Early weight bearing in acetabular and pelvic fractures.
Journal
Acta bio-medica : Atenei Parmensis
ISSN: 2531-6745
Titre abrégé: Acta Biomed
Pays: Italy
ID NLM: 101295064
Informations de publication
Date de publication:
02 09 2021
02 09 2021
Historique:
received:
10
10
2020
accepted:
03
11
2020
entrez:
6
9
2021
pubmed:
7
9
2021
medline:
21
9
2021
Statut:
epublish
Résumé
The incidence of pelvic and acetabular fractures is increasing during the years, counting 37 pelvic fractures per 100000 people annually. No weight bearing or toe touch weight bearing are usually chosen in the initial management to allow fracture and ligamentous healing and avoid fracture displacement and fixation failure. On the other hand, early weight bearing may stimulate fracture healing and allow prompt functional recovery, faster return to work and recreational activities and reduce complications linked to late rehabilitation. Aim of the study is to review the literature about weight bearing indications for pelvic and acetabular fractures to highlight clinical and biomechanical evidence supporting early weight bearing. Two independent reviewers independently extracted studies on early weight bearing of pelvic and acetabular fractures. All selected studies were screened independently based on title and abstract. Then the full text of any article that either judged potentially eligible was acquired and reviewed again. Any disagreement was resolved by discussing the full text manuscripts. 44 studies including reviews, meta-analysis, clinical and biomechanical studies were selected. Despite biomechanical data, few clinical evidences can be found to support early weight bearing in pelvic and especially acetabular fractures treatment. The promising results of some clinical experiences, however, should direct further studies to clearly define the indications and limits of early weight bearing in these injuries. Recognizing intrinsic lesion stability and bone and fixation technique quality, together with patient age and compliance, should be the mainstay for post-operative management choice.
Sections du résumé
BACKGROUND AND AIM OF THE WORK
The incidence of pelvic and acetabular fractures is increasing during the years, counting 37 pelvic fractures per 100000 people annually. No weight bearing or toe touch weight bearing are usually chosen in the initial management to allow fracture and ligamentous healing and avoid fracture displacement and fixation failure. On the other hand, early weight bearing may stimulate fracture healing and allow prompt functional recovery, faster return to work and recreational activities and reduce complications linked to late rehabilitation. Aim of the study is to review the literature about weight bearing indications for pelvic and acetabular fractures to highlight clinical and biomechanical evidence supporting early weight bearing.
METHODS
Two independent reviewers independently extracted studies on early weight bearing of pelvic and acetabular fractures. All selected studies were screened independently based on title and abstract. Then the full text of any article that either judged potentially eligible was acquired and reviewed again. Any disagreement was resolved by discussing the full text manuscripts.
RESULTS
44 studies including reviews, meta-analysis, clinical and biomechanical studies were selected.
CONCLUSIONS
Despite biomechanical data, few clinical evidences can be found to support early weight bearing in pelvic and especially acetabular fractures treatment. The promising results of some clinical experiences, however, should direct further studies to clearly define the indications and limits of early weight bearing in these injuries. Recognizing intrinsic lesion stability and bone and fixation technique quality, together with patient age and compliance, should be the mainstay for post-operative management choice.
Identifiants
pubmed: 34487095
doi: 10.23750/abm.v92i4.10787
pmc: PMC8477081
doi:
Types de publication
Journal Article
Meta-Analysis
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
e2021236Références
J Bone Joint Surg Am. 1996 Nov;78(11):1632-45
pubmed: 8934477
J Bone Joint Surg Am. 2018 Oct 3;100(19):1704-1712
pubmed: 30278001
J Am Acad Orthop Surg. 2013 Aug;21(8):458-68
pubmed: 23908252
J Am Acad Orthop Surg. 2019 Sep 15;27(18):667-676
pubmed: 30889037
Acta Orthop. 2012 Dec;83(6):653-60
pubmed: 23140093
Rev Chir Orthop Reparatrice Appar Mot. 2007 Dec;93(8):818-27
pubmed: 18166954
J Bone Joint Surg Am. 2018 Jun 6;100(11):936-941
pubmed: 29870444
Oper Orthop Traumatol. 2009 Sep;21(3):270-82
pubmed: 19779683
J Biomech. 2001 Jul;34(7):859-71
pubmed: 11410170
EFORT Open Rev. 2018 May 21;3(5):326-334
pubmed: 29951272
Clin Orthop Relat Res. 2003 Feb;(407):173-86
pubmed: 12567145
J Biomech. 2006;39(11):1996-2004
pubmed: 16120442
EFORT Open Rev. 2019 Jun 3;4(6):313-320
pubmed: 31312519
J Orthop Trauma. 2006 Jan;20(1 Suppl):S44-51
pubmed: 16385207
Biomed Res Int. 2016;2016:7151950
pubmed: 27493962
J Orthop Trauma. 2011 Sep;25(9):523-7
pubmed: 21857419
J Bone Joint Surg Br. 2007 Dec;89(12):1553-60
pubmed: 18057352
Clin Orthop Relat Res. 1996 Aug;(329):88-96
pubmed: 8769439
Injury. 2008 Jul;39(7):725-7
pubmed: 18329646
Injury. 2005 Nov;36(11):1330-6
pubmed: 16051241
Radiology. 1986 Aug;160(2):445-51
pubmed: 3726125
J Orthop Trauma. 2012 Feb;26(2):73-9
pubmed: 21804413
J Orthop. 2017 Aug 09;14(4):530-536
pubmed: 28878511
J Orthop Traumatol. 2014 Sep;15(3):173-9
pubmed: 24879360
J Rehabil Med. 2019 Apr 1;51(4):290-297
pubmed: 30767022
J Bone Joint Surg Am. 2012 Sep 5;94(17):1559-67
pubmed: 22992846
Orthopedics. 2014 Oct;37(10):675-8
pubmed: 25275967
Clin Orthop Relat Res. 1980 Sep;(151):56-64
pubmed: 7418324
Orthopedics. 2017 Jul 1;40(4):e652-e657
pubmed: 28481386
Orthopedics. 2012 Jan 16;35(1):e31-7
pubmed: 22229610
Gait Posture. 2012 Jul;36(3):646-9
pubmed: 22633830