Can a pelvic fracture from a car accident cause paralysis?

Simple pelvic fractures caused solely by traffic accidents do not lead to paralysis. However, paralysis can occur when a comminuted pelvic fracture is accompanied by nerve damage.

1. No paralysis

Comminuted pelvic fracture refers to breaks in multiple parts of the pelvic ring formed by the sacrum, pubis, and ilium. Whether such a fracture leads to paralysis depends on whether the lower limbs are affected. The spinal cord runs within the vertebral canal and ends at the level of the lower border of the first lumbar vertebra—meaning the terminal end of the spinal cord lies above the pelvis. Therefore, pelvic fractures generally do not damage the spinal cord and rarely cause paralysis of the lower limbs.

2. Paralysis may occur

Pelvic fractures are not simple fractures; they typically result from high-energy trauma that causes disruption of the pelvic ring and often involves multiple injuries. The most severe complication is massive hemorrhage. Additionally, the pelvis encloses the pelvic cavity, which houses major organs, the cauda equina, and nerves supplying the lower limbs. Injury to these structures can lead to lower limb paralysis and urinary or fecal incontinence. When pelvic fracture occurs together with spinal fracture, it may compress or sever the spinal cord, resulting in paraplegia.

Once a pelvic fracture is identified, if the patient shows impaired limb movement or loss of bladder control, nerve injury should be suspected. In such cases, the patient should be kept lying flat, moved carefully by multiple people without exertion, as improper handling may worsen nerve damage. After the condition stabilizes, further examinations should be conducted to determine the extent of nerve injury, followed by appropriate treatment.