Fracture is the deterioration of bone or cartilage integrity. There are no medical cracks. The term crack is used for non-moving breaks. When a fracture occurs, it is accompanied by soft tissue injury. The first important stage of fracture treatment is performed by the orthopedic surgeon. Treatment at this stage also affects the later stages of rehabilitation. Depending on the condition of the fracture, the fracture site is placed in its proper place with the help of plaster, splint or surgery. Immobilization is required for the fracture to heal. Problems such as joint stiffness, muscle atrophy (muscle wasting) may occur due to long-term immobilization. The aim of fracture rehabilitation service is to restore the function before the injury.
How Does Fracture Heal?
Pain at the fracture site, edema, deformities, significant local tenderness, muscle cramps, abnormal mobility, loss of function are the first signs of fracture. The fracture site is positioned high to reduce swelling and improve blood flow. The joint above and below the fracture line is fixed with a plaster cast to prevent dislocation of the fracture fragments. If necessary, the patient is operated on. Three phases of bone healing have been reported in fracture healing:
Inflammatory phase: lasts 12 weeks. After some time, inflammation begins to develop at the site of the broken hematoma, which is formed with increased vascularity. The blood cells that migrate here with inflammation clean the dead tissue and prepare the fracture site for the repair phase.
Repair phase: This phase can take months. The breakpoint is attacked by chondroblasts and fibroblasts. Soft parts are formed, consisting of fibrous tissue, cartilage and some bone tissue.
Reconstruction phase: This phase can take months or even years. At this stage, immature irregularly knitted bone transforms into mature and organized lamellar bone, further increasing stability at the fracture line.
What is Post Fracture Rehabilitation?
The rehabilitation process depends on the patient, the location and condition of the fracture. The real question about Fracture Rehabilitation is whether there is adequate support. This is decided by a good interview, clinical examination and radiological evaluation.
After a fracture, the person usually walks with the aid of two canes or two crutches. The load capacity is practically examined in five subgroups. These; They are grouped into stress-free, fingertip, partially supported (mostly 25kg presses), fully loaded and fully supported.
Exercises are started for all joints that do not require immobility after fracture. Exercise and movement are the main elements of mobilization. It has been shown that various physiotherapy applications such as superficial cold, heat applications, TENS, ultrasound, laser, electrical stimulation, hydrotherapy are beneficial, reduce pain and edema, and have a positive effect in the acute phase of fracture treatment and in the post-fracture rehabilitation phase.