Physical therapy for fractures

1. Physical therapy for fractures

2. 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 .

3. 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

4. Common Types of Fractures

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

6. 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

7. The complication of fractures General complications 1- hemorrhage 2- infections 3- shock 4- fat embolism 5- crush syndrome 6- bed ridden complications

8. Local complications • Bone healing complication • Nearby joints • Vessels • Nerves • Muscles • Ligament and tendons

9. 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

10. Physical therapy program during immobilization period • 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

11. 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

12. 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

13. 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.

14. CKC EXERCISES (NWB, PWB & FWB) e.g. - mini-squats - leg press - step-ups - proprioception training - stationary bicycle

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

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

17. Thanks