Pelvic Fractures

The pelvis is composed of several bones including the hip bones (ilium, ischium, pubis), sacrum, and coccyx. These structures are connected forming the “pelvic ring” that has the vital function of providing stability, transmitting the loads from the upper to the lower part of the body (and vice versa), and providing connection to different muscles of the upper and lower extremities. Pelvic fractures refer to any fracture reported to one or more bones of the pelvic girdle. Due to the pelvic ring’s high resilience, these injuries are typically caused by high-energy traumatic events in young and healthy populations, such as motor vehicle accidents. Because of this, pelvic fractures are often associated with additional damage to other body structures (e.g.: vascular, visceral, neural, soft tissues, etc). In older populations, or in subjects affected by specific conditions that make the bones more fragile (e.g.: osteoporosis), pelvic girdle fractures can also happen with low-energy mechanisms, such as with a fall. Pelvic fractures can lead to significantly different symptomatology depending on the injured district, traumatic mechanism, associated damages, and severity of the fracture. Patients typically present with pain that can be localised or generalised (pain can radiate to different structures such as the leg, spine, etc), large bruises and swelling, potential deformity of the pelvic area, and significantly impaired functioning (e.g.: inability to weight bear, moving the leg, walking, etc). Due to the high-energy traumatic nature of these injuries, patients are typically assessed by emergency doctors and trauma surgeons through a thorough physical and imaging examination (e.g.: Magnetic resonance imaging, Computed Tomography)

Management

The management of patients affected by pelvic-girdle fractures strongly depends on the location of the injury, the specifics of the fracture itself, the presence of associated injuries, and the characteristics of the patients affected by the fracture (e.g.: age). Due to their high-energy injury mechanisms, these injuries are typically part of a polytrauma (multiple injuries) with the treatment priority being stabilising the general medical condition of the patient through a highly individualised treatment plan. Regarding the pelvis, fractures must be stabilised, and multiple procedures can be performed. After this, rehabilitation can commence. Certain pelvic injuries (e.g.: small and stable fractures that do not compromise the body’s functioning) can be managed conservatively with rehabilitation. Regardless of the implemented management strategy (surgical or conservative), rehabilitation is necessary to optimise the outcomes and minimise potential complications. In Isokinetic, your rehabilitation process will be structured in different stages and take place in four different environments, the pool, the gym, the movement analysis and retraining room and the pitch. In the early stages, the main goals are to restore homeostasis by reducing pain and swelling, recovering mobility, and gradually restoring lower limb functioning. In the mid-stage of rehabilitation, lower limb strength and endurance recovery become the priority, together with the optimisation of the general movement quality to learn how to effectively distribute the load among different joints. Finally, to complete the recovery process, on-field rehabilitation plays a fundamental role in allowing our patients to return to participate in their favourite activities, maximising the outcomes and reducing the likelihood of complications.

Pelvic Fractures

Management

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