Novel physiotherapeutic approach towards a case of complex multiple fracture

Manali Bub, Swapna Jawade*, Om C. Wadhokar

Ravi Nair Physiotherapy College, Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra, India

ABSTRACT

A straddle fracture of the pelvis is a fracture of the superior and inferior pubic rami which is considered an unstable injury. Injuries most often associated with straddle fracture include sacral fracture, neurological injury, pelvic ring disturbance, lumbar spine fracture, and severe soft tissue injury. A pelvic fracture can happen through the mechanism of either moderate or medium intensity effects. This can range in magnitude from relatively minor mishaps to moderately traumatic fractures that are potentially fatal. L5 transverse process fracture are often associated with pelvic ring fractures, which may indicate high energy trauma. A 35-year-old female with a left-sided straddle fracture, a sacral ala fracture associated with an L5 transverse process fracture L5 was diagnosed by orthopaedic surgeon, on X-ray after a slip and fall sustaining injury to pelvic region, on which open reduction and internal fixation with a 5-hole pre-contoured plate was placed. Temporary reduction was done by K-wire and sacral ala fracture was fixed with 2 CC screws. Post operatively the patient had impaired limb movements and inability to perform daily activities. After operation, patient was managed with physical therapy treatment comprising of static regimens, progressing to dynamic exercises, electrotherapeutic techniques, strengthening exercises, gait exercise for duration of 10 weeks. Patient was given physiotherapy regime for 5 days per week for 10 weeks. This study shows that the operative method and timely recovery in physical therapy contributed to the progress of ROM, strength of muscle, functional activities progressively, which successfully led to further recovery.

Keywords:

Straddle fracture, Sacral ala fracture, Internal fixator, Physical rehabilitation