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Treatment and Rehabilitation of Fractures

The document discusses the treatment and rehabilitation of fractures. It describes fractures as breaks or discontinuities in bone caused by trauma or pathology. It then classifies fractures based on completeness, displacement, and growth plate involvement (using the Salter-Harris classification). The principles of fracture treatment include reduction, maintenance of reduction through casting or fixation, and preservation of function. Physical therapy aims to restore tissue and joint mobility, increase strength, and improve function. Complications can include delayed union, non-union, and malunion.

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Julia Salvio
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108 views30 pages

Treatment and Rehabilitation of Fractures

The document discusses the treatment and rehabilitation of fractures. It describes fractures as breaks or discontinuities in bone caused by trauma or pathology. It then classifies fractures based on completeness, displacement, and growth plate involvement (using the Salter-Harris classification). The principles of fracture treatment include reduction, maintenance of reduction through casting or fixation, and preservation of function. Physical therapy aims to restore tissue and joint mobility, increase strength, and improve function. Complications can include delayed union, non-union, and malunion.

Uploaded by

Julia Salvio
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPT, PDF, TXT or read online on Scribd
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TREATMENT AND

REHABILITATION OF
FRACTURES
FRACTURES

 Break or discontinuity of the bone


caused by trauma or pathology
 Etiology:
a. Pathologic
b. Traumatic
1.violence
2. muscular traction
CLASSIFICATION OF
FRACTURES
A. According to
completeness 2. Complete
1. Incomplete a. Simple
a. greenstick b. Impacted
b .fissured c. Comminuted
c. perforating d. complicated
d. depressed
CLASSIFICATION OF
FRACTURES
 B. According to displacement:
1. Transverse
2. Oblique
3. Spiral
4. comminution
Classification

. A, Longitudinal fracture line parallel to bony axis. B, Transverse fracture line


perpendicular to bony axis. C, Oblique fracture line at angle to bony axis. D,
Spiral fracture line runs a curvilinear course to the bony axis. E, Impacted
fractured bone ends compressed together. F, Comminuted fragmentation of
bone into three or more parts. G, Greenstick bending of bone with incomplete
fracture of convex side. H, Bowing bone plastic deformation. I, Torus buckling
CLASSIFICATION
Salter and Harris:
I-cartilage plate
II-cartilage plate and
triangular metaphysis
III- cartilage plate and
epiphysis
IV-Cartilage
plate+epiphysis and
metaphysis
V-crushing of the growth
plate
FRACTURE
 Signs and Symptoms:
1. Abnormal mobility
2. Crepitus
3. Ecchymosis
4. Deformity
5. Pain and tenderness
6. Swelling
7. Absence of active movement due to pain
8. Muscle spasm
FACTORS AFFECTING
REPAIR
 Age  Severity of injury
 Type of fracture  Size and shape of
 Vascularity bone
 Immobilization  General condition
of the patient
 Infection
 Location of fracture
 Limbs affected
STAGES OF FRACTURE
HEALING
A. Stage of hematoma
formation
B. Stage of granulation
tissue formation
C. Stage of callus
formation
D. Stage of
consolidation
E. Stage of remodeling
FRACTURE HEALING
PRINCIPLES OF
FRACTURE TREATMENT
A. Reduction
1. Manipulation
2. Traction
PRINCIPLES OF
FRACTURE TREATMENT
B. Maintenance of
reduction
1. External
fixation:casts
2. Internal fixation
3. Traction
a. Skin:Buck’s,Russel’s
traction’Bryant’s
traction
b. Skeletal Traction
PRINCIPLES OF
FRACTURE TREATMENT
 Casts brace
PRINCIPLES OF FX TREATMENT
PRINCIPLES OF FX TREATMENT
PRINCIPLES OF FX TREATMENT
PRINCIPLES OF
FRACTURE TREATMENT
PRINCIPLES OF
FRACTURE TREATMENT
C. Preservation and restoration of
function
COMPLICATIONS OF
FRACTURE
A. Delayed Union
Causes:
1. Inaccurate reduction
2. Inadequate or interrupted immobilization
3. Severe local traumatization
4. Impairment of bone circulation
5. Infection
6. Loss of bone substance
7. Distraction or separation of fragments
COMPLICATIONS OF
FRACTURE
B. Non-Union
 >6 months
 Systemic disturbances
 Insufficient protection
 Common Sites:

1.Femoral neck
2.Femoral shaft
3.Tibia
4.Humerus
5.Radius and ulna
scaphoid
COMPLICATIONS OF
FRACTURE
C. Malunion
1. Shortening
2. Rotation
3. angulations
PHYSICAL THERAPY
PRINCIPLES AND
CONSIDERATIONS
A. Tissue response and guidelines after
period of immobilization
 Local Tissue response
 Immobilization in bed
 Functional adaptations
PHYSICAL THERAPY
PRINCIPLES AND
CONSIDERATIONS
B. Post immobilization Period
1. Determine bone healing
2. Examine the pt
3. Joint mobilization
4. Neuromuscular inhibition
5. Self stretching
6. Activities
7. Muscle performance
8. Scar tissue mobilization
PHYSICAL THERAPY
PRINCIPLES AND
CONSIDERATIONS
1. Educate the patient
 Inform the pt of limitations until the fracture
site is healed radio graphically
 Teach home exercise program
2. Provide protection until radiographically
healed
 Use partial weight bearing in LE and
nonstressful activities in the UE
PHYSICAL THERAPY
PRINCIPLES AND
CONSIDERATIONS
3. Initiate active exercises
 Active ROM;multiple joint isometrics

4. Increase joint and soft tissue mobility


 Initiate joint stretching techniques with
the force applied to the proximal site
5.Increase strength and muscle
endurance
6. Improve CP fitness
There is nothing
beyond the Reach of
determination

HAVE FUN!!!!!!!!

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