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Fractures

Fractures are broken bones. The severity of a fracture usually depends on the force required to break the bone: the larger the force, the worse the fracture.

What’s really going on inside

Fractures may be caused by a traumatic incident, repetitive stress, or pathological.

Falls, motor vehicle accidents, or tackles during a rugby match are traumatic events that can all result in fractures.

A stress fracture usually occurs when muscles become fatigued and are unable to absorb shock. Eventually, the fatigued muscle transfers the excess stress to the bone, causing a tiny fracture called a stress fracture.

Some medical conditions, such as osteoporosis, cause our bones to weaken and increase your risk of fracture. An osteoporotic fracture is an example of a pathological fracture.

Fracture Classification:

  • Open Vs Closed: An open fracture is a type of fracture that pierces the skin. Alternatively, if the overlying skin remains intact, the fracture is classified as a closed fracture.
  • Stable Vs Unstable: If the fractured bones are aligned the fracture is usually classified as “stable”. Most open fractures and unstable fractures require surgery to re-align the displaced bones.
  • Complete Vs Incomplete: A complete fracture involves the whole width of the bone, whereas an incomplete fracture does not cross the whole width of the bone.
  • Type: Bones can break by being twisted (spiral fracture), bent (transverse fracture), compressed, pulled (avulsion fracture), or a combination of the above.

Physiotherapy Management of Fractures

Physiotherapists are involved in fracture detection, management decisions, and rehabilitation. Upon detection, your physiotherapist may refer you for imaging (x-rays, MRI, CT scans), or to an orthopaedic surgeon to better guide management.

If you have sustained a fracture, it is critical you contact a physiotherapist early to optimise healing and facilitate return to normal function.

Physiotherapy can assist your fracture healing by:

  • Muscle Assessment: Following injury, muscles surrounding the fracture site weaken. It is critical that a safe exercise program is prescribed and progressed under the supervision of a physiotherapist to restore strength and prevent secondary complications.
  • Joint Mobilisation: Joint stiffness often occurs when a limb is not allowed to move for several weeks. Physiotherapists are trained in techniques that can improve and restore range of movement of the affected joints once the fracture has healed.
  • Heat and Electrotherapy: It is very common for stiffness within soft tissues to occur following immobilisation. Heat and Electrotherapy have been shown as useful adjuncts to manual treatment and exercise therapy in relieving pain and restoring muscle length.
  • Gait Education: If your fracture requires the use of gait aids, such as crutches, your physiotherapist can prescribe you with the most appropriate equipment and way of walking that promotes optimal healing and safety.

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