Pelvic fractures are breaks in one or more of the bones making up the pelvis - including the ilium, ischium, pubis, sacrum, or acetabulum (hip socket). Because the pelvis forms a ring structure, a fracture in one area often associates with damage elsewhere in the ring. Pelvic fractures range from mild, stable breaks to complex, unstable injuries often from traumatic events.
These injuries are less common than typical hip or femur fractures, accounting for about 3% of adult fractures.
Pelvic fractures generally occur from:
High-energy trauma, such as motor vehicle collisions, falls from heights, or crush injuries
Low-impact events in patients with osteoporosis or weakened bone (especially in older adults)
Athletic or avulsion fractures (where a ligament or tendon pulls off a small piece of bone) in younger, active patients
Risk factors include age, bone density, prior fractures, and overall health status.
Common symptoms include:
Significant pain in the pelvic, groin, or hip region
Difficulty or inability to stand or walk
Pain with movement, twisting, or hip rotation
Possible swelling, bruising, or tenderness in the pelvic area
Rarely, urinary or bowel symptoms, numbness, or nerve signs if soft tissues or organs are affected
Diagnosis generally begins with X-rays of the pelvis (AP view) and hip, followed by more detailed imaging (CT, MRI) when needed to evaluate fracture lines, displacement, involvement of the acetabulum or soft tissues.
In complex or high-trauma cases, a full trauma workup is needed to assess associated injuries (organs, vessels, nerves) and patient stability.
Pelvic fractures are often classified by stability:
Stable fractures: A single break or minimal displacement, where the structural ring remains largely intact. These may heal without surgery. Unstable fractures: Multiple breaks or significant displacement, disrupting the pelvic ring. These often require surgical stabilization.
Additionally, fractures involving the acetabulum (hip socket) or those with intra-articular extension demand specialized care and attention to joint mechanics.
For stable, non-displaced fractures or in medically fragile patients:
Bed rest and limited weight bearing (often using crutches or walker)
Pain control, blood clot prevention, and monitoring
Physical therapy when safe, focusing on gentle mobility, strengthening, and gradually increasing load
Close follow-up imaging to confirm fracture healing
Many stable fractures heal without surgery, though recovery can take several weeks to months.
For unstable, displaced, acetabular, or ring-disruption fractures, surgery is often indicated. The goals are fracture reduction, stabilization, and restoration of anatomy to allow safe weight bearing and preserve joint function.
Techniques may include:
Open Reduction & Internal Fixation (ORIF) using plates, screws, rods
External fixation (temporary or in severe trauma) to stabilize the pelvis while managing other injuries
Reconstruction of the acetabulum when involved, with careful restoration of joint congruity
In rare cases, joint replacement if damage to the hip cartilage or femoral head is too severe
Patient-specific planning is essential, particularly when the fracture involves the hip socket or joint surfaces.
Recovery timelines vary based on fracture severity, surgical vs conservative treatment, patient comorbidities, and rehabilitation adherence. Some general milestones include:
Early Phase (0–6 weeks): Limited or no weight bearing, pain management, protected mobility
Intermediate Phase (6–12 weeks): Gradual increase in load, physical therapy for range of motion, core strength, gait training
Late Phase (3–6+ months): Progressive strengthening, balance training, return to functional and recreational activities
In complex fracture cases, recovery can extend to 6–12 months or more. Close monitoring and collaboration with a skilled PT team is critical.
Pelvic fractures carry risks beyond bone healing, including:
Bleeding / internal hemorrhage
Injury to pelvic organs, bladder, urethra, bowel
Nerve damage (sciatic, lumbosacral plexus)
Non-union or malunion of fractures
Joint degeneration, arthritis (especially if acetabulum involved)
Thromboembolism, infection, chronic pain
Because pelvic bones protect many critical structures and house large vessels and nerves, surgical planning must carefully address both stability and safety.
Board-certified hip and orthopedic surgeon with experience managing complex pelvic and acetabular fractures
Access to coordinated, multidisciplinary care in Chicago, including trauma, vascular, urology, and rehabilitation specialists
Imaging and surgical planning capabilities to optimize fixation and preservation of hip joint function
Patients from Chicago, suburbs, and surrounding states seek his expertise for challenging reconstructive fractures
Committed to not only restoring stability but also promoting functional recovery and long-term mobility
If you’ve sustained a pelvic fracture or suspect injury near your hip or pelvic region - whether from trauma or a fall - reach out today for a consultation with Dr. Williams in Chicago. He will review your imaging, guide you through surgical vs conservative options, and coordinate your path toward healing, stability, and mobility.
If your doctor suggests hip treatment, seek a second opinion and explore the best option.
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