Related injuries and complications

Are there any risks or complications?

There are a number of complications that can occur after pelvic fractures, usually related to the injury but occasionally to surgery. It is important that should you become aware of any of these inform hospital staff, as early treatment can be more effective.

Bladder injury

The bladder can be injured, this is obvious if there is blood in the urine, but bladder injury can also cause:

  • pain or difficulty with passing urine
  • a need to pass urine much more frequently than before

Sciatic Nerve Injury

The most common early complication of this fracture is nerve damage, most often the sciatic nerve. This is a large nerve that passes down the back of your thigh and branches into the lower leg. Symptoms can vary and include numbness or pain in the foot, calf or thigh, weakness of the foot and ankle, or complete inability to move the leg.

Other nerves can also be damaged, leading to similar symptoms in other parts of the leg. Nerve injuries can take many months and sometimes years to recover, having no recovery at all is very unusual. If the sciatic nerve is injured by the fracture then it will usually be looked at during surgery, and more information can be obtained regarding the likelihood of recovery.

Sexual Function

Numbness can also occur:

  • around the perineum (pelvic floor area, this is a large group of muscles which pass from your pubic bone in the front of your pelvis to your coccyx (tail bone) behind),
  • on one side of the penis (in men).

Some nerve damage can cause problems with sexual function (in both men and women) including difficulty in achieving an erection for men.   Although this is a sensitive issue, but should this be a problem it is advisable to mention this to your doctor/ physiotherapist.    This may be a short-term problem following your injury.  However, should this continue to be a concern you should mention it to your doctor at your follow up clinic appointment.   They can then refer you to the Urology team or other specialists in this field.  There is more information on this website about sexual dysfunction following trauma - for men, and for women.

  1. Infection

Infection is another possible complication, against which many measures are taken including antibiotics at the time of surgery. Infection usually presents with:

  • pain
  • redness
  • discharge (oozing) from the wound
  • occasionally a feeling of being generally unwell.

If you think your wound is infected after you have left hospital you should contact your GP. If they want to admit you to hospital it is best if you are re-admitted to St George’s hospital. 

Arthritis

The biggest long term complication of a broken pelvis is the development of arthritis. The main reason doctors operate on these fractures is that they know from past experience that if they leave the fractures in a poor position, although they will often heal, arthritis may follow within five years. This is mainly because of the amount of damage done to the joint surfaces at the time of injury. This means that even if the pieces are put back together perfectly, the cartilage (soft tissue) on the joint surface is damaged beyond repair. In some cases the bone is crushed and simply doesn’t fit back together properly, or the bone loses its blood supply and dies over the next two years. However, even in these complex cases, many patients will avoid arthritis for many years after successful surgery and it is therefore generally the best option. 

Difficulty passing urine

This means you need a urinary catheter (a tube to drain the urine from your bladder) for a few days after surgery, until you are able to use a bed-pan or toilet.

Chest Infection

This might mean that you need a course of antibiotics.

Other anaesthetic complications

These can occur during or after any big operation. This includes problems with your bowel and heart. They are usually caused by the stress of surgery making an already existing condition, which may or may not be known about, worse. The anaesthetist will see you before your operation and can explain these risks in more detail.

Possible complications

  • Pain
  • Bleeding which can happen during or after the operation. A blood transfusion is sometimes needed.
  • Blood clots in your legs. These can travel to the lungs and cause a pulmonary embolism (a clot in your lungs). You will be given blood thinning tablets to help with this.