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Fracture Treatment

What is a fracture?

A fracture is a break in bone which disrupts its continuity.

What does fracture physiotherapy include?

Physiotherapy should start immediately after the fracture has been immobilized.

Physiotherapy during fracture healing will concentrate on:

• Promoting healing

• Reducing swelling

• Reducing pain

• Maintaining range of movement of the affected and surrounding joints

• Maintaining strength of weakened muscles

• Encouraging weight bearing

After your fracture has healed and your cast has been removed physiotherapy is continued for 1-6 months or until you have regained your complete level of function.

The aims of physiotherapy are to:

• Progress weight bearing activities

• Return to full function

• Return strength and full range of movement to muscles / joints

• Focus on sport-specific rehabilitation

• Optimize the range of movement at the affected joint.

What are the benefits of physiotherapy following a fracture?

Physiotherapy can offer you a quicker return to complete functional recovery and a more positive rehabilitation outcome.

This rehabilitation depends on fracture type and how it get treated by orthopedic surgeon that is whether it is managed operatively or conservatively.

There are many different types of fractures:

• Simple fracture: a single fracture

• Complicated fracture: other structures like blood vessels are also damaged

• Open/compound fracture: the bone breaks the surface of the skin

• Closed/simple fracture: the surface of the skin is not broken

• Stable fracture: a single fracture of the pelvis

• Unstable fracture: the pelvis has fractured in more than one place

• Transverse fracture: directly across the bone

• Oblique fracture: a fracture at an angle

• Spiral fracture: a twisting fracture

• Comminuted fracture: the bone is broken into many pieces

• Greenstick fracture: found in young children when the bone bends on one side and breaks on the other

How are fractures treated?

The broken bone needs to be realigned (fracture reduction). This can be done either through surgery (open reduction) or by force (closed reduction or non operatively). Surgery involves fixation - internal or external (Plates, wires, screws and rod) is used for unstable and complicated fractures. Closed reduction techniques are known as conservative treatments and are applied to stable and simple fractures.

 Open Reduction (With Operation)

• Internal fixation (ORIF) using steel screws, rods, plates, pins or K-wires to hold the broken bones in the correct position( good alignment for healing).

• External Fixation which attaches a metal framework outside the limb and include the ilizarov method and an X-frame (For maintain good length of bone or healing)

 Closed Reduction (Non Operative)

• Conservative treatments (non surgical/operation management)

• Closed reduction by hand

• Reduction under anesthesia (Without operation)

• Traction which pulls the area into the correct place

As the bone is healing it must be immobilised and kept in the correct position. Immobilisation methods include:

1. Surgical fixation (internal or external)

2. A cast made from Plaster of Paris, plastic or resin

3. Slings; triangular bandage, collar and cuff, high sling

4. Splint

5. Air cast boot