Facture in the arm

Facture in the arm

1. Anatomy of the arm

   • Compartments of the arm
     • Anterior Compartment
       • Biceps
       • Brachialis
       • Coracobrachialis
     • Posterior Compartment
       • Triceps
   • Elbow region
   • Humerus

2. Risk factors for falling

   • Old age
   • Living alone
   • Previous falls
   • Chronic illness ,neuromuscular
   • Medications
   • Use of walker
   • Reduced vision

3. Types of fracture

   • Twisting force = spiral fracture
   • Compression force = short oblique fracture
   • Bending = triangular 'butter-fly‘ fragment
   • Tension force = Transverse

4. Complication of fracture

   • General
     • Shock
     • ARDS
     • Fat embolism
     • Head, chest, abdomen and pelvic injuries
     • Crush syndrome
     • Tetanus
     • Gas gangrene
     • DVT/PE
     • Bed sores
     • Depression
     • Vascular or neurological lesions
   • Local
     • Early
       • Visceral injury
       • Vascular injury
       • Nerve injury
       • Haemarthrosis
       • Compartment syndrome
     • Late
       • Delayed union
       • Non-union
       • Mal-union
       • Tendon rupture
       • Myositisossificans
       • Osteonecrosis
       • Algodystrophy
       • Osteoarthritis and joint stiffness

5. Managements of fracture

   • Casts
     • Holds a broken bone in place as it heals
     • Prevent or decrease muscle contractions, and are effective at providing immobilization, especially after surgery.
     • Casts immobilize the joint above and the joint below the area that is to be kept straight and without motion.
     • What is it made up of?
       • Hard part of the cast
         • Plaster (white in color)
         • Fiberglass
       • Inside of the cast
         • Cotton and other synthetic materials
     • Types of Casts
   • Physiotherapy
     • Importance
       • Some complications are not detectable by doctors but can be detected by physiotherapist & physiotherapy prevents atrophy of the muscles
     • Includes
       • Massage
       • Ice therapy
       • Scar management
       • Exercise
       • Joint manual therapy
       • Balance and control walking
       • Return to sport preparatory work.
       • Lasers and ultrasound.
       • Structured and progressive regime.

6. Bone Healing

   • Healing is faster in bone than in cartilage due to lack of blood vessels in cartilage
   • Clinical treatment
     • Fracture Fixation
       • External fixation
         • Used for fractures that are too unstable for a cast. You can shower and use the hand gently with the external fixator in place.
       • Internal fixation
         • Surgical procedure that stabilizes and joins the ends of fractured (broken) bones by mechanical devices such as metal plates, pins, rods, wires or screws.
       • Frame fixation
         • Allows correction of deformities by moving the pins in relation to the frame.
     • Reduction of Fractures
       • Closed reduction = restore pieces to normal position by manipulation
       • Open reduction = realignment during surgery
       • Surgical procedure to restore a fracture or dislocation to the correct alignment
       • Aim
         • To regain normal lenght & alignment

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