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Physical therapy

for fractures

Fracture
Fractures or loss of continuity in the substance
of a bone are a common occurrence and
represent considerable treatment time and
financial costs in the accident and emergency
room
It is interruption of anatomical cortical
continuity of the bone cortex . Or loss of
continuity of bone cortex.
it is the breakdown of the bone into two or
more pieces .

The fractures are classified into:

Simple and compound fractures.


Stable and unstable fracture.
Displaced and undisplaced.
Complete or incomplete fractures.
According to the shape of fracture line
(transverse, oblique, spiral, comminuted and
butterfly ) .
Pathological, stress, traumatic fractures

Common Types of Fractures

Diagnosis of fractures
History
Clinical picture (pain, deformity, creaptus,
swelling, loss of function, loss of motion..)
Examinations and special signs and tests
Investigations

Assessment of the cases

Assess the affected area (expose and hind area)


Assess the total region
Assess the related areas
Assess the whole limb
Assess the total body

The complication of fractures


General complications
1- hemorrhage
2- infections
3- shock
4- fat embolism
5- crush syndrome
6- bed ridden complications

Local complications

Bone healing complication


Nearby joints
Vessels
Nerves
Muscles
Ligament and tendons

Managements of fractures
There are three stages in the management of
fractures:
Reduction: manipulation of the bone to its
correct anatomical position
Immobilization: a means of holding the bone
in the correct reduced position
Rehabilitation: returning the person to as full
function as possible after the trauma or
disease

Physical therapy program during


immobilization period
1. To prevent respiratory complications
- breathing exercises.
- postural drainage
- teach patient the correct way of cough and huff
2. To prevent circulatory complications
- circulatory exercises
- elevation if available
- gentle massage if available
3. To prevent stiffness, weakness & atrophy of the free parts
ROM exercises
- strengthening exercises

4. To delay and prevent weakness of immobilized


parts static & isometric exercises
5- to prevent bed source .
- changing position every 2 hours
- alternating air mattress
- alternating water mattress
- alternating pressure mattress
6- balance ex and co-ordination ex
7- proprioceptive ex
8- postural correction ex
9- positioning in bed

10- treatment of complication if presents


11-treatment of other physical disorders if
presents
12- preparing for ambulation by strengthen the
crutch muscle, and explain the gait with assistive
devices

Physical therapy program after


immobilization

Problem solving approach


Strengthening ex for weak ms
Stretching ex for tight structures
Mobilizing ex for limited ROM in certain joint
Balance ex and co-ordination ex
Proprioceptive ex
Gait training with and without assistive devices
Orthoses and prostheses
Functional rehab.

CKC EXERCISES (NWB, PWB & FWB)


e.g.

- mini-squats
- leg press
- step-ups
- proprioception training
- stationary bicycle

N.B
Psychological rehab. And
occupational therapy
may be need

Also
The rehabilitation is a complicated
process depend on all the team
work members