Amy J. Litterini
© 2018 Julia Pratt
Background: Unstable pelvic ring fractures (PRF) seldom occur in isolated injuries. Most pelvic fractures are caused by motor vehicle accidents (MVA) concurrently with multiple traumas. PRF have an extremely high mortality rate, ranging from 20-50%. When patients suffer multiple traumas including a pelvic fracture, their mortality rate increases by 10%, and their ability to return home after treatment decreases by 33%. The purpose of this case report was to describe the outcomes of physical therapy (PT) interventions for a nonagenarian patient following an unstable PRF. Case Description: A 99 year-old male suffered a high impact unstable PRF in addition to other traumas secondary to an MVA. Following discharge from acute care, the patient received PT seven days a week for 14 sessions. The plan of care included bed mobility, lower extremity strengthening and functional transfer, gait, and balance training. Outcomes: The patient demonstrated progress by improvement in the Timed Up and Go (unable to 22 seconds), the Two Minute Walk Test (31 meters to 104 meters), and the Modified 30 Second Sit to Stand (0 to 9 chair rises). The patient’s observed gait pattern and level of independence with bed mobility and functional transfers improved from evaluation to discharge. Discussion: The patient appeared to have benefitted from PT based on his improvement in functional mobility, strength, gait, and balance. The patient’s age and extent of injury presented an interesting clinical challenge to rehabilitation that is not commonly seen in literature to date. Further research on treatment interventions for pelvic fractures, as well as normative values for functional outcome measures in the extreme geriatric population would be beneficial for designing and assessing progress of rehabilitation programs.
Pratt, Julia, "Inpatient Rehabilitation Of A 99-Year-Old Patient Following A High-Impact Unstable Pelvic Ring Fracture: A Case Report" (2018). Case Report Papers. 95.