Conclusion

After studying different kinds of traumas and fractures, we can understand the great importance of physical therapy during rehabilitation. Physiotherapy is a science related to human health specialized in the use of manual techniques in order to recover the lost motion due to an injury. During these twelve weeks, I wrote about differents fractures and how physical therapy is applied to the patient. I read a lot of research and articles related to the techniques used to achieve a perfect rehabilitation. I hope that everything written in my blog motivate you to continue doctoral studies in physiotherapy. The health of the human being is very important and should be in the hands of professionals who love their profession. If you want to know more information, leave a comment and I will answer gladly. Thanks for your atenttion.

Here I leave the link of my website. On this page you will find more information about me.
http://agabrielrv.wix.com/personal-webpage

                                     

Spinal Deformities: Scoliosis

The spine is composed of 24 separate bones: 7 cervical, 12 thoracic, 5 lumbar, sacrum and coccyx. Its main functions are to help carry the weight of the body, balance it and absorb the shock of human walking. Congenital deformities of the spine are one of the most interesting and controversial problems of the orthopedic surgery. They represent an abnormal curvature of the spine. Physical therapy plays an important role in these types of conditions because they have the task of helping the patient regain his position.

The posture of the human being is extremely important for the functioning of our vertebrae. Three conditions exist that affect posture: the cirdosis, lordosis and scoliosis. This last condition is a lateral curve of the spine caused by the abnormal development of the vertebral bodies. Scoliosis occurs during the first six weeks of intrauterine life but it is developing with time (in some cases it never develops). It is very important the early detection of this condition to prevent deterioration.

The diagnosis plays a decisive role in the physical therapy treatment of scoliosis. Scoliosis should certainly be diagnosed by radiographic analysis, have an X-ray can be useful to achieve more easily the objectives of physiotherapy. During the diagnosis, it is important to undress the patient for clinical examination. From several studies, scoliosis is classified between structural and non-structural (no vertebral rotation).

Physical therapy does not correct the curves, but improves respiratory function and muscle and is recommended for psychological reasons. Treatment varies according to the severity and type of scoliosis that presents the patient. It consists of: analgesics, rest, physical therapy, use of belts or brace, and, in some cases, when no improvements occur, surgery is needed. The objectives of outpatient physical therapy comprising various facets. The program consists of a few excersises (two to three) that the patient can then learn and practice at home.

In conclusion, the deformations of the spine are conditions that implement different physiotherapy and orthopedic techniques. These are necessary before, during and after treatment for many faster results.

Bibliography:

Huaroto Rosa-Perez, Julio. "Enfermedades Congenitas e Ideopaticas de la Columna Vertebral." "Cirugia Ortopedica y Traumatologia" (n.d.): 267-274.

J. A. Martin Benlloch and M. Laguia Garzaran. "Deformidades congénitas de la columna vertebral ." "REVISTA ESPAÑOLA DE CIRUGÍA OSTEOARTICULAR" Vol. 28.No. 164 (1993): 101-114.

M.A. Diez Ulloa. "Patología de la columna: prevención y tratamiento." "BOLETÍN DE LA SOCIEDAD DE PEDIATRÍA DE ASTURIAS, CANTABRIA, CASTILLA Y LEÓN" (2007): 53-58.

        

                                         

Cervical Fracture

The cervical spine is a highly mobile segment of the axial skeleton that allows a large range of motion in flexion, extension and rotation. It is vulnerable to injury because is unprotected and is composed of seven cervical (C1 – C7). An injury to one of its cervicals is extremely dangerous due to the function exercised by each one with regard to the movement. A blow to this area may incapacitate the patient, while in other cases, can cause death. Urgent care is vital to patient recovery and development (mostly young and adults in full working capacity).

After a trauma, the patient may have some of these symptoms: pain in suboccipital region, neck stiffness, limited movement and if there are medullary affection, can be felt from altered sensation and mobility to the patient's death depending on the degree of damage and affected segment. Fractures in the spine are classified according to trauma stability (stable or unstable) and by the affected cervical (upper or lower). An unstable fracture is considered one that presents neurological damage, ligament damage and significant displacement of the vertebral body. Moreover, a higher trauma are those involving the C1, C2 or C3, while a lower trauma goes from C3 to C7.

To determine the patient's diagnosis, radiography, MRI and CT are used. In cervical injuries, the first therapeutic element to consider is the provisional immobilization collar and referral of the patient to the hospital. The primary goal of treatment for stable fractures without neurological injury, is to reduce displacement and stabilize the spine. These fractures have an orthopedic treatment. There are different devices to do this, among them we can find: occipital cervical brace with adjustable support and mental, immobilizer sterno-occipital-mandibular, cervical traction metal bracket, orthotics cervical Halo type, among other devices. Furthermore, unstable fractures were treated with traction and cranial surgical stabilization (these fractures have surgical treatment). Treatment depends on whether the injury occurs in the anterior or posterior region of the cervical vertebrae.

Like most of the fractures that occur around the human body, physical therapy is, in some cases, the main treatment for these traumas. As for cervical trauma, the purpose is to help the patient regain mobility through analgesics, anti-inflammatory and through physical therapy. Among the services and techniques that offer physical therapy to patients with cervical trauma is: education and advice given by the physiotherapist, home exercise, massage and thermotherapy, electrotherapy, among other things.

Bibliography:

Alday, R., et al. "Traumatismos cervicales." Neurocirugia (1995): 22-31.

Vera García, Marta, et al. "Fracturas Cervicales." Fisioterapia Vol. 3 (n.d.).

                    

                                        

Traumatic Brain Injury (TBI)

Traumatic brain injury (TBI) is a common condition, constituting one of the leading causes of death in the pediatric population and young adults. It is a global health problem that produces motor disabilities, behavioral or cognitive sphere. These traumas are the leading cause of death in children over one year old and is also the cause of mental retardation, epilepsy and physical disabilities. It also represents one of the most frequent causes of death and disability in young people in our society. It requires immediate medical treatment and, sometimes, it requires surgical treatment. Approximately 50% of all deaths are associated with this trauma and this increases to 60% when it is for a vehicular accident.

Diagnosis, treatment and prognosis of these injuries has been modified in recent years based on the introduction of new techniques. The aim of urgent attention to TBI, regardless of severity, is to prevent secondary brain damage and identify intracranial abnormalities requiring emergency surgery. The pathophysiology of brain injury is classified into three types of injuries: primary, secondary and tertiary injury. The primary lesion is the direct damage caused by the impact of the trauma or the acceleration-deceleration mechanism, secondary develops as a consequence of the primary lesion, developing bleeding, edema, hyperemia, thrombosis and other secondary pathophysiologic processes and finally the tertiary injury is the late expression of progressive damage or caused by primary and secondary injury (causes neuronal death).

The pathophysiology of traumatic brain injury helps to have a better understanding of the different clinical manifestations of this type of trauma and its consequences in the short, medium and long term, in order to develop an appropriate therapeutic management of these patients. The diagnosis requires studies such as x-rays of the spine and skull, monitoring of intracranial pressure (ICP), computed tomography (CT), cerebral angiography, among other studies.

The general treatment for an injury in the brain skull can lead any of the following treatments: infusion of crystalloid solutions, maintaining a normal mean arterial pressure, apply pressure to sites of active bleeding, emergency surgery, if is necessary, reinforce cerebral perfusion and prevent secondary brain damage, among other treatments. To conclude, the medical care it is very important.

Bibliography:

Cruz Benítez, Luis and Francisco Javier Ramírez Amezcua. "Estrategias de diagnóstico y tratamiento para el manejo del traumatismo craneoencefálico en adultos." Trauma Vol. 10.No. 2 (2007): 46-57.

Guzmán, Francisco. "Fisiopatología del trauma craneoencefálico." Colombia Médica Vol. 39.No. 3 (2008): 78-84.

Ortega, Jorge Eduardo. ""Trauma Cráneo Encefálico: Actualización en el Manejo Médico"." Revista Medica Hondureña 66.4 (1998): 147-153.

  

Physical Therapy: A Treatment Option for Carpal Tunnel Syndrome

Carpal tunnel syndrome occurs when the median nerve is compressed at the carpal tunnel of the wrist (formed by the flexor retinaculum and the carpal bones). This painful disorder typically occurs in association with activities that place repetitive stress through the flexor tendons. When this tension is excessive due to too much repetition or high force, damage to the tendons may occur. This results in swelling and inflammation of the tendons, thereby reducing the dimensions of the carpal tunnel, compressing the median nerve (responsible for supplying some sensation and motor control to the hand). This syndrome is associated with repetitive occupational trauma, rheumatoid arthritis, pregnancy, acromegaly, wrist fractures, and other conditions.

Some of the Carpal Tunnel Syndrome (CTS) sufferers will usually experience the following symptoms in their hand or fingers: hand pain or aching, pins and needles, numbness at night, burning, weakness or cramping and swelling. The incidence of carpal tunnel syndrome is located from 0.1 to over 10 percent. Although carpal tunnel syndrome can occur at any age, it is commonly seen in patients greater than 50 (is more common in women). The diagnosis of the carpal tunnel syndrome is based on an analysis of a physiotherapist, or general doctor, about the symptoms. They usually use various tests such as Phalen’s test, Tinel’s test or the wrist flexion/median nerve compression test.

Most cases of carpal tunnel syndrome are usually treated with the appropriate physiotherapy. This includes careful assessment by the physiotherapist to determine which factors have contributed to the development of the condition. The physiotherapist will address: carpal bone mobilization and flexor retinaculum stretching to open the carpal tunnel, nerve and tendon gliding exercises to ensure full unrestricted nerve motion is available, muscle and soft tissue extensibility, cervicothoracic spine to correct any referral or double crush syndromes, grip and pinch, thumb abduction and forearm strengthening in later phases, comprehensive upper limb, wrist and hand ROM strengthening and endurance exercises and posture, fine motor and hand dexterity exercises. The treatment of this syndrome includes: ultrasound, traction, splints, medication, electrical stimulation, ice or heat treatment, gliding exercises and manual therapy. During recovery, the patient should follow the RICE protocol (rest, ice, compression and elevation). A surgery may be required to decompress the median nerve.

To conclude, it is very important to take this condition seriously. This syndrome can cause loss of independence.

Bibliography:
Carpal Tunnel Syndrome. s.f. <http://www.physioadvisor.com.au/9250550/carpal-tunnel-syndrome-symptoms-diagnosis-trea.htm>.

Gómez Conesa, Antonia and Gisbert Serrano. "Carpal Tunnel Syndrome." Fisioterapia (2004): 170-185.

Miller, John. Physio Works. March 22, 2015. <http://physioworks.com.au/injuries-conditions-1/carpal-tunnel-syndrome>.

Mishock, John R. Mishock Physical Therapy and Associates. 2014. <http://www.mishockpt.com/physical-therapy-a-treatment-option-for-carpal-tunnel-syndrome/>

 
      

Ankles Fractures

Ankle fractures are the most common type of fractures treated by orthopedic surgeons (account for 9% of fractures). The ankle consists of the articular surfaces of the talus, tibia and fibula, as well as its binding ligaments and capsule. The tibia is the shinbone and is located on the inner, or medial, side of the leg, the fibula is located on the outer, or lateral, side of the leg and the talus is a small bone that sits between the heel bone (calcaneus) and the tibia and fibula. The distal ends of the tibia and fibula bones are also known as the medial and lateral malleoli, respectively. Ankle fractures are common injuries that are most often caused by the ankle rolling inward or outward.

The contribution of the articular surfaces, ligaments, capsular and ligamentous structures and the ankle function and stability are influenced by changes in load characteristics and joint position and altered in response to injury. Doctors classify ankle fractures according to the area of bone that is broken. The ankle fractures can range from the less serious avulsion injuries (small pieces of bone that have been pulled off) to severe shattering-type breaks of the tibia, fibula, or both. These fractures can be caused by a car accident, one false move, diseases such as imperfect osteogenesis (failure in the bone development) and rheumatoid arthritis (inflammation of the joints) and by sports injuries, such as basketball or football. An ankle fracture is accompanied by one or all of these signs and symptoms: immediate and severe pain, significant swelling, bruising, inability to walk, cannot put any weight on the injured foot, and change in the appearance of the ankle so that it differs from the other ankle.

The goals of treatment are the fracture healing and the recuperation of the ankle's movement and function. The treatment will depend of the diagnosis which can be done by an arthrogram, bone scan, computed tomography (CT), x-joint (radiography of articulation) or with a MRI (magnetic resonance imaging). Treatment of ankle fractures depends upon the type and severity of the injury (lateral malleolus fracture, medial malleolus fracture, posterior malleolus fracture, bimalleolar fractures or bimalleolar equivalent fractures, trimalleolar fractures or syndesmotic injury). For some ankle fractures, surgery is needed to repair the fracture and other soft tissue related injuries. No matter if it is broken or not, it's important to follow the "RICE" protocol (rest, ice, compression and elevation). Also, immobilization and medication can be needed. Obviously, physical therapy plays an important role in recovery. 

To conclude, it is important to follow your surgeon’s instructions after treatment. Failure to do so can lead to infection, deformity, arthritis, and chronic pain.

Bibliography: 

American College of Foot and Ankle Surgeons. (n.d). Ankle Fractures. Retrieved from ACFAS: http://www.foothealthfacts.org/footankleinfo/ankle-fracture.htm

American College of Foot and Ankle Surgeons. (2006). Ankle Fractures. ACFAS, 1-2.

American Orthopaedic Foot & Ankle Society. (2015). Ankle Fracture. Retrieved from AOFAS: http://www.aofas.org/footcaremd/conditions/ailments-of-the-ankle/Pages/Ankle-Fracture.aspx

Crist, B., Dunbar, R. P., & Fischer, S. J. (March, 2013). Ankle Fracture. Retrieved from Ortho Info: http://orthoinfo.aaos.org/topic.cfm?topic=a00391

Cunha, J. P. (March 13, 2015). Broken Ankle (Ankle Fracture). Retrieved from Emedicine Health: http://www.emedicinehealth.com/ankle_fracture/article_em.htm#broken_ankle_ankle_fracture_overview

Education for ABC Health Program. (n.d.). "Fractura de Tobillo". 1-3.

Varela, B., Federico, C., Rainero, V., Salvo, J. N., Ventura, E. A., & J. I. (n.d.). "Fracturas de Tobillo" . 1-20.

             

IDD Therapy Disc Treatment

The IDD Therapy - Intervertebral Differential Dynamics Therapy - is a proven treatment for the relief of lower back pain. With a significant success rate, thousands of patients have experienced dramatic pain relief and healing. This treatment is non-surgical, non-invasive, and typically does not involve pain medications. The treatment is safe and painless, also comfortable and relaxing. The therapy includes approximately 20 treatment sessions and is completed in about 35 days. The IDD Therapy treatment can reduce pressure on the vertebral joints, promote retraction of herniated discs, and promote self-healing and rehabilitation of damaged discs, thereby relieving low back pain.

Intervertebral discs are the spongy shock absorbers between the vertebrae bones in our spines, and patients with long term disc problems have limited treatment options available to them. The most important thing for good spinal health and disc health is movement.  Thus when there is muscle spasm and pain, mobility in the spine is lost. When it comes to treating discs, the purpose is to help restore movement in the spinal segments. To achieve this, doctors and therapists works to change posture, to restore muscle balance, releasing muscle tension and a variety of other interlinked problems. These are the reasons why other methods and techniques are used.

The IDD Therapy disc treatment tool is a mechanical advancement which uses computer controlled pulling forces to open and mobilize targeted spinal segments where there is an injured disc. IDD Therapy allows clinicians to take pressure off the targeted disc and other spinal structures to relieve pain. The combination of IDD Therapy with other manual therapy interventions provides us with a complete programmed of care for our disc patients and in particular those with long term problems.

To conclude, the degeneration of vertebral discs can cause spinal structures to pinch nerve roots, thereby causing pain. It is extremely important to address these complications quickly due to their effects. The IDD therapy provides an effective solution to this condition.

Bibliography:

Stefaan. (2015, January 15). NEW HOPE FOR DISC PAIN PROBLEMS. Retrieved from Core Warwick: 

http://www.chiropractorswarwick.co.uk/index.php/2015/01/15/new-hope-for-disc-pain-problems/

What is IDD Theraphy? (n.d.). Retrieved from Crissman Family Practice: http://www.crissmanfamilypractice.com/index.cfm/fuseaction/site.content/mode/dtl/type/83688/post/58505.cfm

                      
                          

Hip fracture

Hip fracture is the most common cause of hospitalization in orthopedic services. This fracture is a break in the femur (thigh bone) of the hip joint. Joints are areas where two or more bones meet. The hip joint is a cavity, in which the femur meets the pelvic bone. Hip fracture is a serious injury and requires immediate medical attention. Patients suffering from this disease may suffer serious complications, ranging from varying degrees of disability to a complete loss of their independence.

The incidence of hip fracture increases with age, people over 60 are more likely to suffer from this disease due to weakening of the bones, commonly caused by osteoporosis. Most fractures result from falls or stumbles, however, about 5% have no history of trauma. There are several risk factors that can increase a person's chances of developing this fracture. Osteoporosis is the principal cause because it decreases the strength of the skeleton. Moreover, other factors are added such as height, low body weight, physical inactivity, and excess caffeine consumption, among others. When the patient goes to a hospital, commonly complain of severe pain in the affected hip and has difficulty or inability to walk. They also tend to have bruising and swelling in the area. It is extremely important to treat the symptoms early to avoid the difficulties continue to increase.

The diagnosis is based on a physical examination and radiographic studies. In most cases, the radiography is able to determine if there is a fracture. In addition, the diagnosis may include other techniques such as magnetic resonance imaging (MRI) or computed tomography. After the diagnosis, it is possible to identify the type of fracture that the patient has, fractures classified as intra-capsular or extra-capsular. Early detection of an intra-capsular fracture is very important, because this type of fracture is prone to complications.

The goal of treatment is to return the patient to their functionality level. Usually, this objective is achieved by surgery. The orthopedic treatment can be considered in patients whose previous functionality can be achieved without surgery. However, the majority of hip fractures are treated surgically. The type of surgery performed depends on the characteristics of the fracture and careful assessment of the patient. The types of treatment available are: an osteosynthesis of femoral neck or replacement prostheses (partial or total). On the other hand, the goal of care after surgery for hip fracture is getting people to remain standing safely and walk again. At first, it requires the patient to rest. Subsequently, various mobilization strategies are used, including gait retraining and exercise programs and electrical stimulation.

In conclusion, to prevent a hip fracture, it is recommended that a person drink large amounts of calcium. It is also very important to do exercises that support the body weight, such as walking or jogging regularly.

Bibliography:

Handoll, H. H., Sherrington, C., & Mak, J. C. (2011, marzo 16). Interventions to improve mobility after hip fracture surgery in adults.

Muñoz, S., Lavanderos, J., Vilches, L., Delgado, M., Carcamo, K., Passalaqua, S., & Guarda, M. (2008). "Fractura de cadera". "Cuadernos de cirugía (Valdivia)", vol.22, 73 - 81.

 

Fracture of the Pattela

The anatomy of the knee is basically composed by three bones that are held together with the help of muscles and tendons. The patella is the bone-shaped lid, which lies between the femur and the tibia. This is located in the terminal tendon of the femoris quadriceps muscles and is ahead of the lower end of the femur. The patella plays an important role as part of the extensor mechanism of the knee, in addition to serving as protection against direct traumas. Likewise, it provides a better aesthetic appearance to the knee.

The fracture of the patella (FR) is frequently observed in emergency services. Its behavior varies depending on the intensity of trauma. This one is usually caused by a direct or and indirect blow, sometimes are both. Athletes, such as football players, have a high probability to suffer fractures. These are classified according to their displacement, as displaced or non-displaced, and according to the stroke of the fracture, as transverse, vertical, marginal, osteochondral and comminuted. To determine the severity of the injury, is important to inspect the area and the movement ability of the active leg extension. From these observations, the doctors can suspect if the patient has suffered a fracture and then they proceeds to confirm the diagnosis by radiography.

According to different sources, treatment may be conservative or surgical. When a patient comes to the emergency room with signs of fracture of the patella, the first thing to do is try to reduce the pain by applying ice or analgesics. After determining the severity of the injury, the treatment is determined. The conservative is to those patients who retain the continuity of the extensor mechanism and non-displaced fracture. This treatment is to immobilize the area for an approximately period of three weeks and, after that, to rehabilitate the patient by physiotherapy, until the bone is consolidated. Moreover, surgical treatment aims to achieve anatomic reduction, restore the congruence of the articular surface and the integrity of the extensor mechanism. To accomplish this, there are a variety of techniques, such as the previous tension banding or a partial and total patellectomy. For most of the techniques, doctors used different instruments like screws, cerclage wire, Herbert's screws and bio-absorbable fixation implants for osteochondral fragments.

In conclusion, the patella fracture is very common in people, especially in athletes. Their treatment varies according to the extensor movement that exerts the patella. If the patient's patella does not comply with its functions, it should try to surgically. The recovery is completed by physiotherapy techniques that helps strengthen the bone and improve the extensor movement.

                         
                                                   

Fractures of the Distal Radius - FDR

According to the American Physical Therapy Association, the goal of physical therapy is to improve mobility, restore function, relieve pain and prevent further injury and damage using a variety of methods. These include exercises, stretching, traction, electrical stimulation and massage. Obviously, the intensity of the physical treatment depends on the severity of the injury. One of the main functions of physiotherapy is to attend fractures like the FRD (fractures of the distal radius). The FDR are the most common of the skeletal, represents approximately 1/6 of all body’s fractures. 

The radius is the largest bone of the forearm. The end of the wrist side is called distal end. Breaking this tip is a very disabling process due to the frequent use of the hand. Those affected are susceptible to physical therapy. The most common cause of these fractures are falls on the outstretched arm (conditions such as osteoporosis increases the possibility of an FDR). A broken wrist usually causes immediate pain and inflammation. In many cases, the wrist is dislocated.

The treatment of bone fractures attempts to locate broken parts and prevent movement of the area until fully recovered. Doctors who specialize in physical health of the body, as physiatrists, use two types of treatment: non-surgical and surgical treatment. If the broken bone is in the correct position, a cast could be applied until the bone consolidated. The cast is removed roughly six weeks after the fracture occurred. At that point, they often start with physical therapy to help improve movement and function of the injured wrist. Moreover, it is sometimes necessary surgery. When the position of the bone is out of place and cannot be corrected or maintained corrected in a cast, surgery may be required. There are different methods to maintain fracture reduction and stabilization like Kirschner’s wires, screws, use of external fixators or introducing various plate.

In conclusion, the FRD are one of the most common fractures. Actually, these fractures remain difficult to treat but techniques are available to ensure its reduction and control and then start early mobilization and avoid possible sequels. The probability of being treated with a surgical mode will depend on the severity thereof. The total recovery of movement rests largely on physiotherapy techniques such as massage. It is critical to resort to an emergency room in case of a possible injury in this area.

Bibliography:

Albadejo, M. F., Chavarria, H. G., & Sanchez , G. J. (2003). Distal radius fracture. "Fisioterapia", 79.

Sánchez Crespo MR, Del Canto Álvarez F, Peñas Díaz F, De Diego Gutiérrez V, Gutiérrez Santiago M. (2009). Functional results and complications of locked distal radius volar. "Revista Española de Cirugía Ortopédica y Traumatología"., 382.

The date of birth of physiotherapy

I was reading a little bit about the origins of physiotherapy to have more knowledge of it. Did you know that the first clinic recognized as a physical therapy center was founded in 1813? I had always thought that the beginning of this career was much earlier. This clinic took place in Sweden thanks to a group of professionals directed by some man called Per Henrik Ling. We should thank this man because may be he is the reason why exist this beautiful career.

"Royal Institute of Gymnastics" was the name of Ling's clinic. He founded it with the purpose of provide massage and exercise to swedish gymnasts. Something curious is that they did not know anything about the concepts of physiotherapy because there not existed such profession. If we compare Ling's "physical therapy" versus which we see today's day, we notice that these have few things in common, like the massages and exercises. This profession was developed during the first and second World War. During 1950 the physiotherapy was recognized as a profession and from this date was when it began to expand around the whole world.

To conclude, I wrote all this because it is important to know how was that the professions we study began. We need to start developing our knowledge. Physiotherapy still remains a growing profession today and is becoming a more integral part of maintaining community health and well-being.




                                                

Introduction

Hello everyone! If you are reading this is because you are in my new blog. I will use this page to talk and express myself about one of the most prestigious careers of health, the physiotherapy. I will publish one post per week and all these will be about related concepts to this theme. I chose physiotherapy because my expectation is to become a physical therapist, also named physiotherapist, in a couple years. I hope you can take advantage of my blog. Enjoy it!