Method for Restorative Treatment of Patients with Unstable Pelvic Type B Injuries Treated with External Fixation Devices (to Help the Practitioner)

I.S. Borovoy, G.V. Lobanov


The paper proposes an original program of restorative treatment for patients with unstable pelvic injuries, treatment of which is performed using external fixation devices. The authors propose to allocate 4 stages of physical rehabilitation for these patients treated by extrafocal fixation method.
The first rehabilitation period includes the time since victim’s elimination of shock and stabilization of the general condition before surgery — extrafocal osteosynthesis with external fixation device. During this period, patients are prescribed isometric contraction of the muscles of the pelvic girdle, lower extremities and anterior abdominal wall to prevent stagnation in the lower extremities, interstitial edema, trophic disorders.
Next rehabilitation period are considered by the authors as an early recovery one. It includes the time interval from 2nd —4th days after the imposition of the device since verticalizing patient and continues until the removal of the locking devices. The purpose of this period is to teach the patient walking with crutches, self-care, patient’s adaptation to the pelvic ring locking device. During this period, the range of physiofunctional procedures expands, the load on the muscles of the pelvic girdle, trunk, shoulder girdle increases. The system of physical exercises that promotes early recovery of the functional state of the locomotor system has been suggested.
The third period of rehabilitation (or late recovery period) continues, the authors say, since removal of external fixator until complete physical recovery, or until the formation of persistent sequelae. After removal of external fixation device, the authors use special orthosis to stabilize the pelvis. The purpose of this period of rehabilitation is to restore movements’ coordination and stereotype, muscle strength and endurance of musculoskeletal system.
Fourth rehabilitation period — period of persistent sequelae removal and prevention of degenerative-dystrophic changes associated with trauma. The authors recommend treatment in specialized rehabilitation centers, dispensaries, health centers.
Using a complex of rehabilitation measures, including minimally invasive osteosynthesis technology (in this case «front» external fixation device) in conjunction with the timely implementation of designed remedial measures complexes, including in a specialized department, allows not only to strengthen the patient as soon as possible, but also to achieve positive long-term functional outcomes.


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