Lec 3 Flashcards
To prevent injury
• Certain exercises help strengthen the muscles, which may help prevent injury.
• Stretching before and after exercise can help prevent injury.
• Proper nutrition, especially for athletes, is also important.
• Protein, calcium, and vitamin D are essential for maintaining healthy bones, muscles, and ligaments.
• Warm up is important before exercise.
Exercise program depend on the following:
1-Patient general health
2- Age
3- Gender
4-Problems (OA, tendinitis, surgery……)
5- ROM
6- Muscle strength
7- Fitness
8- Conservative or postoperative
9- Need of patient
10- Individuality
Fracture definition
It is interruption of anatomical cortical continuity of the bone cortex .
Or loss of continuity of bone cortex.
• it is the breakdown of the bone into two or more
pieces .
The fractures are classified into:
Simple and compound fractures.
• Stable and unstable fracture.
• Displaced and undisplaced.
• Complete or incomplete fractures.
According to the shape of fracture line
(transverse, oblique, spiral, comminuted and butterfly ) .
According to etiology:
Pathological fractures
stress fractures
traumatic fractures
Compare
Open fracture
1. There is wound.
2.infection.
3.External fixation.
4.delayed or non union fracture.
Closed fracture
1.no wound.
2.no infection.
3. Cast.
4.heals rapidly.
Complete fracture
1.from side to side.
2. 1view ( AP or lateral view ).
3. Common in adults
Incomplete fracture
1.in one side.
2. 2views ( AP and lateral view ).
3. Common in children( greenstick ).
Common Types of Fractures
Comminuted
Compression
Spiral decreed grenstck in children
Transverse
Epiphseal
Diagnosis of fractures
• History
• Clinical picture (pain, deformity, creaptus, swelling, loss of function, loss of motion…..)
• Examinations and special signs and tests
• Investigations
Assessment of the cases
• Assess the affected area (exposed and hind area)
• Assess the total region
• Assess the related areas
• Assess the whole limb
• Assess the total body
General complications of fracture
1- hemorrhage
2- infections
3- shock
4- fat embolism
5- crush syndrome
6- bed ridden complications
Local complications of fracture
Bone healing complication
Stiffness of the joint
Compression at the vessel
For vain -> Edema
For artery -> partial ischemic or acute ischemic
Come and cutting of the nerve
* ComPression on sensory nerve -> pain
Cut of Sensory nerve -> Anesthesia
ComPression on Motor nerve -> weakness of the muscles
Cut of motor nerve-> paralysis of muscles
Muscle
If autonomic it’s gonna effect the blood vessels and the circulation
Inflammation of muscles ( myositis )
Myositis ossification ( bone inside the muscle) contraindicated for massaging
Rupture of Ligaments and tendons
Managements of fractures
Reduction : manipulation of the bone to its correct anatomical position ( closed and open reduction )
Immobilization : a means of holding the bone in the correct reduced position ( Thomas and Bohler splints, cast)
Rehabilitation: returning the person to as full function as possible after the trauma or disease
Rehabilitation has a 2 stages
Stage 1 DURING immobilization period
- To prevent respiratory complications
- breathing exercises.
- postural drainage
- teach patient the correct way of cough and huff - To prevent circulatory complications
- circulatory exercises
- elevation if available
- gentle massage if available - To prevent stiffness, weakness & atrophy of the free parts
- ROM exercises
- strengthening exercises
To delay and prevent weakness of immobilized parts
→ static & isometric exercises
5- to prevent bed source .
- changing position every 2 hours
- alternating air mattress
- alternating water mattress
- alternating pressure mattress
6- balance ex and co-ordination ex
7- proprioceptive ex
8- postural correction ex
9- positioning in bed
10- treatment of complication if
presents
11-treatment of other physical
disorders if presents
12- preparing for ambulation by
strengthen the crutch muscle, and
explain the gait with assistive
devices
N.B Psychological rehabilitation
sometimes needed.
13- Give instructions about the case
Stage 2 AFTER immobilization
• Strengthening ex for weak ms
• Stretching ex for tight structures
• Mobilizing ex for limited ROM in certain joint
• Balance ex and co-ordination ex
• Proprioceptive ex
• Gait training with and without assistive devices
• Orthotics and prostheses
• Functional rehab.
• Ergonomic advices
Exercises OKC and CKC
OKC EXERCISES
- isometrics
- knee ROM exercises
- SLR
- terminal knee extension
- free weight exercises
CKC EXERCISES (NWB, PWB & FWB) e.g.
- mini-squats
- leg press
- step-ups
- proprioception training
- stationary bicycle
N.B
Psychological rehab. and occupational therapy may be need.
The rehabilitation is a complicated
process depend on all the team
work members.
