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
123456-

hemorrhage
infections
shock
fat embolism
crush syndrome
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

Als
o

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