Post operative rehabilitation

Post fracture rehabilitation encompasses a wide range of interventions depending on the type and severity of injury sustained. When a fracture occurs it is important to seek emergency treatment. Controlling the movement of the broken bone prevents further injury. Following surgery, the person is placed in the care of a team of professionals consisting of a physician, nursing staff, a physiotherapist and an occupational therapist. Depending on the type of fracture, the person may be seen by one of these team members more than the others. For example, someone who has had a lower extremity fracture may spend more time with the physiotherapist.

Pain management during rehabilitation is an important consideration to allow the person to begin moving the injured part as quickly as possible. Pain may lead to guarding of the affected part, resulting in disuse. Pain is best managed with ice, heat, ultrasound or massage. This will help to make the patient more comfortable as well as loosen up muscles and make them more responsive to exercise.

Following surgery a person may have some swelling or edema. This will be treated with ice, compression and elevation. Proper positioning is essential to reducing edema. A person with an upper extremity fracture may have it immobilised in a sling, however the arm should be rested on pillows when the person is seated or lying down. It should never be allowed to hang down. For fractures of the knee or lower extremity, the leg should be supported on a low stool during sitting and on pillows or bolsters when lying.

Early movement of the part is essential to reduce edema, prevent stiffness or atrophy from lack of use. Depending on the type of fracture, we may need to do a passive ROM. Active ROM follows when the acute stage is past. It is important that you perform ADLs (activities of daily living) to gain a feeling of independence as well as regaining function and strength.

Post fracture rehabilitation may also involve getting rid of scar tissue which begins to build up when healing begins. We may use massage or vibration of the scarred area to soften scar tissue, followed by stretching. Active exercise against resistance may be started about 4 weeks following injury. Heat treatments with hot packs, paraffin dips or fluidotherapy also help get rid of scar tissue.

A positive approach to treatment will contribute to the best possible outcome for the post fracture patient.