Mobile Injury Lawyer

Fracture of the Pelvis

In many different types of accidents such as car accidents, truck accidents and especially pedestrian accidents, a victim may sustain what is called an "open book" fracture of the pelvis.  This fracture disrupts the pubic symphysis anteriorly and both sacroiliac joints posteriorly, thus "opening" the pelvis like a book.  Typically an open book fracture consists of disruption of the cartilaginous joint between the pubic bones, or a fracture of the pubic bones themselves, coupled with fracture or dislocation of the sacroiliac joint or iliac bone fractures. This injury breaks the pelvic ring, which must be intact to support a person's weight when walking. The ligaments holding the posterior part of the sacrum to the pelvis are often spared. These then act as the "binding" of the open book fracture. They may provide some stability as the fracture is reduced. When an open technique is used to reduce the fractures, plates are affixed by screws to the pubic bones. The plates are removed when the posterior fractures become stable since the natural wobbling of the pubic joint loosens the screws. The sacrum acts as a keystone when a person is walking upright, so it is essential that it is correctly aligned. To aid in alignment, an external framework may be used to support and align the pelvis.

With an open book fracture to the pelvis, accident victims also often suffer from damage to their urogenital system and the peripheral nerves.  The urethra can be torn at the point where it exits the prostate.  The nerve damage can include some of the spinal nerves at the inferior end of the spinal cord called the cauda equine.

Such devastating injuries require several weeks in the hospital.  The victim will progress from bed rest to crutches, and finally to a walker with the help of physical therapists.  Unfortunately, there are often lasting marks left by this type of injury, e.g., residual lower limb pain, muscle weakness, and sexual dysfunction due to nerve injuries.  Often, we see pelvic injuries in the context of nursing home abuse or neglect and in these cases, it is advised that you seek the counsel of an Alabama personal injury attorney for legal guidance. 

QUESTION: Why is neurologic trauma so common in persons with pelvic fractures?

ANSWER: Nerve damage is common in pelvic fractures because the nerves that form part of the lumbar and sacral plexus are intimately associated with the sacrum Movement of the bones causes the nerves to be stretched or tom. Since multiple nerve roots are involved, many combinations of injury occur. The most common deficits are muscle and sensory weakness in the lower limbs. Nerves to the bladder, rectum, and genitals are also frequently injured. Branches from sacral nerves 2 to 4 innervate the erectile tissue. Injury to these nerves caused Mr. Riordan's impotence. Since many of the pelvic injuries occur at the level of the cauda equina (Fig. 19-14), the collection of symptoms including bladder, bowel, and sexual function deficits is sometimes referred to as the cauda equina syndrome.

If you have suffered any type of pelvic fracture or injury caused by the carelessness of another,  contact an Alabama Personal Injury Attorney at McAleer Law - 251-341-0116.