A broken pelvis is a fracture in one or more of the bones in your lower abdomen. Pelvic fractures are typically caused by high impact traumas, like car accidents. Pelvic fractures can be severe and may accompany other life threatening injuries.

A broken pelvis happens when you fracture one of your pelvic bones, which includes your hip bones, sacrum, and coccyx. Your pelvis is typically a very stable structure, but it can break under certain conditions.

A broken pelvis is most common after a high impact trauma, such as a car accident or a fall from a great height. Older adults, who tend to have weaker bones, can also break their pelvis after a low impact fall. Pelvic fractures vary in severity and may include anything from a single crack to multiple severe breaks.

This article will provide you with more information on the different types of pelvic breaks, how they’re treated, and what recovery looks like.

A broken pelvis is a break (fracture) in any of the bones of your pelvis. The pelvic bones form the butterfly-shaped structure at the base of your spine. Bones in your pelvis include your hips, sacrum, and coccyx. Together, these bones help support and protect the organs, nerves, and other tissues in your lower abdomen.

A broken pelvis can involve a minor break, where your bone appears cracked, or a major displacement, where your bone snaps out of place. Your bones can also break in several places at the same time. Because of the ring-like shape of your pelvis, a break in one part of your pelvis often happens along with a break in another part.

A doctor will classify your pelvic break as one of two types: stable or unstable.

Stable fractures

In a stable fracture, there’s usually only one break in your pelvic structure, and the ends of the broken bones line up with one another. Stable fractures usually happen with low impact injuries, such as falls from a sitting or standing position. This makes them more common in older adults with bone weakness.

If you have a stable pelvic fracture, it may be further classified as a:

  • Closed fracture: Your skin hasn’t been broken.
  • Partial fracture: The break doesn’t go all the way through your bone.
  • Stress fracture: Your bone has a crack in it.

Unstable fractures

In an unstable fracture, there are usually two or more breaks in your pelvic ring, and the ends of the broken bones don’t line up with one another. Unstable fractures usually happen after high impact injuries such as car accidents or falls from high places.

Unstable fractures may also be classified as:

  • Open fractures: A bone is sticking out through your skin.
  • Displaced fractures: Your bone breaks into two pieces and twists or moves so that the ends don’t fit back together easily.

Common patterns

A doctor will use the Young-Burgess classification system to identify the type of break in your pelvis. This system helps doctors classify common pelvic fracture patterns, which can help them decide on your treatment. This classification system is based on the direction of the initial impact that caused the break. They may classify your injury as an:

  • Anterior to posterior compression injury: a break going from front to back
  • Lateral compression injury: a break going from one side of your body to the other
  • Vertical shear injury: a vertical break that pushes one part of the bone up toward your head

Your pelvis is a strong structure, so pelvic breaks are rare and typically happen during high impact traumatic events, such as car or motorcycle accidents. A broken pelvis can also occur during an accident that involves crushing or falling from a height, such as off of a ladder.

Because of the severity of these impacts, other injuries often happen at the same time. This can mean damage to tissue or organs within your pelvic cavity, such as your lower intestines, bladder, and reproductive organs.

A pelvic break might also occur in someone with bone loss. Bone loss is common in older adults, who are at risk of osteoporosis. Someone with bone loss could break a pelvic bone with a fall to the ground from a standing or walking position. Usually, these are stable fractures.

Rarely, a fracture can happen when a part of your ischium bone breaks off at the location where your hamstring muscle attaches. This is called an avulsion fracture. It’s most commonly seen in young athletes. It’s also considered a stable fracture.

Pelvic fracture risk factors

  • playing certain sports
  • riding a motorcycle
  • climbing
  • engaging in high speed activities
  • bone loss (osteoporosis)
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Pain is the key indicator of a broken pelvis. Pain typically worsens when walking or with hip movement. Swelling or bruising can also occur. You may feel pain in your pelvis or lower back.

There are many major blood vessels and organs in your abdomen that could also have been injured at the time of the pelvic fracture. An unstable pelvic break is a major medical emergency that requires immediate treatment. Bleeding may be internal and difficult to identify.

Bleeding could occur from your vagina, penis, or rectum. Call 911 or local emergency services and get immediate medical help if you have any bleeding or abdominal pain.

A doctor will perform a physical exam and look for any life threatening injuries. Because your pelvis is so closely positioned to your spine, they may also evaluate your spine, arms, and legs for pain and range of motion.

A doctor may order X-rays and a computed tomography (CT) scan of your abdomen and pelvis to look for bone breaks and any bleeding. Doctors may also perform a retrograde urethrography, which is a procedure that looks for damage to the urethra.

A doctor will watch closely for bleeding in your abdomen. Internal bleeding is possible with some pelvic breaks.

Treatment of a broken pelvis depends on whether it’s a stable or unstable fracture.

Stable fractures will usually heal on their own and won’t require surgery. You can generally continue walking during the healing process, but you’ll need to rely on crutches or a walker for support.

A doctor may recommend over-the-counter pain medications such as acetaminophen to help control your pain while you heal.

For an unstable fracture, surgery is usually required to realign your pelvic bones. The surgeon will place surgical screws into your bones to help keep them in place while they heal.

The doctor may also use skeletal traction, which is a system of pulleys and weights that helps realign your bones.

Following surgery for an unstable pelvic fracture, you’ll need to stay in bed and use a wheelchair for several days to weeks as you heal.

A doctor may prescribe an anticoagulant, or blood thinner, to prevent blood clots in the veins of your legs. They may also prescribe pain medications.

The doctor may allow you to return to normal activities about 3 months after your injury. But some people may need to use a cane or assistive walking device for longer.

Many people with pelvic bone injuries experience some long-term problems. One 2022 report found that, on average, people report a significantly lower quality of life both mentally and physically 2 years following treatment for pelvic breaks. This is the case even when imaging shows a healed pelvic break.

Because pelvic fractures often happen alongside other significant injuries, researchers point out that it’s difficult to determine if the pelvic fracture or other disabilities caused the overall dissatisfaction.

As your broken pelvis heals, a doctor may recommend physical therapy to help restore flexibility and range of motion in your hips. These exercises will help you build strength and increase blood flow, which encourages healing.

A broken pelvis is a break in any of the bones that create the pelvic ring at the base of your spine. Your pelvic ring is a strong and stable structure. It requires significant force to break these bones unless you have bone loss or osteoporosis.

A high-energy impact such as from a car accident or a fall from a height can break your pelvis. Only one area of your pelvis might fracture, or there can be several breaks around your pelvic ring. Doctors will classify your break as stable or unstable depending on how many breaks there are and whether your bones are lined up with one another.

A stable broken pelvis will often heal on its own and may only require you to use crutches or a walker. An unstable fracture is a medical emergency requiring immediate action and surgery to place pins and stabilize your pelvis.