Published on September 24, 2013
Basic Principles of FRACTURE MANAGEMENT Parathuvayalil Hospital & Orthopedic Center
WHAT IS A FRACTURE? Fracture is a break in the continuity of a bone.
Types of Fracture Fractures can be classified on the basis of its pathology as Traumatic fracture & Pathological fracture. Traumatic Fracture can be transverse, oblique, spiral, displaced, angulated, impacted, rotated, distracted or comminuted
Traumatic Vs. Pathological Fractures A fracture sustained due to trauma is called traumatic fracture. A fracture through a bone which has been made weak by some underlying disease is called a pathological fracture.
Healing of fracture A fracture begins to heal as soon as the bone is broken provided the conditions are favorable; healing proceeds through several stages until the bone is consolidated.
Treatment Principle in Fracture The three fundamental principles of treatment of fracture are Reduction Immobilization & Rehabilitation.
Reduction, Immobilization & Rehabilitation Reduction is the technique of setting a displaced fracture to proper alignment. Immobilization is to prevent the displacement of the fracture that might interfere with the reunion. Rehabilitation essentially consists of muscle reeducation exercises and gait training.
REDUCTION OF FRACTURES This is the technique of setting a displaced fracture to proper alignment. Reduction can be done in three ways: Closed Manipulation, Continuous Traction & Open Reduction
Closed Manipulation Re-aligning a displaced fracture by feeling it through the soft tissues
Continuous Traction Re-aligning a displaced fracture by feeling it through the soft tissues
Open Reduction Fragments are reduced under direct vision during operation
IMMOBILIZATION OF FRACTURES: Conservative methods The conservative methods for the immobilization of fractures include: Strapping Immobilization by using a sling, cast etc. Functional bracing Applying traction
Strapping The fractured part is strapped to an adjacent part of the body
Immobilization by using a sling
Immobilization by using a cast Using plaster of paris, fiber glass casting tapes etc.
Functional bracing Continuous use of the affected limb while the fracture is kept adequately supported
IMMOBILIZATION OF FRACTURES: Operative Methods Operative method for immobilization include internal or external fixation. In internal fixation, fracture once reduced is fixed internally with the help of some metallic or non- metallic device such as steel wire, screw, plates etc. In external fixation, the fracture is held in a steel frame outside the limb.
Conservative OR Operative Method? Conservative methods for immobilization are used in CLOSED FRACTURES (Fractures not communicating with external environment) and operative methods in OPEN FRACTURES (Fracture with break in the overlying skin and soft tissues leading to the fracture communicating with the external environment), usually.
REHABILITATION OF FRACTURES Rehabilitation of fractured limb begins at the time of injury and goes on until the maximum possible functions have been regained. It essentially consists of muscle reeducation exercises and instructions regarding immobilization of the limb and gait training.
Immobilizing the limb For immobilization, one may need to support the limb with braces, calipers, casts etc. Walking aids such as walker, crutches, sticks etc. may be necessary
Exercises Suitable exercises are observed during immobilization and after immobilization Rehab- exercises are adviced. Rehabilitation exercises differ from fracture to fracture and need to be observed under the guidance of a clinician.
Reach Us: Dr. Pathrose Parathuvayalil Group Post Box no: 9, Keezhillam PO Perumbavoor, Ernakulam, Kerala, India. Pin-683 541 Ph: 91-484-2653041, 2653875, 2653876, 2653042 Email: firstname.lastname@example.org URL: www.parathuvayalilhospital.com Dr. Pathrose Parathuvayalil Group is social now fb.com/pathroseparathuvayalilgroup pathroseparathuvayalilgroup.blogspot.com linkedin.com/in/drpathroseparathuvayalil Image courtesy: AO Foundation
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