Post fracture rehab for all student.pptx

Post fracture rehab for all student

1. POST FRACTURE REHABILITATION MANAGEMENT

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 . 9/11/2024 2

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 9/11/2024 3

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5. Diagnosis of fractures History Clinical picture (pain, deformity, creapitus , swelling, loss of function, loss of motion…..) Examinations and special signs and tests Investigations 9/11/2024 5

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 9/11/2024 6

7. Complications of fractures General complications hemorrhage infections shock fat embolism crush syndrome bed ridden complications 9/11/2024 7

8. Local complications Bone healing complication Nearby joints Vessels Nerves Muscles Ligament and tendons 9/11/2024 8

9. Orthopedic Goals 1. to obtain stability at the fracture site either by external or internal fixation, immobilization. 2. to prevent infection. 3. to reduce displaced fragment if any. 4. to obtain neck shaft angle of 130-150 degree and retroversion angle of 30 degree ( proximal humeral # ) 9/11/2024 9

10. Rehabilitation Goals Attempt made to restore full ROM (however, there may be some residual loss of movement). Regain the strength of muscles. (enlist the muscles) Prevent tissue adhesion Control oedema . 9/11/2024 10

11. Functional Goals To restore day to day activities like self care, dressing, grooming etc. To make patient as independent as possible. 9/11/2024 11

12. PT Rx Day 0 to 1 week . Precautions: No lifting with the affected hand. ROM: if in brace or splint no Rom exercises to the involved segment of joint. ROM exercises to joints proximal and distal to the involved segment. - is stability is done by ORIF or EF gentle active and active assisted ROM exercises can be given. 9/11/2024 12

13. 3. Muscle Strengthening- no isotonic exercises, isometric exercises can be prescribed. 4. Functional activity- uninvolved extremity may be used for self –care and ADLS. 5. Weight bearing- no weight bearing on affected extremity. 6. Check for wound healing. Manage oedema by hand elevation, crape bandage, pneumatic compression etc 9/11/2024 13

14. 2 to 4 week Precautions – no lifting weights with affected extremity. ROM- active and active assisted ROM exercises to proximal and distal joint. PROM to involves joint within pain limit. ( in case of shaft fracture stabilized with IM nail movements can be stated after 48 hours within pain tolerance .) 9/11/2024 14

15. 3. Muscle strengthening –(in case of shoulder involvement )- gentle pendular exercises to shoulder joint. Continue isometric exercises, progress to resistive by end of 3 week using resistance bands etc. 4. Functional activities- in case of ORIF or EF extremity can be used for feeding, grooming and writing. 5. Weight bearing- no wt bearing on affected extremity. Limited wt bearing with fixators . 9/11/2024 15

16. 4 to 6 weeks 1. Precautions – no heavy lifting with the affected extremity. 2. ROM- active ROM exercises to all the segments. 3. Muscle strengthening- ex progressed to isotonic exercise. 4. Weight bearing – allowed. 9/11/2024 16

17. 8 to 12 weeks . precautions- no contact sports. ROM – all movements permitted. muscle strength – Progressive resisted exercise stared. Weight bearing – full weight bearing is allowed. 9/11/2024 17

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