{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T03:57:59Z","timestamp":1783051079809,"version":"3.54.6"},"reference-count":49,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,5,16]],"date-time":"2024-05-16T00:00:00Z","timestamp":1715817600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>Pelvic fracture (PF) is common, especially among older patients, and its prevalence increases over time. In contrast to hip fracture (HF), the literature on rehabilitation after PF is scant, mandating a study of the outcomes of rehabilitation in patients with PF. The present study compared patients who underwent intensive rehabilitation following HF or PF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective study of patients 65\u2009years of age and older who underwent intensive rehabilitation in the Geriatrics Department. Data were collected on patients with PF, while data on patients with HF were taken from an earlier study. All patients in both groups suffered from low-energy trauma. Rehabilitation outcomes were measured using the Montebello Rehabilitation Factor Score-revised (MRSF-R).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>144 PF patients were compared with 138 HF patients. The mean age of the patients in the HF group was 82.5\u2009\u00b1\u20097.1 compared to 81.5\u2009\u00b1\u20096.9 in the PF group (<jats:italic>p<\/jats:italic> =\u20090.230). Females comprised 77.5% of the patients in the HF group and 90.3% in the PF group (<jats:italic>p<\/jats:italic> =\u20090.04). All patients in the HF group underwent surgical repair of their fracture, while all patients in the PF group had non-surgical treatment. More patients in the HF sample had a nursing caregiver prior to the fracture (92.0% vs. 60.4%, <jats:italic>p<\/jats:italic> &amp;lt;\u20090.001), had a higher Charlson Co-morbidity Index total score (2.1\u2009\u00b1\u20091.9 vs. 1.6\u2009\u00b1\u20091.7, <jats:italic>p<\/jats:italic> =\u20090.13), developed more delirium (21.7% vs. 8.3%, <jats:italic>p<\/jats:italic> =\u20090.16), more infections (29.0% vs. 11.1%, <jats:italic>p<\/jats:italic> &amp;lt;\u20090.002), and more cardiovascular complications (23.9% vs. 5.6%, <jats:italic>p<\/jats:italic> &amp;lt;\u20090.001) during hospitalization. They had longer hospital stays (20.9\u2009\u00b1\u20097.5 vs. 18.2\u2009\u00b1\u20097.7\u2009days, <jats:italic>p<\/jats:italic> =\u20090.0007), and had a higher mortality rate (13.8% vs. 6.3%, <jats:italic>p<\/jats:italic> =\u20090.037) over the first year following the fracture than the PF group. A similar rate of patients in both groups (64.5% vs. 60.4%, <jats:italic>p<\/jats:italic> =\u20090.483) had successful intensive rehabilitation. In the PF group only cognitive state was an independent predictor of successful rehabilitation, with each additional point in the Mini Mental State Examination (MMSE) increasing the patient\u2019s chance of reaching an MRFS-R score\u2009\u2265\u200950 by 20.5%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Despite slightly different characteristics in the two groups, the results of intensive rehabilitation were similar. Cognitive state was the only independent factor that affected achievement of a better rehabilitation outcome. With the increasing rate of PF, more studies should focus on rehabilitation in this patient population.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2024.1346354","type":"journal-article","created":{"date-parts":[[2024,5,16]],"date-time":"2024-05-16T04:42:26Z","timestamp":1715834546000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Intensive rehabilitation after pelvic and hip fractures: a comparative retrospective study"],"prefix":"10.3389","volume":"11","author":[{"given":"Dori","family":"Katz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Geftler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Abu-Ajaj","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evgeni","family":"Makulin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Star","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evgeniya","family":"Zikrin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Shacham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Velikiy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamar","family":"Freud","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Press","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,5,16]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2239","DOI":"10.1007\/s00198-012-1964-3","article-title":"A systematic review of hip fracture incidence and probability of fracture worldwide","volume":"23","author":"Kanis","year":"2012","journal-title":"Osteoporos Int"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"599","DOI":"10.1093\/gerona\/glp003","article-title":"Recurrent and injurious falls in the year following hip fracture: a prospective study of incidence and risk factors from the sarcopenia and hip fracture study","volume":"64","author":"Lloyd","year":"2009","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1016\/s0020-1383(02)00414-x","article-title":"Functional outcome after hip fracture. A 1-year prospective outcome study of 275 patients","volume":"34","author":"Rosell","year":"2003","journal-title":"Injury"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1093\/ageing\/afi042","article-title":"Having had a hip fracture--association with dependency among the oldest old","volume":"34","author":"Stenvall","year":"2005","journal-title":"Age Ageing"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"412","DOI":"10.1007\/bf03325146","article-title":"Comorbidity and mortality following hip fracture: a population-based cohort study","volume":"20","author":"de Luise","year":"2008","journal-title":"Aging Clin Exp Res"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1186\/s12877-016-0332-0","article-title":"A critical review of the long-term disability outcomes following hip fracture","volume":"16","author":"Dyer","year":"2016","journal-title":"BMC Geriatr"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"M498","DOI":"10.1093\/gerona\/55.9.m498","article-title":"Recovery from hip fracture in eight areas of function","volume":"55","author":"Magaziner","year":"2000","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1019","DOI":"10.1177\/0269215508096183","article-title":"Home rehabilitation after hip fracture. A randomized controlled study on balance confidence, physical function and everyday activities","volume":"22","author":"Zid\u00e9n","year":"2008","journal-title":"Clin Rehabil"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"475","DOI":"10.1016\/j.injury.2021.11.063","article-title":"Pelvic ring and acetabular fracture: concepts of traumatological forensic interest","volume":"53","author":"Basile","year":"2022","journal-title":"Injury"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1177\/2151458515616250","article-title":"A Nationwide analysis of pelvic ring fractures: incidence and trends in treatment, length of stay, and mortality","volume":"7","author":"Buller","year":"2016","journal-title":"Geriatr Orthop Surg Rehabil"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1431","DOI":"10.1007\/s00590-014-1439-7","article-title":"Elderly pelvic fractures: the incidence is increasing and patient demographics can be used to predict the outcome","volume":"24","author":"Clement","year":"2014","journal-title":"Eur J Orthop Surg Traumatol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1141","DOI":"10.1302\/0301-620X.83B8.0831141","article-title":"Fractures of the pubic rami. Epidemiology and five-year survival","author":"Hill","year":"2001","journal-title":"J Bone Joint Surg Br"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1007\/s001980070112","article-title":"Epidemiology of osteoporotic pelvic fractures in elderly people in Finland: sharp increase in 1970-1997 and alarming projections for the new millennium","volume":"11","author":"Kannus","year":"2000","journal-title":"Osteoporos Int"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"2797","DOI":"10.1007\/s00198-012-1907-z","article-title":"Burden of pelvis fracture: a population-based study of incidence, hospitalisation and mortality","volume":"23","author":"Prieto-Alhambra","year":"2012","journal-title":"Osteoporos Int"},{"key":"ref15","first-page":"139","article-title":"Prognosis of acute pelvic fractures in elderly patients: retrospective study","volume":"7","author":"Leung","year":"2001","journal-title":"Hong Kong Med J"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"e0216809","DOI":"10.1371\/journal.pone.0216809","article-title":"Pelvic ring injury in the elderly: fragile patients with substantial mortality rates and long-term physical impairment","volume":"14","author":"Banierink","year":"2019","journal-title":"PLoS One"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"585","DOI":"10.1016\/j.jbspin.2008.01.024","article-title":"Outcome of osteoporotic pelvic fractures: an underestimated severity. Survey of 60 cases","volume":"75","author":"Breuil","year":"2008","journal-title":"Joint Bone Spine"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1021","DOI":"10.1007\/s00068-018-0971-2","article-title":"Outcome of pubic rami fractures with or without concomitant involvement of the posterior ring in elderly patients","volume":"45","author":"Loggers","year":"2019","journal-title":"Eur J Trauma Emerg Surg"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"2498","DOI":"10.3390\/jcm9082498","article-title":"Isolated pubic ramus fractures are serious adverse events for elderly persons: an observational study on 138 patients with fragility fractures of the pelvis type I (FFP type I)","volume":"9","author":"Rommens","year":"2020","journal-title":"J Clin Med"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1016\/s1297-319x(03)00015-0","article-title":"Mortality and functional outcomes of pelvic insufficiency fractures in older patients","volume":"70","author":"Taillandier","year":"2003","journal-title":"Joint Bone Spine"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1306","DOI":"10.1097\/ta.0000000000000212","article-title":"Preinjury ambulatory status is associated with 1-year mortality following lateral compression type I fractures in the geriatric population older than 80 years","volume":"76","author":"Ting","year":"2014","journal-title":"J Trauma Acute Care Surg"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1503\/cjs.011518","article-title":"Morbidity and mortality following pelvic ramus fractures in an older Atlantic Canadian cohort","volume":"62","author":"Hamilton","year":"2019","journal-title":"Can J Surg"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1309","DOI":"10.1111\/j.1532-5415.2011.03455.x","article-title":"Outcomes of displaced and nondisplaced pelvic and sacral fractures in elderly adults","volume":"59","author":"Mears","year":"2011","journal-title":"J Am Geriatr Soc"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"646","DOI":"10.1136\/pmj.76.900.646","article-title":"Closed pelvic fractures: characteristics and outcomes in older patients admitted to medical and geriatric wards","volume":"76","author":"Morris","year":"2000","journal-title":"Postgrad Med J"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1093\/ageing\/afu123","article-title":"Admission for osteoporotic pelvic fractures and predictors of length of hospital stay, mortality and loss of independence","volume":"44","author":"Marrinan","year":"2015","journal-title":"Age Ageing"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"1789","DOI":"10.1002\/jbmr.3116","article-title":"Excess mortality after pelvic fractures among older people","volume":"32","author":"Andrich","year":"2017","journal-title":"J Bone Miner Res"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"725","DOI":"10.14740\/jocmr3891","article-title":"Low-energy pelvic ring fractures in the elderly population: expected outcomes and associated mortality rates","volume":"11","author":"Ghassibi","year":"2019","journal-title":"J Clin Med Res"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1097\/00005131-199701000-00003","article-title":"Pubic rami fracture: a benign pelvic injury?","volume":"11","author":"Koval","year":"1997","journal-title":"J Orthop Trauma"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1016\/0020-1383(85)90136-6","article-title":"The mortality of patients with minor fractures of the pelvis","volume":"16","author":"Spencer","year":"1985","journal-title":"Injury"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"1363","DOI":"10.1007\/s00198-019-04922-x","article-title":"Risk of institutionalization following fragility fractures in older people","volume":"30","author":"Benzinger","year":"2019","journal-title":"Osteoporos Int"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1007\/s00590-017-2044-3","article-title":"Pelvic fractures in the Netherlands: epidemiology, characteristics and risk factors for in-hospital mortality in the older and younger population","volume":"28","author":"Verbeek","year":"2018","journal-title":"Eur J Orthop Surg Traumatol"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1186\/s12891-020-03361-8","article-title":"Exercise for people with a fragility fracture of the pelvis or lower limb: a systematic review of interventions evaluated in clinical trials and reporting quality","volume":"21","author":"Keene","year":"2020","journal-title":"BMC Musculoskelet Disord"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"771","DOI":"10.1093\/ageing\/afaa050","article-title":"Effects of an intervention to reduce fear of falling and increase physical activity during hip and pelvic fracture rehabilitation","volume":"49","author":"Pfeiffer","year":"2020","journal-title":"Age Ageing"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"2907","DOI":"10.1007\/s11606-020-05666-9","article-title":"Exercise to reduce mobility disability and prevent falls after fall-related leg or pelvic fracture: RESTORE randomized controlled trial","volume":"35","author":"Sherrington","year":"2020","journal-title":"J Gen Intern Med"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"592693","DOI":"10.3389\/fmed.2020.592693","article-title":"Intensive inpatient vs. home-based rehabilitation after hip fracture in the elderly population","volume":"7","author":"Levi","year":"2020","journal-title":"Front Med (Lausanne)"},{"key":"ref36","article-title":"Fractures of the pelvis and acetabulum","volume-title":"Principles and methods of management","author":"Achor","year":"2015"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1016\/0021-9681(87)90171-8","article-title":"A new method of classifying prognostic comorbidity in longitudinal studies: development and validation","volume":"40","author":"Charlson","year":"1987","journal-title":"J Chronic Dis"},{"key":"ref38","volume-title":"An investigation of geriatric nursing problems in hospital: National Corporation for the Care of Old People","author":"Norton","year":"1962"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1016\/0022-3956(75)90026-6","article-title":"\"Mini-mental state\". A practical method for grading the cognitive state of patients for the clinician","volume":"12","author":"Folstein","year":"1975","journal-title":"J Psychiatr Res"},{"key":"ref40","volume-title":"Diagnostic and statistical manual of mental disorders","year":"2013"},{"key":"ref41","first-page":"6","article-title":"The functional independence measure: a new tool for rehabilitation","volume":"1","author":"Keith","year":"1987","journal-title":"Adv Clin Rehabil"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1016\/j.archger.2007.01.059","article-title":"The effect of co-morbidity on the rehabilitation process in elderly patients after hip fracture","volume":"45","author":"Press","year":"2007","journal-title":"Arch Gerontol Geriatr"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1080\/17453674.2021.1878329","article-title":"Epidemiology and mortality of pelvic and femur fractures-a nationwide register study of 417,840 fractures in Sweden across 16 years: diverging trends for potentially lethal fractures","volume":"92","author":"Lundin","year":"2021","journal-title":"Acta Orthop"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"279","DOI":"10.2105\/ajph.79.3.279","article-title":"Determinants of recovery 12 months after hip fracture: the importance of psychosocial factors","volume":"79","author":"Mossey","year":"1989","journal-title":"Am J Public Health"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"1307","DOI":"10.2147\/cia.S374366","article-title":"Handgrip strength as a predictor of successful rehabilitation after hip fracture in patients 65 years of age and above","volume":"17","author":"Milman","year":"2022","journal-title":"Clin Interv Aging"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"M101","DOI":"10.1093\/geronj\/45.3.m101","article-title":"Predictors of functional recovery one year following hospital discharge for hip fracture: a prospective study","volume":"45","author":"Magaziner","year":"1990","journal-title":"J Gerontol"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"224","DOI":"10.3109\/09638289609166305","article-title":"Factors related to successful rehabilitation after hip fracture: a case-control study","volume":"18","author":"Lieberman","year":"1996","journal-title":"Disabil Rehabil"},{"key":"ref48","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2024.01.030","article-title":"Impact of Prefracture cognitive impairment and postoperative delirium on recovery after hip fracture surgery","author":"Kamimura","year":"2024","journal-title":"J Am Med Dir Assoc"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1111\/j.1532-5415.2000.tb02647.x","article-title":"Mortality and institutionalization following hip fracture","volume":"48","author":"Cree","year":"2000","journal-title":"J Am Geriatr Soc"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2024.1346354\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,16]],"date-time":"2024-05-16T04:42:32Z","timestamp":1715834552000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2024.1346354\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,16]]},"references-count":49,"alternative-id":["10.3389\/fmed.2024.1346354"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2024.1346354","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,16]]},"article-number":"1346354"}}