Question 1

What is an iliac wing fracture and is it serious?

Accepted Answer

An iliac wing fracture (also called Duverney fracture) is a break in the wing of the iliac bone - the large flat bone forming the side of your pelvis (the bony part you can feel at the top of your hip). It usually occurs from a direct blow to the side of the pelvis - most commonly in motor vehicle side-impact collisions (T-bone accidents), falls from height, or pedestrian struck by vehicle. SERIOUSNESS: Iliac wing fractures are STABLE pelvic fractures - meaning they do NOT involve the pelvic ring (the circular structure of bones around pelvis), so the pelvis remains structurally stable. This is good news compared to unstable pelvic ring fractures which can cause life-threatening bleeding. However, iliac wing fractures are PAINFUL and often occur with HIGH-ENERGY trauma. The main concerns are: 1) Severe pain requiring hospital admission and strong painkillers. 2) ASSOCIATED injuries are common (10-30% have other injuries) - intra-abdominal injuries (liver, spleen, bowel damage), bladder or urethral injury, other skeletal fractures. 3) Recovery takes 3-6 months. PROGNOSIS: For isolated iliac wing fractures (no other injuries), prognosis is GOOD - 80-90% return to normal function within 6 months. Most are treated without surgery.

Question 2

Why do I need a CT scan if the X-ray already showed the fracture?

Accepted Answer

X-rays are good at detecting the fracture but CT scan provides much more detailed information needed for proper assessment: 1) FRACTURE DETAIL: CT shows exact fracture pattern, degree of displacement, and any small bone fragments. This helps decide if surgery needed (usually not, but CT confirms). 2) ASSOCIATED INJURIES: This is the MAIN reason for CT. Iliac wing fractures occur from high-energy trauma which often causes other injuries. CT of chest, abdomen, and pelvis screens for: Intra-abdominal injuries (liver or spleen laceration, bowel injury, kidney injury) - occurs in 10-20% of iliac wing fractures. These can be life-threatening and need urgent treatment (surgery or observation). Bladder rupture or urethral injury - occurs in 5-10%. Retroperitoneal haematoma (large blood collection behind peritoneum) - common but usually not dangerous unless massive. Other pelvic fractures missed on X-ray. Spinal fractures. Rib fractures. 3) TREATMENT PLANNING: If intra-abdominal injuries found, may need surgery (laparotomy to repair injuries). CT findings determine if patient can be discharged or needs admission. Without CT, serious associated injuries could be missed.

Question 3

Will I need surgery for my iliac wing fracture?

Accepted Answer

PROBABLY NOT - 90-95% of iliac wing fractures are treated WITHOUT surgery (conservative treatment). Surgery is only considered for: 1) Severely displaced fracture (over 2-3cm displacement) causing obvious pelvic deformity. Even then, many surgeons still prefer conservative treatment as outcomes similar. 2) Large fracture fragment causing nerve compression (specifically lateral femoral cutaneous nerve causing thigh numbness and pain). 3) Young high-demand patient (athlete, manual laborer) with significantly displaced fracture who wants fastest possible return to activities. Even then, evidence for surgery is weak. CONSERVATIVE TREATMENT (non-operative) is STANDARD for most iliac wing fractures because: The fracture is STABLE - does not involve pelvic ring so no mechanical instability requiring fixation. Bone heals well with conservative treatment - 95%+ union rate. Outcomes with conservative treatment are good - 80-90% return to normal function. Surgery does NOT significantly improve outcomes for most fractures. Surgery carries risks (infection, bleeding, nerve injury) that may outweigh benefits. CONSERVATIVE treatment involves: Hospital admission 2-7 days for pain management with strong painkillers (IV then oral opioids). Early mobilization with physiotherapy (walk with frame as pain allows). Full weight-bearing permitted (no restrictions). Outpatient physiotherapy. Recovery 8-12 weeks to return to normal activities.

Question 4

Can I walk on my fractured pelvis or will that make it worse?

Accepted Answer

YES, you can and SHOULD walk on your fractured iliac wing as soon as pain allows - it will NOT make the fracture worse. Iliac wing fractures are STABLE fractures meaning the pelvis structure is intact despite the fracture. Weight-bearing does NOT cause fracture displacement or prevent healing. Modern treatment emphasizes EARLY MOBILIZATION with FULL WEIGHT-BEARING from Day 1 as pain allows. PAIN is the limiting factor - not fracture stability. Initially (first 3-7 days) pain is severe and you can only manage bed-to-chair or few steps with frame. As pain improves (week 1-4), you progressively increase weight-bearing from partial (50%) to full (100%) as comfort allows. Most patients achieve full weight-bearing by 4 weeks. BENEFITS of early mobilization: Reduces risks of bed rest complications (blood clots, pneumonia, pressure sores). Maintains muscle strength and bone density. Faster return to function. Better long-term outcomes than prolonged bed rest. PAIN MANAGEMENT is key - adequate painkillers (opioids initially, then paracetamol/NSAIDs) allow mobilization. Physiotherapist teaches safe mobilization techniques and provides walking aids (frame, crutches). MISCONCEPTION: Old teaching (1960s-1980s) recommended prolonged bed rest for pelvic fractures. Modern evidence shows this is HARMFUL. Current best practice: mobilize as soon as possible with appropriate pain relief.

Question 5

How long will I be off work?

Accepted Answer

Time off work depends on job type and trauma severity: SEDENTARY WORK (desk job, office work, driving if passenger not driver): 4-6 weeks if isolated iliac wing fracture. Can return when: Pain controlled on oral medications (off strong opioids - these impair concentration), can sit comfortably for work hours (sitting painful first 4 weeks), can safely commute (walking, stairs, driving/transport), not too fatigued. May need workplace accommodations: option to stand/walk during day, parking close to building, flexible hours for physiotherapy appointments. LIGHT MANUAL WORK (retail, light healthcare duties, light warehouse): 8-10 weeks. Can return when: Walking without aids, can stand/walk all day, can lift light weights (under 5kg), pain managed. May need modified duties initially (no heavy lifting, frequent rest breaks). HEAVY MANUAL WORK (construction, nursing with patient handling, factory floor, heavy warehouse): 10-16 weeks. Can return when: Full mobility restored, can lift heavy weights (10-20kg), can bend/squat without pain, can work full shifts. Often phased return starting with light duties 10-12 weeks, building to full duties 14-16 weeks. ASSOCIATED INJURIES significantly prolong time off work. If intra-abdominal surgery required, add 4-8 weeks. DISABILITY BENEFITS: May be eligible for sick leave, workers compensation (if work-related injury), or disability insurance depending on circumstances and insurance coverage.

Medical Disclaimer

Iliac Wing Fracture (Duverney Fracture - Broken Pelvic Bone)

📖What is Iliac Wing Fracture (Duverney Fracture - Broken Pelvic Bone)?

🔬What Causes It?

⚠️Risk Factors

You may be at higher risk if:

🛡️Prevention