Physical Therapy Management of Fractures

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In simple terms, a fracture is defined as a discontinuity in a bone resulting from mechanical force.

There are a number of reasons that fractures might occur, eg, a blunt force, a weakened bone, metabolic diseases that result in injuries to the bones, etc.

The main concern that patients, doctors and physical therapists share, after a fracture is the restriction of movement that most patients face. This must be encountered by physical therapy that allows a patient to preserve the amount of movement remaining and also gives him the opportunity to build on strength.

Starting Physical Therapy After Fracture

  • Often, physical therapy begins soon after a fracture. Immobilisation and casts are used to provide stability to the injured joint.
  • During this time it is important to mobilise the surrounding joints. This will allow proper diffusion of fluids in the injured joint as well, promoting good healing.

Continuing Physical Therapy

  • It is important to continue physical therapy even after the removal of the cast.
  • This leads to the strengthening of the newly formed cartilage and bones. It also promotes the reduction of oedema around the injury and the strengthening of the muscles.

Role of A Physiotherapist In Healing Of Fractures

A reliable physiotherapist must have a strategy to help you recover fully from a fracture. This includes focussing on reducing the negative effects of long-term immobilisation and coming up with plans to ensure that muscle development in the future is on track.

Your physical therapist must also be on the lookout for the following complications:

  • Compartment syndrome
  • Fat embolism
  • Osteomyelitis
  • Malunion, delayed unions or incorrect union of the bones
  • Avascular necrosis

In addition to the above, the main role of a physiotherapist immediately after a fracture is to educate the patient regarding the steps that he must take to prevent further injury to the joint structures. This includes joint positioning after wearing the cast, proper stretching techniques and practical weight bearing in case the lower limbs are affected.

Strengthening of the joints is also crucial, however, this can begin only after the cast has been removed. Gentle strengthening exercises are progressively increased to the point where the patient can comfortably bear the weight.

What Physical Therapy After A Fracture Must Include?

No matter the kind of fracture that a person encounters, there are some common goals that need to be met for all-round development and healing.

  • Promotion of healing: The oedema and loss of movement must be addressed immediately so as to promote healthy healing of the bone and its surrounding tissues.
  • Encouragement of weight bearing: As soon as it is possible the patient must be encouraged to begin weight bearing on an affected limb, partially or totally.
  • Maintenance of strength and range of motion: The strength and range of motion of the surrounding tissue structures is important to prevent stiffness in the affected joint once the cast has been removed and the bone has healed.
  • Reduction of pain and swelling: Swelling and pain need to be affected as soon as a patient approaches a physical therapist. Icing and gentle movements are something that help the most to achieve this goal.

Benefits Of Physical Therapy After A Fracture

  • A shorter recovery period is something that you can expect if you start physical therapy early on.
  • Increased strength and mobility can be expected as one of the earliest benefits of physical therapy after a fracture.
  • A reduction in the number of days away from work becomes obvious when there is a shorter recovery period.
  • An increase in strength also indicates more protection in the future as the new bones and the structures surrounding them are stronger.
  • An improved physiological state of the patient is also obvious when there is a shorter recovery time and less loss of mobility.