Causes of fracture
Most fractures are a result of some form of injury. This might be a direct blow, a fall from a height or a weight falling onto a part of the body.
Other fractures may be caused by indirect trauma, such as falling on an outstretched hand leading to the transmission of force up the arm causing a fracture of the clavicle.
Twisting forces may result in fractures of the tibia and fibula, for example during soccer or skiing when the weight of the body rotates on a fixed foot.
Stress or fatigue fractures are caused by repeated minor trauma, which can occur after walking or running long distances, and often affect the foot metatarsals.
Pathological fractures :
These occur as the result of a disease that weakens the composition of the bone itself such as diseases osteoporosis, Paget’s disease, carcinoma, osteomyelitis .
Clinical Features Of Fracture
Clinical features vary depending on the cause and nature of the injury, and range from unconsciousness to the patient being able to use the limb, although complaining of pain .
And these features are :
- Pain
- Deformity
- Edema
- Loss of function
- Muscle spasm
- Muscle atrophy
- Abnormal movement
- limitation of joint motion
- shock
When is fracture healed
The answer to this question depends upon many factors, including :
- The type of bone fractured
- The type of fracture sustained
- The age of the person
- The treatment undergone
- The nutritional status of the person.
A fracture is considered to be clinically healed based upon the combination of physical findings and symptoms over time.
And the following suggest complete healing :
- absence of pain on weight-bearing, lifting or movement
- no tenderness on palpation at the fracture site
- blurring or disappearance of the fracture line on X-ray
- full or near full functional ability .
Fracture management
Once a fracture has been diagnosed, the most suitable treatment must be decided upon. This should be the minimum possible intervention that will safely and effectively provide the right environment for healing of the fracture.
And it can be managed by :
- Reduction
- Immobilization ( By Plaster of Paris , intramedullary nails , Functional bracing , Internal and External Fixation )
- Traction .
Role of physiotherapy
The physiotherapist’s role is to identify the cause of the problem and to select the appropriate procedure to alleviate or eliminate the cause of the loss of movement .
Doing an assessment for the patient is necessary also doing The problem-oriented medical record (POMR) system ( is based on a data collection system that incorporates the acronym SOAP:
- Subjective – any information given to you by the patient: allergies, past medical history, past surgical history, family history, social history (living arrangements, social conditions, employment, medication), review of systems .
- Objective – all information obtained through observation or testing, e.g. range of joint movement, muscle strength .
- Analysis – a listing of problems based on what you know from a review of subjective and objective data.
- Plan – this refers to the plan of treatment ) .
Also By Using specific exercises, the aim is to reduce any swelling, regain full muscle power and joint movement and to bring back full function.
The treatment will depend very much on the problems identified during your initial assessment, but may include a mixture of the following:
- Soft tissue massage, particularly to manage Edema and swelling
- Scar management if the patient had surgery to fix the fracture
- Ice therapy
- Stretching exercises to regain joint range of movement
- Joint manual therapy and mobilizations to assist in regaining joint mobility
- Structured and progressive strengthening regime
- Balance and control work and gait (walking) re-education where appropriate
- Taping to support the injured area/help with swelling management
- Return to sport preparatory work and advice where required
