What is a fracture?

A fracture is a break in a bone which disrupts its continuity. There are many different types of fractures:

Open/compound: the bone breaks the surface of the skin
Closed/simple: the surface of the skin is not broken
Stable: a single fracture of the pelvis
Unstable: the pelvis has fractured in more than one place
Transverse: directly across the bone
Oblique: a fracture at an angle
Spiral: a twisting fracture
Comminuted: the bone is broken into many pieces
Greenstick: found in young children when the bone bends on one side and breaks on the other
Simple: a single fracture
Complicated: other structures like blood vessels are also damaged

How are fractures treated?

The broken bone needs to be realigned (reduction). This can be done either through surgery (open reduction) or by force (closed reduction). Surgery involves fixation (internal or external) is used for unstable and complicated fractures. Closed reduction techniques are known as conservative treatments and are applied to stable and simple fractures.

Open Reduction

Internal fixation (ORIF) using steel screws, rod, plates, pins or K-wires to hold the broken bones in the correct position.
External Fixation which attaches a metal framework outside the limb and include the Llizarov method and an X-frame

Closed Reduction

Conservative treatments (non surgical management)
Closed reduction by hand
Reduction under anaesthetic
Traction which pulls the area into the correct place

As the bone is healing it must be immobilised and kept in the correct position. Immobilisation methods include:

Surgical fixation (internal or external)
A cast made from Plaster of Paris, plastic or resin
Slings; triangular bandage, collar and cuff, high sling
Splint
Air cast boot

What does fracture physiotherapy include?

Physiotherapy should start immediately after the fracture has been immobilised. Physiotherapy during fracture healing will concentrate on:

Promoting healing
Encouraging weight bearing
Maintaining strength of weakened muscles
Maintaining range of movement of the affected and surrounding joints
Reducing pain
Reducing swelling

After your fracture has healed and / or your cast has been removed physiotherapy is continued for 3-12 months or until you have regained your full level of function. The aims of physiotherapy are to:

Progress weight bearing activities
Return to full function
Return strength and full range of movement to muscles / joints
Focus on sport-specific rehabilitation
Optimise the range of movement at the affected joint

What are the benefits of physiotherapy following a fracture?

Physiotherapy can offer you a quicker return to full function and a more positive rehabilitation outcome. If you are recovering from a fracture and would like to maximise you rehabilitation potential with one of specialist musculoskeletal physiotherapists please call 0161 883 0077 to book an assessment.

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