- Type
- Closed or simple vs open or compound
- Complete or incomplete
- Complete fracture : transverse, oblique, spiral, comminuted, avulsion, osteochondral
- Incomplete fracture : compression, greenstick, perforation, stress
- Fracture name
- Colles’
- type of fracture of the distal forearm in which the broken end of the radius is bent backwards
- Complications may include damage to the median nerve.
- It typically occurs as a result of a fall on an outstretched hand.
- Risk factors include osteoporosis.
- The tip of the ulna may also be broken.
- Galeazi
- Pott’s
- Dupuytren’s
- Colles’
- Common site of stress fractures : tibia, metatarsals, navicular, femur and pelvic
- Staging of healing
- Massage contraindication
- During immobilization
- No traction before union has occurred
- No hot hydro distal or immediately proximal to cast — causes congestion under cast
- If fracture was a muscle attachment site, Active Free and Active Resisted Testing should only be performed with MD approval
- With open reduction, on site work avoided until skin is healed
- With stress fracture, on-site work CID while site is tender
- Immobilization removed
- Overpressure contraindicated before consolidation
- No extreme temperature hydro on tissue under cast — perception of temperature may be altered
- No deep longitudinal technique on muscle until tissue health and muscle tone are regained. Passive stretch done carefully
- No hot hydro with pins or metal plates
- During immobilization
- Massage treatment
- During Fracture Immobilization
- Cool hydrotherapy, applied distal to the cast
- Manual Lymphatic Drainage proximal to the cast
- Limb proximal to cast treated with effleurage, petrissage, kneading to reduce pain, hypertonicity, as well as to increase drainage, venous return
- No traction before union occurs
- Mid-range pain-free Passive ROM to proximal and distal limbs
- Vibrations through cast can decrease SNS firing
- Work distal to cast restricted to light stroking, muscle squeezing, vibrations
- Start the two-week count from when the cast was removed.
- Mild contrast hydrotherapy ( to increase circulation) to tissue that was under cast
- Proximal Manual lymphatic Drainage if edema still present
- Proximal limb treatment to decrease Hypertonicity and Trigger Point
- Stimulating, light techniques on muscle with atrophy. Gentle petrissage, muscle squeezing, shaking, point kneading, light tapotement
- Pain free passive and active ROM — until tone has improved, do not put a stretch on muscles
- Around after 2 weeks ( standard but not for everyone)
- fascial techniques
- Friction
- Trigger point
- Swedish massage
- Pain free passive stretch to muscles to re-align fibers
- Once consolidation has occurred, joint play is indicated to joints beneath cast to restore ROM
- During Fracture Immobilization
- Self-care
- During immobilzation
- Hydrotherapy : cold and cool on distal to cast
- For the compensating structures : stretch
- AF rom of the joints distal to the cast
- Strengthening under the cast : susbmaximal isometric exercise
- Immobilization removed
- Hydrotherapy : when the cast is first removed are cool or mid contrast on site. Gradually increasing the temperature
- For the compensating structures : stretch
- AF ROM onsite → AR rom
- During immobilzation
Fracture
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