i fractured my pubis and ishium on 30th july , i had xray on the 25th october, and the break on the pubis has not healed and is still open and has not changed any, should this have not healed by now or is this usuall, how long should this take or should it need surgery.
A fracture through the pubic rami and ischium should heal in about 6 to 8 weeks. But, every patient is different and may take a little less or a little more. This fracture usually heals well, since it is a bone to bone healing.
However, if the symphysis pubis is injured, through the cartilage connection, and is widely separated, then healing may not occur. Symphysis pubis injuries widened more than 2 cm are usually need to be surgically fixed.
So, by 12 weeks, a fracture through the bony portion of the pubic rami and ischium should have at least some signs of healing. It is around this time, that the decision, of wait a little longer, or bite the bullet and surgically fix the fracture has to be made.
Fractures, by definition, are not a nonunion until 6 months have passed, but it is usually possible to tell before that which fractures have the appearance of going on to a nonunion.
You need to discuss your options with your surgeon. Be sure to ask about the risks and benefits of each and what the expected outcome is to be.
thank you for your reply.the consultant i have seen has chosen to leave it for another 6week before making a decision,and i have been in the hospital gym for the last 8wks could this be the cause of the pubis not healing and should this stop.thank you
When rehabilitating a fracture, letting pain be your guide is always the best bet. If you have sharp, intense pain right at the fracture site, then you need to back off and stop the offending activity. As this type of pain is telling you, that you are exceeding the stress limits for the injury.
If you have work-out type pain that you get when you do physical activity or stretching, that is okay. That is just the muscles working to get back into shape.
If you put too much stress on the bone, it will let you know. If you have no pain, or just minimal tolerable pain, you are not doing any damage.
And, actually applying stress across fractures will help stimulate the body to heal the injury. This is called Wolff's Law - bones will respond to the stresses applied to them. That is why your bones get stronger and stouter when you lift weights and develop osteoporosis when you are sedentary (age, injury, space flight).
So, again, just let pain be your guide. Hope your fracture heals in the next few weeks. Actually, if you have minimal pain at the fracture site, the fracture has sort of been "glued" together with a soft matrix called osteoid. Osteoid is laid down in the fracture site first, then the body calcifies it. Once it begins to calcify, it is called callus. Callus is the new bone formation that heals fractures.
But, osteoid is not strong enough to withstand the stresses of everyday life. But, it is a start in the healing process. So, maybe in the next few weeks, you will see some calcification going on around the fracture.