Fractures PPT_student

Assessment and Intervention: Fractures Biomechanics for Occupation II

Objectives

  • Common Fractures of the Upper Extremity (UE)

  • Inclusive Evaluation Plan

    • Synchronize with healing timeframes, precautions, and methods of reduction.

  • Inclusive Treatment Plan

    • Align with healing timelines, precautions, and reduction methods.

  • Post-Fracture Issues

    • Problems encountered in rehabilitation, assessment, and treatment strategies.

  • Edema Reduction and Scar Healing

    • Compare methods based on effectiveness and healing timeframes.

Common Upper Extremity Fractures

  • Distal radius: Most common fracture in the body.

  • Other common fractures:

    • Mid/proximal humeral fractures

    • Metacarpal fractures

    • Proximal phalanx (P1)

    • Scaphoid fractures

    • Radial head fractures

    • Radial and ulnar shaft fractures

Important Terms

  • Reduction: Realigning fracture fragments

    • Closed Reduction: Stable fractures; treated with casts, slings, or percutaneous pins.

    • Open Reduction: Unstable fractures requiring internal/external fixation.

    • Classification based on joint involvement: Intra-articular vs. Extra-articular.

Wound Healing for Bone

  • Primary Healing:

    • Bypasses inflammation and repair phases; relies on rigid fixation.

    • Requires adequate vascularity and fragment compression, allowing early activity.

  • Secondary Healing:

    • Involves three phases: inflammation (hematoma), repair (callus), and remodeling (bone reorganization).

    • Typical healing duration exceeds 7 weeks; AROM begins 4-6 weeks post-reduction.

Common Assessment Procedures (All Fractures)

  • Outcome Measurement: No specific diagnosis outcomes for UE fractures.

  • Observations and Assessments:

    • Tissue length, muscle atrophy, deformity, edema, sensorimotor function, pain assessment.

    • Assess ADLs, posture, substitution patterns, and joint mobility.

Assessment Methods for Edema Measurement

  • Volumeter: Measure by water displacement.

    • Ensure consistency by measuring both sides.

  • Circumferential Measures:

    • Use a tape measure at strategic anatomical locations; document edema spatially.

Principles of Edema Reduction

  • Lymphatic System:

    • Interconnected with the circulatory system; facilitated by movement.

    • Promotes drainage via pressure changes and body movement starting from the trunk.

Types of Edema

  • Acute Edema: Easily pitted; rebounds quickly.

  • Subacute/Chronic Edema: Slow to rebound, has a viscous quality, and may appear taut/hard.

Indications for Edema Reduction

  • Acute Phase: Active muscle pumping of unaffected areas; may include pneumatic compression.

  • Chronic Phase: Manual lymphatic treatment starting from the trunk to manage edema effectively.

Common Fracture Interventions

  • Priority: Edema control.

  • Strategies include the use of safe-position orthotics, elevation, and massage techniques.

  • Emphasize the use of Kinesio tape and other gentle modalities.

General Interventions

  • Focus on preventing deformities through appropriate positioning and management of edema.

Post-Op Interventions

  • Includes the use of compressive wraps and scar management techniques.

  • Edema and scar massage routines; introduction of pressure therapy and ultrasound if indicated.

Distal Radius Fracture Management

  • Colles’ Fracture: Hyperextension at wrist; most prevalent.

  • Smith’s Fracture: Hyperflexion during a fall; requires specific surgical interventions.

  • Fracture treatment includes ORIF, percutaneous pinning, and assessment of anatomical involvement for rehab outcomes.

Assessment and Intervention After Distal Radius Fracture

  • Consider patient-specific healing timeline for AROM, PROM, and strengthening.

  • Always assess joint mobility and functionality at every stage of recovery.

Metacarpal and Phalangeal Fractures

  • Assessment and intervention focused on restoring joint mobility, preventing adhesions, and ensuring functional recovery.

  • Highlighted the importance of edema control and tissue lengthening throughout treatment.

General Fracture Intervention Principles

  • Rehabilitation protocols depend on physician directives, healing phases, and patient safety. Interventions should focus on occupational performance and gradual progression through rehabilitation.

Absolutely! I can help you understand the material on fractures and their management. What specific areas or concepts would you like to focus on? Some key topics include types of fractures, assessment procedures, treatment plans, and rehabilitation principles. Let me know where you would like to start!

Absolutely! I can help you understand the material on fractures and their management. What specific areas or concepts would you like to focus on? Some key topics include types of fractures, assessment procedures, treatment plans, and rehabilitation principles. Let me know where you would like to start!