Pelvic ring injuries: recovery of patient-perceived physical functioning and quality of life

Sustaining a pelvic ring injury is a life event that is likely to have a major and long-lasting effect on the patient’s daily life. Even after two years, 25% of patients have not yet returned to their pre-injury level of physical functioning and quality of life. The physical and mental consequences require a holistic approach to both treatment and outcome evaluation. Valid and reliable patient-reported outcome measures (PROMs) on physical and mental functioning and quality of life should be the most important aspects in evaluation of treatment and rehabilitation protocols. These PROMs may be an important step toward further improving rehabilitation programs. Ideally, rehabilitation should be approached multidisciplinary and involves trauma surgeons, rehabilitations physicians, geriatricians, physiotherapists, psychologists and dieticians. By encouraging the patient to stay in charge of his own health, the focus can shift towards the patient’s strength rather than his weakness, and subsequently improve resilience. Special attention should be paid to the fragile elderly patient who is at risk for serious injuries, even after minor trauma, complications and high-mortality up to 27% within a year. This can be related to the pre-existing limited physical condition as a result of comorbidities or decreased muscle quality and quantity, of which the latter was found to be present in almost half of elderly patients with pelvic ring injuries. Surgical treatment of pelvic ring injuries can be improved by using three-dimensional assisted techniques which tend to have a positive influence on operating time, blood loss, radiation and screw accuracy.