Apart from excessive bleeding that results from the injury there are many other complications of pelvic fracture which can be directly related injury or as an indirect result. There are other complications which may be related to the treatment.
Complications related To Treatment
Most complications of extenral fixation are the result of pin loosening or infection, and inadequacies of the reduction and fixation. Improper insertion and location of fixation pins in the ilium usually results in early loss of fixation. This leads to pain, loss of reduction, and pin-track infection.
Infection and fixation in malposition are frequent complications of internal fixation.
The risk of postoperative infection of pelvic surgery is quite significant.
Neurologic Complications
Neurologic injury is a major cause of long-term morbidity after a pelvic ring disruption, particularly a posterior ring disruption. The incidence of neurologic injury varies between 2 percent and 50 percent
The lumbosacral trunk is injured as a result of traction from significant external rotation and posterosuperior displacement of the hemipelvis.
The superior gluteal nerve usually is injured directly by fracture fragments near the SI joint.
Recovery from neurologic injury is unpredictable. Most nerve injuries are traction induced and require early conservative treatment.
The results of surgical repair of the sciatic nerve are poor.
Thromboembolism
Deep venous thrombosis (DVT) with the potential for a subsequent fatal PE is a common complication of a pelvic fracture. It can be minimized by the use of appropriate prophylactic measures.
These rates may become much higher if the patient has sustained polytrauma with the involvement of multiple organ systems.
A high injury severity score, increased age, a concomitant lower extremity or spinal cord injyry, and a part history of venous stasis disease increase the risk.
Persistent Pelvic Pain
About 60% of pelvic fracture victims have prolonged posterior pelvic pain.
Electromyographic studies and nerve conduction velocities and an MRI or myelography may be useful for evaluating neurologic pain.
Nonunion and Malunion
Late deformities and a nonunion can involve one or more sites around pelvic ring.
Urologic and Gynecologic Problems
These may include incontinence, urinary dysfunction, dyspareunia, dysmenorrhea, and difficulty with vaginal delivery and overall sexual function.
Overall, serious problems appear to be relatively uncommon.
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