A sciatic fracture is a serious damage to the musculoskeletal system. Most often, it occurs as a result of traffic accidents or when falling from a great height. Similar injuries can cause internal bleeding. Fracture can be complicated by intestinal paresis or a shock condition.
The pelvic part includes two bones that do not have a name. Before a person reaches adolescence, these bones are divided into 3 parts: pubic, sciatic and iliac. After 18 years, these parts begin to grow together and eventually turn into one bone. Cartilage connects them to the femur.
The sciatic bone has a fine structure. It consists of a body and branches bending at a certain slope. Its upper part contains blood vessels and nerve fibers. In the same zone there is a tubercle (a small thickening with a rough surface).
Types of Fractures
Fractures of the ischium of the pelvis are closed, open, with and without displacement. They are also divided into 2 types:
The second type of fracture most often causes various complications. This damage is unstable, since at any time displacement of parts of the bone can occur, and even the slightest load can contribute to this.
Similar injuries can occur as a result of several different circumstances:
- Traffic accident;
- Injuries during professional sports;
- РџР ° РґРµРЅРёРµ СЃ РІС ‹СЃРѕС, С‹;
- Large objects falling on the pelvic area.
Sometimes a fracture can occur against the background of pathology, one of the symptoms of which is bone fragility. And during childbirth in women, a pubic symphysis rupture is possible.
Symptoms of a fracture
Fracture of the pubic and sciatic bones is similar in symptoms, but the clinical picture may vary depending on the type of injury. If a fracture of the ischial branch has occurred, then the person has the following adverse signs:
- Sensation of severe pain in a certain area;
- Swelling at the site of damage;
- Inability to raise the leg in a prone position (a symptom called “sticking heel”).
In case of injury to the pubic and sciatic bones, the pain caused by overturning is also added to the above-mentioned discomfort.
With damage to the pelvic ring and joint, severe complications can occur, which are characteristic of:
- Pain in the perineum and symphysis;
- The need to search for body position for painless knees or tilt.
With an injury to the pubic bone, pain and swelling also occurs in the fracture zone. Such injuries are always accompanied by internal bleeding due to a violation of the integrity of the vessels.
The general symptoms of a sciatic fracture include:
- Shock after injury – appears in 30% of fractures. It is characterized by pallor of the skin, low blood pressure, cold, sticky sweat and a frequent pulse. Sometimes fainting occurs;
- Symphysis rupture and urethral damage in men is a very common occurrence with sciatic injury. Blood clots may appear in the urine, difficulty urinating and emptying the bladder;
- Bruising and bruising in the perineum;
- Sharp pain during leg movements;
- Asymmetry of the shape of the pelvis;
- Inability to lean on the lower limbs;
- Bleeding from the anus with rectal injury.
Diagnosis of a fracture is a mandatory procedure before prescribing treatment. A patient during a physical examination should tell the specialist all his complaints about changes in health. Next, the doctor palpates the area in which the patient has pain.
An X-ray is prescribed to accurately diagnose a sciatic fracture. With it, you can determine how severe the injury to the bone and nearby tissues and organs. To assess organs, an aim x-ray is used, which allows you to take a picture of the pelvis from the side.
Additional diagnostic procedures are prescribed to determine the possibility of internal injuries. The introduction of contrast allows you to identify the condition of the genitourinary system. A cystographic examination is prescribed if there is a risk of through holes in the bladder.
If a sciatic fracture is suspected, an ambulance should be called immediately. Self-transportation should be avoided, as this may cause deterioration.
After the ambulance arrives, the victim should be put on a stretcher, laying a pillow under his knees and fixing his legs firmly. With any type of bleeding (internal or external), a bandage is used to compress the injured vessels.
In the hospital, the patient is laid on a special orthopedic bed, fixing his legs in a certain position: pillows are placed under the knees, they are slightly bent and spread apart.
The very first step in treating a sciatic fracture without displacement is to take painkillers, which will remove the main symptom of such injuries – pain. Further, procedures are already being implemented to prevent blood loss.
The above actions should be performed only by a doctor, since unqualified help, on the contrary, can lead to serious consequences, including damage to nearby organs.
The specialist should help the patient to correctly take a supine position, spreading his knees to the side. In case of marginal or isolated fracture, a special fixing hammock is used. Sometimes it is possible to use Beler tires.
The most dangerous consequence of a sciatic fracture is heavy bleeding. It occurs when large blood vessels are damaged. To stop profuse bleeding, large wipes are used, dipped in a hot isotonic sodium chloride solution.
It is worth noting that such lotions can cause the development of inflammatory processes with the formation of pus, but with severe bleeding, only they are able to quickly stop blood loss and save a human life.
Properly performed surgery for fracture of the pubic or ischium will help to avoid unpleasant consequences in the form of disability. But even after the correct procedure, the patient needs a rehabilitation period. Its duration can be very significant, since such injuries are serious damage.
During rehabilitation, the regular implementation of special therapeutic exercises is required, which will help the patient recover faster. Their main task is to strengthen the tone of the pelvic muscles and their development. Gymnastics must be done constantly, but without overworking.
Recovery from a sciatic injury also consists of several procedures:
- Thermal radiation treatment;
- Diet therapy;
- Medicines with collagen in the composition.
An open or closed fracture of the pubic and ischium can cause various complications. In addition to damage to the internal organs of the patient, the following unpleasant consequences may occur:
- Sensory impairment;
- Slow or incorrect bone fusion;
- Change in leg length;
- Deterioration of the functionality of nerve fibers and muscles;
- Infectious disease.
As a result of such a fracture, a person may have problems with nearby internal organs or the mobility of the lower extremities will be limited.
A sciatic fracture is a serious injury that can lead to rupture of adjacent internal organs and major bleeding. The most important in this incident is the competent first aid. The rehabilitation period lasts several months, but if all medical requirements are followed, the victim will be able to return to their usual way of life.
Shishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.
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