Rehabilitation of patients  with acetabular fractures

Maurer, F.; Mutter, B.; Weise, K.; Belzl, H.

doi:10.1007/pl00003393

Cited by 3 publications

(6 citation statements)

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“…In general, many authors state that rehabilitation is as important as proper fracture reduction and fixation, although only a few authors describe their rehabilitation protocol extensively. Regarding the post-surgical rehabilitation of fractures of the proximal humerus, acetabulum and tibial plateau, 6 eligible papers (1, 2, 4, I II I II I II I II I II I 8-10) were found, of which 5 discussed the rehabilitation of proximal humerus fractures (1, 2, 8-10) and 1 the rehabilitation of acetabulum fractures (4). No paper addressed protocols for the post-surgical rehabilitation of tibial plateau fractures.…”

Section: Discussionmentioning

confidence: 99%

“…Of the 6 eligible papers, 5 addressed physiotherapeutic/ occupational therapeutic rehabilitation after surgical treatment of proximal humerus fractures (1,2,(8)(9)(10) and one addressed post-surgical physiotherapeutic/ occupational therapeutic rehabilitation of acetabulum fractures (4). No paper describing the rehabilitation of tibial plateau fractures met the selection criteria.…”

Section: Content Descriptionmentioning

confidence: 99%

“…Acetabulum fractures. The paper by Maurer et al (4) addressed the physiotherapeutic/occupational therapeutic rehabilitation of acetabulum fractures after surgical as well as conservative treatment, although in the present paper we only outline the post-surgical rehabilitation programme. Maurer et al (4) described the therapy in more detail compared with the papers addressing the rehabilitation of proximal humerus fractures.…”

Section: Icf -Participation Levelmentioning

confidence: 99%

“…The choice of rehabilitation protocol depends on the reduction and fixation strategy used. Clinical practice has shown that rehabilitation greatly influences the recovery of the patient (1)(2)(3)(4).…”

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confidence: 99%

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Evidence-based rehabilitation therapy following surgery for (peri-)articular fractures: A systematic review

Schnackers¹,

Horn²,

Meys³

et al. 2019

J Rehabil Med

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The aim of this study was to review the scientific litera ture on the availability of explicitly reported protocols or guidelines for therapists describing rehabilitation treat ment of patients with one or more complex fractures of the upper arm, pelvis or knee joint that needed to be operated on. Online databases, stakeholder internet sites, clinical guidelines and textbooks were searched. The papers found were critically reviewed. Five papers describing the rehabilitation of patients with an upper arm fracture and one paper on rehabilitation treatment after a pelvis fracture were identified, mainly describing muscle strength, joint mobility or endurance issues. Little information about therapy dosage was reported. No scientific evidence was provided on which to base the rehabilitation programmes. This review reveals a lack of explicitly formulated rehabilitation protocols fo cusing on improving patients' activities of daily living and of patients' participation in social life. More scienti fic evidence is needed on such protocols. Objective: To assess the availability of explicitly reported protocols describing post-surgery rehabilitation of (peri-)articular fractures of the proximal humerus, acetabulum and/or tibial plateau, and to critically review any scientific evidence on the effectiveness of these protocols. Data sources: MEDLINE (PubMed), Cochrane databases, CINAHL, PEDro and Embase (Ovid) were searched to November 2018. Furthermore, stakeholder internet sites, clinical guidelines and standard textbooks were searched. Study selection: Screening was performed independently by 2 researchers based on a priori defined eligibility criteria. Data synthesis: Five papers addressed post-surgical rehabilitation of proximal humerus fractures, one paper addressed acetabulum fractures. No eligible information was found on stakeholder sites or in standard textbooks. Overall, the main focus of the protocols identified was on the International Classification of Functioning, Disability and Health (ICF) "Body Functions and Structures" level. In general, little information about therapy dosage was reported. None of the protocols provided scientific evidence on which the content of described rehabilitation programmes was based. Conclusion: This review reveals a paucity of explicitly formulated protocols focussing on post-surgical rehabilitation of common (peri-)articular fractures targeting patient-centred care at all ICF levels. There is a need for more scientific evidence on which to base protocols regarding common (peri-)articular fracture rehabilitation.

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Section: Discussionmentioning

confidence: 99%

Section: Content Descriptionmentioning

confidence: 99%

Section: Icf -Participation Levelmentioning

confidence: 99%

mentioning

confidence: 99%

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Evidence-based rehabilitation therapy following surgery for (peri-)articular fractures: A systematic review

Schnackers¹,

Horn²,

Meys³

et al. 2019

J Rehabil Med

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“…The same set of exercises in supine or side-lying abduction is usually postponed until 5-14 days postoperatively. Partial weight-bearing with stepwise progression usually starts 6 weeks postoperatively and full weight bearing is eventually allowed at 10 weeks (Maurer et al, 1997). Recently, interesting information was obtained by direct measurements of acetabular contact pressures during rehabilitation exercises in subject with pressure-instrumented partial endoprostheses where it was found that acetabular pressures may not follow the predicted rank order corresponding to the commonly prescribed temporal order of rehabilitation activities (Givens-Heiss et al, 1992;Tackson et al, 1997).…”

Section: Introductionmentioning

confidence: 99%

Acetabular Loading in Rehabilitation

Debevec¹,

Iglič²,

Kralj‐Iglič³

et al. 2009

Rehabilitation Engineering

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Biomechanical comparison of fixation techniques for transverse acetabular fractures – Single-leg stance vs. sit-to-stand loading

Quang

Schmoelz

Lindtner

et al. 2020

Injury

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Objectives: To biomechanically compare five different fixation techniques for transverse acetabular fractures using both the single-leg stance (SLS) and the sit-to-stand (STS) loading protocols and to directly compare fracture gap motion (FGM) and relative interfragmentary rotation (RIFR).Methods: Transtectal transverse acetabular fractures were created on fourth-generation composite hemipelves in a reproducible manner. Five different fixation techniques were biomechanically assessed using both an SLS and STS loading protocol: anterior plate (AP) only, posterior plate (PP) only, anterior plate plus posterior column screw (AP + PCS), posterior plate plus anterior column screw (PP + ACS) and anterior plus posterior plate (AP + PP). After preconditioning, the specimens were loaded from 50 to 750 N with a ramp of 100 N/s. FGM and RIFR under loads of 750 N were measured using an optical 3D measurement system.Results: In the three groups of fixation techniques addressing both columns, STS loading resulted in higher mean FGM and in RIFR than SLS loading. No construct failure was observed. In the single plate groups (AP only and PP only), STS loading resulted in failure of all specimens before reaching loads of 750 N, while no failure occurred after SLS loading. No significant differences in FGM and RIFR were found between the double plate (AP + PP) and the single plate plus column screw (AP + PCS and PP + ACS) techniques. Conclusion:SLS loading appeared to overestimate the strength of acetabular fracture fixation constructs and STS loading may be more appropriate to provide clinically relevant biomechanical data. Internal fixation of a single column might not provide adequate stability for transverse fractures, while strength of single plate plus column screw fixation and double plate fixation was comparable.

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Rehabilitation of patients with acetabular fractures

Cited by 3 publications

References 0 publications

Evidence-based rehabilitation therapy following surgery for (peri-)articular fractures: A systematic review

Evidence-based rehabilitation therapy following surgery for (peri-)articular fractures: A systematic review

Acetabular Loading in Rehabilitation

Biomechanical comparison of fixation techniques for transverse acetabular fractures – Single-leg stance vs. sit-to-stand loading

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