Pelvic Fractures in Nursing Homes

Pelvic injuries in the elderly cause a threefold increase in mortality rates, making them an extremely dangerous injury [1]. The pelvis protects the internal organs, including the reproductive organs, so fractures can lead to long-term complications like sexual dysfunction and chronic pain [2].

Unfortunately, pelvic fractures are common in the elderly and may be the result of nursing home neglect. If you or a loved one has suffered a pelvic fracture in a nursing home, contact the Nursing Home Law Center for a consultation about your legal rights. 

Common Types of Pelvic Fractures

Elderly adults are more likely to suffer mild pelvic fractures caused by low-energy falls or osteoporosis [3]. They may be fixed or displaced, and they usually involve both the anterior and posterior bones [4]. 

Open pelvic fractures occur when the bone breaks through the skin, while closed fractures are when the injury remains inside the body. Both closed and open fractures may occur in either stable or unstable fractures [5]. 

Stable Pelvic Fractures

Stable fractures usually involve only one broken bone in the pelvic ring, where the ends of the bone line up well [6]. Most pelvic fractures in the elderly are stable fractures because they typically result from low-energy accidents like falls [6].

Types of stable fractures include:

Avulsion Fractures – These occur when a tendon or ligament pulls off a piece of the hip bones [7]. Because the sacrospinous and sacrotuberous ligaments run through these areas, avulsion fractures may involve these ligaments [8]. 

Iliac Wing Fractures—These pelvic ring fractures compromise the pelvic bones on either side of the pelvis, called the iliac wings. They are generally high-energy pelvic fractures, like those seen after a car accident [9]. This type of fractured pelvis usually does not require surgical intervention [10]. 

Sacral Fractures – Sacral fractures are common pelvic ring injuries involving the large triangle-shaped bone at the bottom of the spine, which is part of the posterior sacroiliac complex [11]. 

The sacrum is attached to the pelvis by the sacroiliac joint, which may be damaged in the injury [12]. In most cases, this pelvic trauma can be treated at home, but severe pelvic fractures of the sacrum may require a surgical procedure [13]. 

Isolated Pubic Rami Fractures – These broken pelvic injuries involve a break where the ilium ischium and pubis meet. Unlike sacral fractures, they do not include the posterior sacroiliac complex [14].  

While rarer, isolated public rami fractures are very severe, especially in elderly people. Individuals with this type of pelvic fracture are more likely to die earlier and experience a decreased quality of life [15].  

Unstable Pelvic Fractures

Unstable pelvic fractures involve two or more breaks in the bony pelvis, and the ends of the breaks are typically displaced. These broken pelvis injuries are more likely to result from high-impact injuries, like a car crash [16]. Types of unstable fractures include:

Lateral Compression Injuries – These pelvic ring fractures occur when high pressure is placed on one side of the pelvis, and the pelvic ring then implodes or collapses. A lateral compression pelvic fracture is closely associated with a closed head injury  [17].

Anterior-Posterior Compression Fractures—The anterior-posterior injury pattern occurs when the legs are forced out of normal alignment or when a direct blow to the anterior pelvis causes a fracture. This pelvis fracture may involve a vertical break through the pelvic rami [18].

Vertical Shear Fractures – These unstable pelvic fractures occur when a strong vertical force forces the pelvic ring, breaking it and pulling it away. They may occur after a fall from a large height [19].

Combined Mechanism Fractures – If multiple causes contribute to pelvic fractures, they are called combined mechanism fractures. These types of fractures can lead to more complications and require more intensive treatment, such as open reduction and internal fixation. This is a surgery where the surgeon makes an incision, puts the bones back together, and then uses metal pins, screws, or metal plates to hold the bone back in place [20]. 

Acetabular Fractures

Acetabular fractures involve the internal rotation component of the pelvic area, which connects the pelvic ring to the femur [21]. The obturator artery is close to this joint, so an acetabular fracture can lead to severe bleeding or a blood clot [22]. These pelvic fractures may have associated injuries like a broken femur or open fractures [23]. 

Geriatric Pelvic Fractures

Low-energy accidents, like a minor fall, are the most common cause of pelvic fractures in the elderly. Risk factors for pelvic fractures include osteoporosis, using pain medication or other medications, central nervous system disorders, and inadequate physical activity [24].

Pelvic fractures are diagnosed through X-rays, magnetic resonance imaging (MRI), or a CT scan. Treatments for pelvic ring injuries can include physical therapy to strengthen the leg muscles and pelvic floor, pain relief, or a pelvic binder. 

In some cases, patients may need skeletal traction, open reduction and internal fixation, or external fixation, which involves metal pins to hold the bone in place [25]. 

Causes of Pelvic Fractures in Nursing Homes

Pelvic fractures in nursing homes may occur due to negligence, including failing to respond quickly to patients’ needs, failing to keep the nursing home free of obstacles, or failing to properly lift and move patients. 

Failure to Conduct Proper Fall Risk Assessments

Every patient should receive a fall risk assessment and have proper interventions to prevent falls. Without assessments, senior citizens may be more at risk for broken bones and other injuries. 

Inadequate Fall Prevention Measures (Bed Alarms, Mats, Assistive Devices)

Each resident should receive a fall prevention plan based on their specific needs. This can include bed alarms, fall mats, and mobility aids. Without these plans, residents don’t have the tools they need to prevent falls and pelvic fractures.

Failure to Adequately Supervise Residents

When staff fail to supervise residents, they may slip and fall or attempt to get out of bed without assistance and suffer injuries. 

Delayed Response to Call Lights or Requests for Assistance

Staff should respond to all requests as soon as possible and ensure that residents don’t attempt to get up or move without assistance. Failure to do so can result in falls and pelvic fractures. 

Improper Lifting or Transferring Techniques

Pelvic fractures can result when staff don’t use the appropriate transfer techniques, such as when moving a resident from their wheelchair to bed. For example, if they don’t use two-person lift techniques, the person could slip and break their hip. 

Failure to Maintain Safe Premises (Wet Floors, Clutter, Poor Lighting)

All nursing homes should be free of obstacles that could lead to trips and falls. Wet floors, fall hazards, or inadequate lighting can lead to serious pelvic fractures. 

Violations of State and Federal Nursing Home Regulations

Nursing homes are subject to strict state and federal regulations around fall assessments, transfer techniques, and nursing home layouts. Violations, such as failing to remove clutter or use two-person lifts, can be a sign of negligence. 

Signs and Symptoms of Pelvic Fractures

• Pain  – Pain may occur in the hip, groin, lower back, or pelvic floor.
• Difficulty Walking – Limping or inability to bear weight can suggest a pelvic injury.
• Swelling and Tenderness – Large bruises around the pelvis may point to pelvic fractures, as blood vessels may have been damaged in the fall.
• Bowel and Bladder Issues – Because pelvic fractures occur near the large intestine and bladder, they can cause incontinence.
• Difficulty Sleeping – Pelvic ring injuries make it difficult to lie comfortably, especially if the patient isn’t given anything to relieve pain.
• Non-Verbal Cues – Dementia patients may not be able to explain what’s wrong, making it important to look for signs of pain [26]. 

Investigation Process for Pelvic Fractures in Nursing Homes

If you or your loved one has suffered a broken pelvis, nursing home abuse attorneys can assist with investigating the incident and negotiating for compensation. This process includes gathering evidence, reviewing documentation, and consulting with eyewitnesses and experts. 

Gathering Medical Records and Treatment Information

To start, your attorney will gather a full medical history, including both before and after the accident. This helps determine whether the victim had any preexisting conditions that may have contributed to the fracture. 

Reviewing the Nursing Home’s Policies and Procedures

We will review the facility’s policies, including fall prevention protocols, cleaning schedules, and transfer policies. This will help us determine whether failure to follow procedures contributed to the accident.

Analyzing Staffing Levels and Training Records

Inadequate staffing or untrained staff can lead to negligence and falls. As such, we’ll identify whether the facility has the appropriate amount of staff and whether all staff have the proper certifications. 

Interviewing Witnesses: Staff, Residents, and Visitors

Staff, residents, and guests of the nursing home may have witnessed the incident or identified signs of neglect, such as residents waiting long periods of time for help or rooms not being cleaned regularly.

Consulting with Medical Experts and Geriatric Specialists

Medical specialists can testify about different types of pelvic fractures and suggest common causes for these injuries. They can also explain the extent of the damage, which can be used in case valuation. 

Legal Options for Families of Nursing Home Residents with Pelvic Fractures

Pelvic ring injury victims have the right to consult with an attorney and pursue damages against the nursing home, including staff and administrators. This can be done through a lawsuit or negotiations with the nursing home’s insurance company. 

Filing a Nursing Home Neglect Lawsuit

Families can file a civil lawsuit against the nursing home for negligence that caused broken pelvis injuries. After presenting the evidence, a jury will determine whether the fractured pelvis was related to negligence and how much the victim should receive. 

Seeking Compensation for Medical Expenses, Pain and Suffering, and Other Damages

Damages that may be recovered in a lawsuit can include:

• Medical expenses
• Relocation costs if the victim is moved from the nursing home
• Out-of-pocket medical expenses like physical therapy and pain management
• Pain and suffering
• Emotional distress
• Loss of enjoyment of life

Wrongful Death Lawsuits (If the Fracture Leads to Death)

When pelvic fractures contribute to a person’s death, the surviving family can file a wrongful death claim. These work similarly to a negligence lawsuit, but damages that can be recovered include funeral expenses and loss of companionship. 

Statute of Limitations for Nursing Home Neglect Lawsuits

In Illinois, the statute of limitations for personal injury and wrongful death is two years from the date of injury or death. It’s crucial to contact a nursing home abuse lawyer as soon as possible after pelvic fractures so that you can ensure you file a lawsuit in time. 

Why Choose Our Law Firm for Your Nursing Home Pelvic Fracture Case?

Nursing Home Law Center is a leading personal injury law firm dedicated to nursing home neglect and abuse cases. We will thoroughly investigate the accident and consult with medical experts to determine the likely cause and consequences of a pelvic injury.

Once we’ve completed our investigation, we’ll firmly negotiate with the nursing home’s insurance agency for maximum compensation. Using our expertise, we’ll evaluate your potential damages and provide evidence proving why you deserve the highest possible sum.

In many cases, pelvic fracture lawsuits are settled out of court. However, if the insurance agency refuses to negotiate, we will represent you in a civil lawsuit. Our experienced trial attorneys will guide you through every step of the process, from filing the lawsuit to stepping into court. 

We have recovered millions in damages for our clients both in and outside of court. Most importantly, we work to minimize the stress of a lawsuit for you and your family. Our goal is to help you achieve the compensation you need to recover in comfort and dignity. 

Contact Our Nursing Home Attorneys for a Free Consultation

If you or a loved one has suffered a pelvic fracture due to nursing home negligence, you deserve compensation. Contact the experienced attorneys at Nursing Home Law Center for a free consultation by calling (800) 926-7565 or using our online contact form. 

References: [1] Frontiers in Medicine, [2] National Library of Medicine, [3] UpToDate, [4] UpToDate, [5] American Academy of Orthopaedic Surgeons, [6] Medical News Today, [7] Northwest Oklahoma Orthopaedic Clinic, [8] Radiopaedia, [9] Science Direct, [10] AO Surgery Reference, [11] Government of Alberta, [12] OrthoIllinois, [13] Government of Alberta, [14] National Library of Medicine, [15] National Library of Medicine [16] Cleveland Clinic, [17] Wheeless’ Textbook of Orthopaedics, [18] MedScape, [19] MedScape, [20] Cleveland Clinic, [21] American Academy of Orthopaedic Surgeons, [22] ScienceDirect, [23] American Academy of Orthopaedic Surgeons, [24] DynaMed, [25] Cleveland Clinic, [26] Cedars-Sinai Medical Center