Fracture Recovery
Post Fracture Recover Program
Your skeleton is composed of 206 bones that create the framework for your body. Bone is living material, constantly growing and changing. Although it is the strongest mineral in our body, it can still break when under sudden trauma or unusual pressure.
A broken or cracked bone is known as a fracture, whether it is complete or partial. Fractures can happen in a variety of ways but the most common causes are: traumas such as falls, motor vehicle accidents or sports injuries. Osteoporosis , a disease resulting in brittle and fragile bone, causes none traumatic fractures and stress fractures can sometimes occur with overuse. There are various types of fractures: simple fractures where the bone is broken but the skin is not lacerated, compound fractures where the skin and soft tissues are damaged, and comminuted fractures where the bone has been broken or crushed into several fragments.
Usually one knows immediately if a bone has been fractured. You may have heard a snap or crack, and the area becomes excruciatingly painful, swollen and sometimes deformed. Doctors will order an x-ray to confirm the diagnosis and discuss the recovery process. The fracture self-repair process is natural and occurs spontaneous but the area needs to be immobilized to allow this to happen. Doctors use casts, splints or other fixation devices for external fixation or they will surgically implant screws, metal plates or pins to internally fixate. The R.I.C.E. formula forms the basis for first aid treatment. R is for rest, I for ice, C for compression and E is for elevation. Consequently one is often seen on crutches and keeping a leg up.
The first phase of healing is the inflammation phase. Immediately upon the fracture, blood clots form and there is an inflammatory reaction that calls for certain cells in the body to clean up the wounded area. The second, reparative stage begins about two weeks later. In this stage certain bone cells called osteoblasts and chondroblasts begin to consolidate into a soft callus. This is new soft bone which will eventually harden to a hard callus. This process takes 6 to 12 week. The final stage is the remodeling phase and this is where the bone matures and remodels into stronger lamellar bone.
Each stage of the fracture recovery process brings different goals to physiotherapy and rehabilitation. Initial pain management goals change to promoting progressive movement, muscular strengthening and improving function once the fixation is removed. Exercise is not usually thought of as promoting fracture healing, yet it does. In general, bone responds to patterns of loading, patterns of movement and pressure to repair. Exercise promotes good circulation, better range of motion and improved strength and co-ordination, all necessary for full functional recovery and different types of exercises are advisable at every stage. Physiotherapists are the musculo-skeletal specialists that recommend individual, specific exercises for each phase of recovery and for each individuals recovery goals.