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.