2. Physical therapy for fractures

3. 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.

4. 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

5. Common Types of Fractures

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

7. 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

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

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

10. 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

11. 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

12. 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

13. 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

14. 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.

15. OKC EXERCISES - isometrics - knee ROM exercises - SLR - terminal knee extension - free weight exercises - Isokinetic exercises

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

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

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