Can a pelvic comminuted fracture cause paralysis?

Written by Lv Yao
Orthopedics
Updated on September 04, 2024
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A pelvic fracture generally includes avulsion fractures, in which the pelvis remains stable, while other types of fractures tend to be comminuted fractures.

Whether paralysis occurs following such a fracture depends on whether there is nerve damage. If there is no significant nerve damage, paralysis is generally unlikely; however, if the fracture is accompanied by nerve damage, such as damage to the sacral nerves causing numbness and limited mobility, it may significantly impact function, especially of the lower limbs. Therefore, it is advised to seek treatment in the orthopedic department of a reputable hospital if a pelvic fracture occurs.

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Can a lumbar crush fracture cause paralysis?

Whether a lumbar burst fracture will cause paralysis mainly depends on the severity of the comminution and whether the fracture fragments protrude into the vertebral foramen, compressing the nerves. If it is simply a comminuted fracture and the fragments do not protrude posteriorly and do not compress the nerve roots, then it will not cause paralysis of the lower limbs. However, if the fracture fragments protrude backwards and compress the spinal nerves, or even damage the spinal nerves, the patient may experience complete loss of muscle strength and sensation in both lower limbs. In this case, emergency surgery is required to relieve this compression and reduce the pressure on the nerves, thereby alleviating the symptoms. If lower limb paralysis occurs, long-term oral medication to nourish the nerves is needed to help the nerves gradually recover. Therefore, whether a fracture can cause paralysis mainly depends on whether the nerve is compressed by the fracture fragments. If there is compression, it will result in complete loss of muscle strength and sensation in the patient's lower limbs. (Please take medication under the guidance of a professional physician.)

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Is a comminuted fracture of the iliac bone serious?

Iliac fractures are assessed based on the severity of the fracture. Generally, there are two types of iliac fractures. The first type is a linear fracture. If this linear fracture does not involve the joint surface and is a simple, non-severe linear fracture, a plaster cast can be sufficient for complete recovery, usually within about two months. The second type is a comminuted fracture, where the fracture ends affect the joint surface; in such cases, surgical treatment may be required to restore the smoothness of the joint and stabilize the fracture pieces, with a recovery time generally ranging from two to three months. Therefore, a comminuted patellar fracture is generally very serious and typically requires surgery. This is because comminuted patellar fractures are likely to lead to the most common form of post-traumatic arthritis, resulting in pain during activity later on.

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Will a comminuted fracture of the tibia cause limping?

If a comminuted tibial fracture is treated correctly, with proper alignment and the shortening kept within one centimeter, limping will absolutely not occur. The reason for limping after surgery for a comminuted fracture is due to unequal leg lengths. There are many reasons for differences in leg length, but no matter the cause, if the difference is less than 1 centimeter, a person will absolutely not limp. However, if it is less than two centimeters, or more, it then becomes apparent that one leg is longer and the other shorter, resulting in a limp. Therefore, for comminuted fractures, whether it is of the tibia, femur, or another bone, as long as the alignment is properly maintained and the shortening is controlled to within 1 centimeter, postoperative recovery will be very good, without any limping.

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Orthopedics
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How long does it take for a comminuted patellar fracture to heal?

If the patella is fractured into fragments, conservative treatment is usually not chosen, and surgical treatment is necessary. There are several surgical methods, but as long as the fixation is sturdy and the joint surface recovers well, normal life and work can generally resume in about six weeks. Typically, a follow-up at the hospital is needed in the fourth week or the twelfth week after surgery. If there are no issues at these check-ups, normal work and life can continue. However, the internal fixatives such as steel pins, wires, or memory alloy bone clamps should be removed within six months to a year post-surgery. It is generally recommended that the internal fixation devices be removed around thirteen months after surgery when the patella has healed well, and the knee joint function has been restored, allowing for a return to a normal life. So, for a comminuted patellar fracture, recovery to normal life typically takes about six weeks, and the internal fixation devices can be removed in about a year.

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Is a comminuted patellar fracture serious?

Patellar comminuted fractures are usually quite severe because once the patella is shattered, it can no longer guarantee a smooth cartilage surface. Moreover, the more severe the fragmentation, the harder it is to restore smoothness. If the smooth surface is not well restored, certain conditions can arise. The first is post-traumatic arthritis, the second is patellar chondromalacia, and the third is patellofemoral arthritis. Therefore, patellar comminuted fractures usually require open reduction and internal fixation surgery. In this surgery, it is crucial to align the cartilage surface of the patella as accurately as possible, making the joint surface as smooth as possible, and then fasten it securely with wire loops or tension bands. If the patellar fragmentation is particularly severe, and it's impossible to restore the integrity of the cartilage surface, it may be considered to remove the patella. If feasible, a prosthetic patella can be installed. If not, the ligaments and joint should be repaired, and then functional exercises should begin three to four weeks post-surgery, although this method of surgery typically results in weakness in extending the knee on the affected side.