Pelvic Fracture

WHAT YOU SHOULD KNOW:

Pelvic Fracture (Discharge Care) Care Guide

  • A pelvic fracture is when one or more of the pelvic (hip) bones are broken. Many pelvic fractures are caused by accidents that happen at high speed, like a car accident, or falling from a great height. Some pelvic fractures are caused by minor falls or injuries. An athlete may get an avulsion fracture when a sudden movement causes the muscle to tear away a piece of hip bone. Pelvic avulsion fractures do not usually cause any other life-threatening injuries. Pelvic avulsion fractures usually can be treated with bed rest, using crutches or a walker, and pain medicine. If you have this kind of fracture, you may have to avoid putting weight on the hip bone until it heals.

  • You may have life-threatening injuries if your pelvic fracture was caused by a high speed injury. Serious injuries may have happened to your chest, head, neck, kidney, and other organs inside your abdomen. You may be taken to the ER after the accident that caused your pelvic fracture. You may need many tests to find out if you have other injuries. After being treated in the ER, you may be taken to the intensive care unit, to surgery, or to another nursing unit.

AFTER YOU LEAVE:

Take your medicine as directed.

Call your primary healthcare provider if you think your medicine is not helping or if you have side effects. Tell him if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

  • Pain medicine: You may need medicine to take away or decrease pain.

    • Learn how to take your medicine. Ask what medicine and how much you should take. Be sure you know how, when, and how often to take it.

    • Do not wait until the pain is severe before you take your medicine. Tell caregivers if your pain does not decrease.

    • Pain medicine can make you dizzy or sleepy. Prevent falls by calling someone when you get out of bed or if you need help.
    Anticoagulants are a type of blood thinner medicine that helps prevent clots. Clots can cause strokes, heart attacks, and death. These medicines may cause you to bleed or bruise more easily.

    • Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth and a soft toothbrush. If you shave, use an electric razor. Avoid activities that can cause bruising or bleeding.

    • Tell your caregiver about all medicines you take because many medicines cannot be used with anticoagulants. Do not start or stop any medicines unless your caregiver tells you to. Tell your dentist and other caregivers that you take anticoagulants. Wear a bracelet or necklace that says you take this medicine.

    • You will need regular blood tests so your caregiver can decide how much medicine you need. Take anticoagulants exactly as directed. Tell your caregiver right away if you forget to take the medicine, or if you take too much.

    • If you take warfarin, some foods can change how your blood clots. Do not make major changes to your diet while you take warfarin. Warfarin works best when you eat about the same amount of vitamin K every day. Vitamin K is found in green leafy vegetables, broccoli, grapes, and other foods. Ask for more information about what to eat when you take warfarin.

Ask for information about where and when to go for follow-up visits:

For continuing care, treatments, or home services, ask for more information.

Bathing with stitches:

Follow your primary healthcare provider's instructions on when you can bathe. Gently wash the part of your body that has the stitches. Do not rub on the stitches to dry your skin. Pat the area gently with a towel. When the area is dry, put on a clean, new bandage as directed.

Cast or splint care:

You may need a cast to keep your leg from moving while your hip heals.

  • You may take a bath when your caregiver tells you it is OK. It is important not to get the cast wet. Before bathing, cover the cast with two plastic trash bags. Tape the bags to your skin above the cast. Keep your injured leg out of the water in case the bag leaks.

  • Follow these instructions if you have a plaster or fiberglass cast:

    • Do not push down or lean on any part of the cast because it may break

    • Check the skin around the cast every day. You may put lotion on any red or sore areas.

    • Do not scratch the skin under the cast by putting a sharp or pointed object down the cast.

Constipation:

Do not try to push the bowel movement out if it is too hard. High-fiber foods, extra liquids, and regular exercise can help you prevent constipation. Examples of high-fiber foods are fruit and bran. Prune juice and water are good liquids to drink. Regular exercise helps your digestive system work. You may also be told to take over-the-counter fiber and stool softener medicines. Take these items as directed.

Diet:

Eat healthy foods from all of the 5 food groups: fruits, vegetables, breads, dairy products, meat and fish. Eating healthy foods may help you feel better and have more energy. It may also help you heal faster.

  • Your caregiver may want you to eat a diet high in calcium. Foods high in calcium are milk, cheese, ice cream, fish, and dark green vegetables, like spinach. High calcium foods help prevent bone loss.

  • It can take time getting used to a new diet. Special cook books may help the cook in the family find new recipes.

Drinking liquids:

Adults should drink about 9 to 13 cups of liquid each day. One cup is 8 ounces. Good choices of liquids for most people include water, juice, and milk. Coffee, soup, and fruit may be counted in your daily liquid amount. Ask your caregiver how much liquid you should drink each day.

Elevation:

Caregivers may give you pillows to elevate (lift) your leg above the level of your heart. This helps decrease swelling and pain, and improves blood flow. It can also help the injury heal faster.

Heat:

Caregivers may use heat to decrease pain or swelling after the first 24 to 48 hours. Heat brings blood to the injured area and helps it heal faster. Caregivers may give you a heating pad (turned on low). Do this for 15 to 20 minutes out of every hour as long as you need it. Do not sleep on the heating pad. This can cause a bad burn.

Preventing blood clots:

  • Change the position of your legs often. Do not cross your ankles or legs for long periods of time.

  • Talk to your caregiver about what socks you should wear. You may need to wear tight knee socks, especially when you are in bed for a long time.

  • When you are sick or have surgery, start walking as soon as caregivers say it is OK.

  • When you travel or need to sit for a long time, try to stand and walk every 1 to 2 hours.

  • Do not wear tight garters or girdles.

  • Do not wear pants that are too tight.

Lifting:

Avoid lifting heavy objects.

Pain clinic:

Caregivers at a pain clinic may help you learn new ways to control your pain. You may learn relaxation or special breathing exercises to help decrease your pain. Caregivers at the clinic will help you find ways to decrease your pain that may work for you.

Physical therapy:

You may need to see a physical therapist to teach you special exercises. These exercises help improve movement and decrease pain. Physical therapy can also help improve strength and decrease your risk for loss of function.

  • Caregivers may use ultrasound to increase blood flow to the injured area. This may help your pelvic injury heal faster.

  • Caregivers may use massage to stretch the tissue and bring heat to the injury which increases blood flow. This can help your pelvis heal faster and better.

  • You may need to use crutches, a cane, or a walker until your pelvic injury heals. It is important to use them correctly. Ask your caregiver for more information about how to use crutches.

  • Caregivers may teach you exercises to strengthen your hip and legs once the pain is gone. Start exercising when caregivers say that it is OK. You will increase to swimming, stationary bicycling, and jogging with time as your pain goes away. Always do stretching exercises before working out. This will loosen your muscles and decrease stress on your hips. Rest between workout programs. Do cool-down exercises after working out.

Get enough rest:

It is very important to rest your hip while it heals. Fractures heal as new bone grows to fill in the gap between the broken pieces. Resting your hip as much as possible will allow the bone to heal. When the pain decreases, begin normal, slow, movements. Slowly start to do more each day. Rest when you feel it is needed.

Always wear a seat belt:

It is very important to wear your seat belt every time you drive or ride in a car or truck. Make sure that you keep the chest belt in the proper place across your chest.

Sexual activities:

You may have sex when you feel ready. Some patients may have problems with sex after a pelvic injury. These problems usually do not last forever and most can be helped. Talk to your caregiver if you are worried. Caregivers can help you find ways to handle these problems.

Do not smoke:

If you smoke, it is never too late to quit. Ask for information about how to stop smoking if you need help.

Support:

Having a pelvic fracture may be life-changing for you and your family. You may need to depend on others to help you do things that you usually do yourself. You and those close to you may feel angry, sad, or frightened. These feelings are normal. Talk to your caregivers, family, or friends about your feelings. Let them help you. Encourage those close to you to talk to your caregiver about how things are at home. Your caregiver can help your family better understand and learn how to support a person with a pelvic fracture.

CONTACT A CAREGIVER IF:

  • Your skin is itchy, swollen, or has a rash.

  • Your pain and swelling increase.

  • You have new symptoms.

  • You have a fever.

  • You have chest pain or trouble breathing that is getting worse over time.

SEEK CARE IMMEDIATELY IF:

  • You suddenly feel lightheaded and have trouble breathing.

  • You have new and sudden chest pain. You may have more pain when you take deep breaths or cough. You may cough up blood.

  • Your leg feels warm, tender, and painful. It may look swollen and red.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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