https://doi.org/10.4081/ejtm.2021.9933

Rehabilitative management of pelvic fractures: a literature-based update

Vol. 31 No. 3 (2021)
Submitted: 23 June 2021
Accepted: 15 August 2021
Published: 17 September 2021
Pelvic, acetabular, fractures, rehabilitation
Abstract Views: 3512
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Authors

Francesco Piccione
Department of Neuroscience, Rehabilitation Unit, University of Padova, Padova, Italy.
Maria Chiara Maccarone
mariachiara.maccarone93@gmail.com
Physical Medicine and Rehabilitation School, University of Padova, Padua, Italy.
Anna Maria Cortese
IRCCS San Camillo Hospital, Venice, Italy.
Guido Rocca
Umberto Sansubrino
Department of Neuroscience, Rehabilitation Unit, University of Padova, Padova, Italy.
Giovanni Piran
Physical Medicine and Rehabilitation School, University of Padova, Padua, Italy.
Stefano Masiero
Department of Neuroscience, Rehabilitation Unit, University of Padova, Padova, Italy; Physical Medicine and Rehabilitation School, University of Padova, Padua, Italy.

A comprehensive rehabilitation program is required after Pelvic Fracture (PF). In a PF rehabilitation setting an effective treatment and a proper management of complications is supplied by an appropriate and reliable clinical assessment. In this literature-based update, we search on MEDLINE, EMBASE, and the Cochrane Database of Systematic reviews to find articles, scientific society guidelines and practioners experiences defining the rehabilitative management of clinically PF outcomes. Based on literature evidences and expert opinions, a set of key topics was collated to generate advices and recommendations to put into daily practice. Even if there are no high-quality evidence for rehabilitative interventions after PF in terms of duration and modality of therapy, rehabilitation setting, care pathways, and long-term functional outcomes, it is strongly recommended an early multidisciplinary intervention to improve recovery from PF.

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Yi C, Hak DJ. Traumatic spinopelvic dissociation or U-shaped sacral fracture: a review of the literature. Injury. 2012;43(4):402-408. DOI: https://doi.org/10.1016/j.injury.2010.12.011
Wong LC, Chiu WK, Russ M, Liew S. Review of techniques for monitoring the healing fracture of bones for implementation in an internally fixated pelvis. Med Eng Phys. 2012;34(2):140-152. DOI: https://doi.org/10.1016/j.medengphy.2011.08.011
Ruedi T. AO principles of fracture management. New York: Thieme; 2007.
Khan F, Amatya B, Hoffman K. Systematic review of multidisciplinary rehabilitation in patients with multiple trauma. Br J Surg. 2012;99 Suppl 1:88-96. DOI: https://doi.org/10.1002/bjs.7776
Meys G, Kalmet PHS, Sanduleanu S, et al. A protocol for permissive weight-bearing during allied health therapy in surgically treated fractures of the pelvis and lower extremities. J Rehabil Med. 2019;51(4):290-297. DOI: https://doi.org/10.2340/16501977-2532
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Szulc P. Impact of Bone Fracture on Muscle Strength and Physical Performance-Narrative Review. Curr Osteoporos Rep. 2020;18(6):633-645. DOI: https://doi.org/10.1007/s11914-020-00623-1
Rice LA, Ousley C, Sosnoff JJ. A systematic review of risk factors associated with accidental falls, outcome measures and interventions to manage fall risk in non-ambulatory adults. Disabil Rehabil. 2015;37(19):1697-705. DOI: https://doi.org/10.3109/09638288.2014.976718
Milner-Brown HS, Miller RG. Muscle strengthening through high-resistance weight training in patients with neuromuscular disorders. Arch Phys Med Rehabil. 1988;69(1):14-19.
Cup EH, Pieterse AJ, Ten Broek-Pastoor JM, et al. Exercise therapy and other types of physical therapy for patients with neuromuscular diseases: a systematic review Arch Phys Med Rehabil 2007;88:1452-64 DOI: https://doi.org/10.1016/j.apmr.2007.07.024
AO Foundation. 2014. Available from: www.aofoundation.org
Schmal H, Hauschild O, Culemann U, et al. Identification of risk factors for neurological deficits in patients with pelvic fractures. Orthopedics. 2010;33(8):10.3928/01477447-20100625-13. DOI: https://doi.org/10.3928/01477447-20100625-13
Kaiser R. Chirurgická léčba poranění nervů dolních končetin [Surgical treatment of lower extremity peripheral nerve injuries]. Cas Lek Cesk. 2016;155(3):16-20.
Kim JW, Shon HC, Park JH. Injury of the obturator nerve in the modified Stoppa approach for acetabular fractures. Orthop Traumatol Surg Res. 2017;103(5):639-644. DOI: https://doi.org/10.1016/j.otsr.2017.03.005
Conway RR, Hubbell SL. Electromyographic abnormalities in neurologic injury associated with pelvic fracture: case reports and literature review. Arch Phys Med Rehabil. 1988;69(7):539-541
Studer P, Kosuge D, Rickman M, Solomon LB. Versatility of an Extended Posterior Approach for the Treatment of Acetabular Fractures With Reference to the Superior Gluteal Neurovascular Bundle. J Orthop Trauma. 2016;30(8):e289-e293. DOI: https://doi.org/10.1097/BOT.0000000000000545
Bogdan Y, Tornetta P 3rd, Jones C, et al. Neurologic Injury in Operatively Treated Acetabular Fractures. J Orthop Trauma. 2015;29(10):475-478. DOI: https://doi.org/10.1097/BOT.0000000000000362
Beaulé PE, Antoniades J, Matta JM. Trans-sacral fixation for failed posterior fixation of the pelvic ring. Arch Orthop Trauma Surg. 2006;126(1):49-52. DOI: https://doi.org/10.1007/s00402-005-0069-2
Lehmann W, Hoffmann M, Fensky F, et al. What is the frequency of nerve injuries associated with acetabular fractures?. Clin Orthop Relat Res. 2014;472(11):3395-3403. DOI: https://doi.org/10.1007/s11999-014-3838-9
Lao A, Putman S, Soenen M, Migaud H. The ilio-inguinal approach for recent acetabular fractures: ultrasound evaluation of the ilio-psoas muscle and complications in 24 consecutive patients. Orthop Traumatol Surg Res. 2014;100(4):375-378. doi:10.1016/j.otsr.2014.02.006 DOI: https://doi.org/10.1016/j.otsr.2014.02.006
Mirovsky Y, Neuwirth M. Injuries to the lateral femoral cutaneous nerve during spine surgery. Spine (Phila Pa 1976). 2000;25(10):1266-1269. DOI: https://doi.org/10.1097/00007632-200005150-00011
Quan RF, Yang DS, Wang YJ. Study of the morphology and biomechanics of sacral fracture. Chin J Traumatol. 2006;9(5):259-265.
Kimura J. Electrodiagnosis in diseases of nerve and muscles: principles and practice. Oxoford University Press. 2001.
Kim DH, Murovic JA, Tiel RL, Kline DG. Intrapelvic and thigh-level femoral nerve lesions: management and outcomes in 119 surgically treated cases. J Neurosurg. 2004;100(6):989-996. DOI: https://doi.org/10.3171/jns.2004.100.6.0989
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How to Cite

Piccione, F. ., Maccarone, M. C., Cortese, A. M., Rocca, G., Sansubrino, U. ., Piran, G., & Masiero, S. (2021). Rehabilitative management of pelvic fractures: a literature-based update. European Journal of Translational Myology, 31(3). https://doi.org/10.4081/ejtm.2021.9933

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