In this time physiotherapy can start to maintain joint range and muscle power. This is usually 6 weeks until the consultant is happy with the check x- rays, and the fracture has healed. Initially Post op the emphasis is on partial weight bearing with elbow crutches in an air cast boot. Moreover, the surgical implant offers appropriate biomechanical fracture stabilisation and acts as a load sharing device allowing for early postoperative mobilization. Intramedullary nailing carries the advantage of minimal surgical dissection with appropriate preservation of blood supply to the fracture. The goals of surgical treatment are to achieve osseous union and to restore length, alignment, and rotation of the fractured tibia. Intramedullary nail fixation remains the treatment of choice for unstable and displaced tibial shaft fractures in the adult. Infection, injury to nerves and blood vessels, blood clots (these may also occur without surgery), malalignment or the inability to correctly position the broken fragments, delayed union or non-union (when the fracture heals slower than usual or not at all). As mentioned in part 1, complications can arise with any fracture particularly a serious displaced fracture. The x-ray below taken at A&E show clearly a displaced oblique fracture to the right tibia and fibula. Case HistoryĪ 21-year-old male footballer sustained a fractured tibia and fibula playing football, as a result of a collision and direct trauma. For the purpose of this rehab blog I have added a selection of exercises from the many that were used in physiotherapy. Understanding the nature of the chosen sport will ultimately dictate the length of rehab, together with the skill acquisition needed before a complete return to a competitive level. He has kindly agreed to share his x-ray results and his progress through rehab, to encourage others that a return to sport is achievable with the right physiotherapy, encouragement and guidance.įrom a physiotherapy perspective following a fracture, as with any athlete, it is vital in the early stages to set realistic rehab goals. In part 2 we will look at young footballer who came to myself for rehab at Physiohaus following a significant lower limb fracture. In part 1 we looked at the 5 complex stages of fracture healing from the initial break to full repair, as the bone forms a bulbous collar around the break during the remodelling phase.
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