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Sobantu N.A.1, Tshabalala M.D.1, Skaal L.2
1Sefako Makgatho Health Sciences University, Physiotherapy, Pretoria, South Africa, 2University of Limpopo, Public Health, Polokwane, South Africa
Background: Trauma as a result of motor vehicle accidents (MVA's) is one of the quadruple burdens of disease in South Africa. Comprehensive and accurate health information is essential to formulate health policy and planning to meet the demand for appropriate health services and interventions. Pelvic fractures are one of the common injuries due to high velocity impacts during MVA. Although there is a higher survival rate of patients following pelvic fractures due to improved multidisciplinary health care management there is an increase in the residual persistent disabilities post-recovery (Metze et al., 2007). The extent of the post-recovery problems in Gauteng province is unknown due to paucity of literature on pelvic fractures.
Purpose: To determine the profile of pelvic fractures, and health care management of patients who sustained pelvic fractures in the Tshwane academic hospitals within the period of 2008 and 2013.
Methods: A descriptive retrospective document analysis was done using a self-constructed data-collection sheet based on literature. Three hundred and sixty nine names of patients with pelvic fractures were identified from the ward registers. Only 236 patients medical records from the three academic hospitals met the inclusion criteria.
Results: From the 236 medical records reviewed, 85% pelvic injuries were due to MVA, of which 31.8% patients were passengers and 30.1% were pedestrians. The ages of the patients ranged between 18 and 70 years. Fifty percent of the patients were between 18 and 29 years followed by the age range of 30 39 years (23.72%). More males (54.7%) had pelvic fractures than females. The majority of the patients (80.5%) sustained poly-trauma with 29.7% having multiple pelvis fractures and 50.8% having fractures that included the pelvis and the rest of the body. Only 19.5% sustained a single pelvic fracture. Classification of pelvic fractures was done in only 1.3% of the study group. Almost twenty percent of patients (19.76%) sustained injuries involving the urinary system. Patients (97.9%) were mainly managed on bed rest, with 25.8% treated on skin traction; surgical fixation of the pelvis was done in 33.47% of patients (68.35% was by an internal fixation and 11.39% by an external fixation).
Only 54.2% of patients received physiotherapy which included strengthening, mobilization exercises and functional training. Pelvic floor exercises were documented in only one patient.
Conclusion(s): The majority of patients who sustained pelvic fractures are still in their productive life span. Although there are multiple reasons for only 54.2% of patients receiving physiotherapy, all patients should be rehabilitated after a single or multiple pelvic fractures / poly-trauma. Physiotherapy addressing the pelvic floor muscles is omitted in the rehabilitation. Pelvic fractures are a type of trauma which should be addressed holistically by physiotherapists in context of the multi-professional team.
Implications: The patients are not receiving optimum health care especially from the physiotherapists. This might lead to multiple residual disabilities including activity limitations and participation restrictions in patients.
Funding acknowledgements: Sefako Makgatho Health Sciences (SMU) Research grant was used.
Topic: Musculoskeletal: lower limb
Ethics approval: Study approved by Sefako Makgatho Health Sciences University Research Council(SMUREC). The clearance ceritificate number is: MREC/H/37/2014: PG
All authors, affiliations and abstracts have been published as submitted.
