For most situations of pelvic fractures that do not involve the acetabulum, a bone plate and screws are usually used to support the fractured ilium. Fractures of the ischium and pubis are usually not repaired. Fractures that do involve the acetabulum may need to have the acetabulum carefully reconstructed and stabilized or a procedure in which the femoral head and neck are cut off the shaft of the femur might be recommended. This procedure is done in order to minimize the chance for the animal to have long-term problems associated with a hip joint that heals in an abnormal way leading to future arthritis. If a sacroiliac luxation is also present, the luxation may require repair and stabilization as well. When both sides of the pelvis are broken, only one or both sides may require surgical repair.
Follow-up Care for Dogs with Pelvic Fractures
If it is determined that surgery is not required for your pet or if it is not necessary to pursue the surgical option, you must strictly confine your dog to allow the pelvis to heal and prevent excessive pain. Because the bone fragments are not stabilized when this course of treatment is followed, excessive motion or activity can prevent the fracture from healing at all or cause it to heal in a location that interferes with motion of the leg or with structures that pass through the pelvic canal like the colon, urethra and uterus.
After surgery and discharge from the hospital, the animal must be restricted from activity to allow the fracture to heal properly. Activity must be restricted for several weeks after surgery (the duration will vary depending on the severity of the injury, the type of fixation that was used, and the age of the animal). Restricted activity means that the animal should be kept confined to a carrier, crate, or small room whenever he cannot be supervised, the animal cannot play or rough-house, even if he appears to be feeling well. In addition, the use of stairs should be limited and outdoor walks should be just long enough for the dog to relieve himself and then should be returned indoors for more rest.
The skin incision needs to be monitored daily for signs of excessive swelling or discharge. These can indicate problems with the incision or possibly infection. Contact your veterinarian if these occur.
If at any point prior to the recheck radiographs your pet stops using the leg again after some improvement following surgery, there could be a problem. Again, the veterinarian should be notified.
Several weeks after surgery, the pelvis will need to be radiographed again to make sure the bones are healing well. If the healing has occurred as expected, the dog’s activity level will be allowed to increase slowly back up to normal over the next few weeks.
In general, any other implants that were used in the repair will be left in place unless they cause the animal a problem at some point in the future. Potential problems can include migration (movement) or infection of the implant.