A fracture is a medical term used to refer to any breaking or discontinuity of bone. The injuries range from hairline fractures — where the bone partially breaks — to comminuted fractures — where the bone shatters into many pieces. Some people are lucky enough to go through life without ever breaking a single bone in their bodies but those who have experienced fractures know the pain and discomfort that follows before they fully heal.
The main cause of fractures is usually accidents caused by falls and other sudden injuries that apply more pressure to the bone beyond what it can withstand. Some people suffer the risk of getting fractures more than others and this can be attributed to their line of work.
Sports people, who include soccer and rugby players, athletes and bikers, have a higher risk of breaking their wrists, ankles and collarbones throughout their respective careers. The healing of the bones after a fracture is the easiest part, but the real task involves management of the fracture.
I have witnessed very few cases of patients walking in with a cast on their legs or a sling over their shoulders in my time working at a physiotherapy and chiropractic clinic.
People do not realise the importance of seeking therapy after suffering physical trauma.
Bones usually heal in six to eight weeks though this varies according to age and medical conditions.
The healing of the bones is only half the problem since there is also damage to soft tissue and other structures in the body.
Physiotherapists are involved in the detection of fractures and the management decisions that accompany the rehabilitation process. Once I encountered a woman whose arm had been plastered after an accident but the doctors who had tended to her did not take their time to properly align her bones. After removal of the plaster, her hand was crooked and lacked mobility but luckily her condition was not permanent but she had to endure excruciating hours of physical therapy before regaining normal functionality of her hand.
A physiotherapist is supposed to detect the problem and refer a patient for either X-ray, CT scans or a surgeon for further guidance to prevent cases of permanent bone damage.
Fractures often affect other parts of the body that may appear to be unrelated. For instance, a fractured shoulder may lead to a stiff wrist or elbow due to the shoulder being kept on a sling for several weeks. After removal of the cast, victims often still experience pain on affected limbs and this is due to complications such as damage to the nerves, tendon ruptures, the stiffness of the joints and cartilage tears.
Such complications are usually not detected by doctors but expert physiotherapists are able to make proper assessments and identify as well as treat the complications.
The typical method of treating fractures is through immobilisation which is done with either a cast or a brace or an operation for internal fixation using screws and plates.
This results in loss of range of motion, weakening of muscles, impaired body balance and awareness and subsequent pain or swelling. Physical therapy mainly plays an important part after immobilisation.
Physical therapy is applied to ensure your return to your optimum functionality in the shortest time possible. Muscle assessment is one of the ways physical therapy assists in the management of fractures.
After an injury, muscles around the site of a fracture weaken and it is vital that safe exercise regimes be prescribed under the guidance of a physiotherapist in order to restore muscle strength.
Physiotherapists also assist a patient with joint mobilisation, this is after you have had your arm strapped to your shoulder for six uncomfortable months and it is as stiff as a log.
Physiotherapists work to ensure you regain full joint range of motion through a number of physical activities.
They also perform soft tissue massage around the fracture to manage swelling and oedema.
When a fracture requires the use of gait aids (walking aids), a physiotherapist advises on the most appropriate equipment as per your condition like crutches or a quad-cane to remove pressure from a healing leg.
Always remember to consult a physiotherapist post immobilisation of the fracture for mobilisation of joints and nerves (where necessary) and muscle strengthening.
This could avoid further complications and prevent permanent damage to your body.
Edith Ndichu, Chiropractic & Physiotherapy Health Centre.