Patients often suffer from shock and may have symptoms of peritoneal irritation such as abdominal pain, abdominal distension, decreased bowel sounds, and abdominal muscle tension. In order to differentiate it from intra-abdominal bleeding, diagnostic abdominal puncture can be performed, but the puncture should not be too deep to avoid entering the retroperitoneal hematoma and being mistaken for intra-abdominal bleeding. Therefore, close and careful observation and repeated inspection are necessary.

3. Urethral or bladder injury The possibility of lower urinary tract injury should always be considered in patients with pelvic fractures. Urethral injury is much more common than bladder injury. Patients may experience difficulty urinating and bleeding from the urethra. The incidence of membranous urethra injury is higher in cases of bilateral pubic ramus fractures and pubic symphysis separation.

4. Rectal injury Unless there is a pelvic fracture accompanied by an open genital injury, rectal injury is not a common complication. If rectal rupture occurs above the peritoneal reflection, it can cause diffuse peritonitis; if it occurs below the reflection, perirectal infection may occur, often anaerobic infection.

5. Nerve damage often occurs when the sacrum is fractured. S1 and S2, which make up the lumbar sacral nerve trunk, are most vulnerable to injury. The gluteal muscles, hamstrings, and calf gastrocnemius muscles may become weak, and there may be loss of sensation in the back of the calf and the lateral part of the foot. When the sacral nerve is severely injured, the Achilles tendon reflex may disappear, but sphincter dysfunction rarely occurs. The prognosis is related to the degree of nerve damage. Mild injuries have a good prognosis and can generally be expected to recover within a year.