Late Reconstruction and Rehabilitation 10-months after Injury in a Patient with unstable Pelvic Ring Fracture / The Japanese Journal of Rehabilitation Medicine

ABSTRACT

We report a patient who received pelvic reconstruction for unstable pelvic ring fracture with severe open-book deformity after 10 months of conservative therapy and regained the ability to walk. The present report indicates that patients with unstable pelvic ring fractures should undergo reduction and fixation in the early period. Unstable pelvic ring fracture is a result of high energy trauma. It is difficult to find the best time for intervention once it has been delayed. This AO Type C3 unstable pelvic ring fracture was examined by CT imaging for pelvic deformity. Independence in activities of daily living (ADL) was evaluated using the Functional Independence Measure (FIM). After pelvic ring deformity was reduced by an external fixation-traction system, anterior fixation was performed and contracture of short external rotators was released. The patient's hip function normalized after the procedures and he was able to walk again 6 months later. Concomitant nerve paralysis also recovered after the reduction and fixation of the pelvic deformity. Unstable pelvic ring fractures may progress to pelvic deformity and adversely affect the patient's ADL unless they are managed with reduction and fixation in the early period. Unstable pelvic ring injury should primarily be treated with reduction and fixation in the acute phase.