Metallic Coll
Rehabilitation of a Colles fracture – Physiotherapy
Colles fracture, the name of Abraham Colles, who described for the first time in 1814 the common fracture the last inch of the radius and ulna near the wrist, is a common consequence of a fall on the outstretched hand (FOOSH). Typical treatment is immobilization in a cast or similar material for five to six weeks to allow bony union, followed by a rehabilitation period of a month or more, a short period which could imply a wristband for comfort during activity. Due to the functional importance of the hand, the immobilization period is maintained to a minimum to prevent dysfunction of the hand and wrist.
Physiotherapy Review begins once the hand has been discharged from plaster of Paris, manually feeling the fracture site should not be more than minimally uncomfortable, which means the fracture is on the right track to healing. Hand color should be normal, change should not have much swelling or severe muscle atrophy. wrist movements were limited to one or two planes, but all movement is not normally reduce significant or not. The pain may be present but again not be severe or occur in all movements of the hand.
Two hours of range of motion exercises are first taught to treat the patient by the practitioner and in many cases the movements of the wrist just enough to improve this alone is required. Elbow and shoulder should be checked to rule out the restrictions before proceeding to pronation and supination of the forearm rotating that are important for normal use hand. most studied movements are flexion and extension of the wrist, fingers and thumb, together with the adduction and abduction of the thumb. Extension wrist and forearm supination movements are most commonly affected.
After the plaster falls off the wrist often feel vulnerable, partly because the cast is rarely left on until the bone is completely healed to prevent the occurrence of complications due to immobilization. Physiotherapists can give the patient a type Futura key, key to a fabric with velcro strips and a piece of metal to the bottom of the wrist so hard. This is not the intention of maintaining immobilized the wrist rather than support the wrist while the patient is carrying out functional activities and then be removed by light activities and performance regular exercise.
If the amplitudes of motion does not improve as the practitioner should consider the use of joint mobilization to facilitate movement. Movements accessories can make to lower radioulnar joint to help pronation and supination, and wrist (wrist) and midcarpal joints, with the physiotherapist, fixing a side of the joint as he or she moves to the other side of the joint passively. This can be done gently or force majeure in end of the range to push against the restrictions within the joint. The demonstrations may also be done with the joint at the end of its motion available give him the slip and sliding movements requires it.
Strengthening the wrist occurs with a gradual increase in functional activities, but joining a class hand can instruct the patient in the practice of the great variety of small hand movements that can be done and needs reinforcement function best hand. Repetitive work on pieces of equipment can strengthen and harden the hand to rotate, twist, throw, catch and work well with your thumb and forefinger. This can proceed to work with weights functional activities, or if you need to return to manual work or other work which requires the strength of upper limb.
Treatment urgency is indicated if the hand is extremely painful, swollen with a strong and has poor movement, with a pain syndrome develops. At this stage of medical examination is important to ensure there are no complications with the fracture, such as poor healing or lack of healing. Analgesia and contrast baths can help with pain, desensitization with hypersensitivity to areas which can develop and massage and exercise with the swelling. Patient education is vital to know have hard work and pain to rehabilitate your hand.
About the Author
Jonathan Blood Smyth is a Superintendent of Physiotherapy at an NHS hospital in the South-West of the UK. He specialises in orthopaedic conditions and looking after joint replacements as well as managing chronic pain. Visit the website he edits if you are looking for physiotherapists in Birmingham.
