With fracture it is meant an interruption of the bone’s continuity. Fractures occur when a force is applied to the bone capable of overcoming its capacity for resistance.
There are different ways to classify and describe fractures:
according to the origins of the fracture: traumatic or pathological (typical in elderly people);
according to the mechanism of the fracture: direct or indirect;
according to the type of fracture: traverse, oblique, spiral or longitudinal;
according to the patterns of fractured segments: comminuted or compound;
according to the extent of damage of the overlying skin: closed or open;
according to the thickness of the bone exposed to fracture: complete or incomplete;
according to the fracture’s stability: stable or unstable.
Typical symptoms in fractures are characterised by pain, rigidity, haematoma and functional limitations in the affected limb. Diagnosis is usually confirmed with a standard X-ray.
The urgency in treatment is managed at the first aid.
Then, it is extremely important to start a personalised rehabilitation treatment. Rehabilitation at the beginning tends to decrease pain and inflammation, after to recover the maximum range of movement possible, in the gym first, and to remove stitches in the pool as well. The gradual recovery of the muscular strength and co-ordination are then fundamental to achieve the maximum functional outcome possible.
Reduction of fractured tibia or fibula
The emergency treatment for fractures involving tibia or fibula is managed by the specialist physician of the first aid, who will be in charge of deciding whether to proceed with the reduction and subsequent immobilisation, or ask for the consultancy of the orthopaedic surgeon to arrange a surgical treatment. After, to achieve the maximum functional outcome possible, it is extremely important to start a precocious rehabilitative treatment and personalise it as discharged from the hospital.
Fractured tibia or fibula rehabilitation
Fractures of tibia and fibula are the most frequent fractures, they can be associated (both) or isolated.
According to the fracture site can be distinguished three different districts: the proximal third (articular fractures), middle third (metadiaphyseal), distal third (articular fractures); this distinction is important both from the point of view of rehabilitation and from a prognostic point of view. In addition, patients can be treated surgically (osteosynthesis, application of plates and screws) or simply immobilized with plaster cast; everything must be taken into account in drawing up the rehabilitation program.
The rehabilitation process includes a first phase of pain control and recovery of active and passive range of motion of the hip, knee and ankle, accompanied by a mild muscle strengthening. Achieved the goal you can start aerobic activity and the phase of the strength recovery with exercises for the gastrocnemius, tibialis anterior and posterior, soleus, flexors and extensors and intrinsic foot, quadriceps, gluteus and flexor muscles of the core; at the same time you will begin proprioceptive exercises and equilibrium increasingly complex.
The key issue is to conclude the rehabilitation program with the last phase of the field with a specific sport gait exercises and a gradual and safe recovery of movement and sporting gesture.