Pelvic Fractures

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1- Introduction

2- Anatomical Overview

3- Causes

4- Treatment

Introduction

Fractures of the hip bone are referred to as pelvic fractures. The term hip fracture is most commonly applied (unfortunately) to fractures of the femoral head, neck, or trochanters.

Avulsion fractures of the hip bone may occur during sports that require sudden acceleration or deceleration forces, such as sprinting or kicking in football, soccer, hurdle jumping, basketball, and martial arts. A small part of bone with a piece of a tendon or ligament attached is “avulsed” (torn away). These fractures occur at apophyses (bony projections that lack secondary ossification centers). Avulsion fractures occur where muscles or ligaments are attached. Common areas for avulsion fractures of the hip bone include the anterior superior and inferior iliac spines, ischial tuberosities, and ischiopubic rami.

© image from Moore's Clinically Oriented Anatomy

Anatomical Overview

Hip Joint

  • Ball-and-Socket Joint: The hip joint is a ball-and-socket joint where the head of the femur (thigh bone) fits into the acetabulum of the pelvis.
  • Bones Involved:
    • Femur: The long bone of the thigh.
    • Acetabulum: The cup-shaped socket in the pelvis.

Sections of the Femur

  1. Femoral Head: The rounded top part of the femur that fits into the acetabulum.
  2. Femoral Neck: The narrow section below the femoral head.
  3. Intertrochanteric Region: The part of the femur between the neck and the long shaft, characterized by the greater and lesser trochanters.
  4. Shaft (Diaphysis): The long, cylindrical part of the femur.
© image from moore clinically oriented anatomy

Causes

  • Trauma:

    • Falls: The most common cause, especially in older adults.
    • High-Impact Injuries: Such as car accidents, more common in younger individuals.

  • Osteoporosis:

    • A condition that weakens bones, making them more susceptible to fractures.

  • Medical Conditions:

    • Cancer: Bone cancer or metastasis to the femur.
    • Pathological Fractures: Due to bone diseases or conditions that weaken the bone.

Treatment

  • Non-Surgical Treatment:

    • Non-Displaced Fractures: Sometimes treated with bed rest, pain management, and physical therapy.

  • Surgical Treatment:

    • Internal Fixation: Screws, plates, or rods to hold the bone together.
    • Hemiarthroplasty: Replacement of the femoral head and neck with a prosthesis.
    • Total Hip Replacement: Replacement of both the femoral head and the acetabulum with artificial components.
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