Physical Therapy in Ankle Fracture
Ankle fractures are among the most common in the lower limbs. It is usually caused by a low-velocity trauma such as twisting injuries, falls, car accidents and injuries related to sports activities.
The incidence of this type of fracture is estimated at 100 fractures per 100,000 people per year. This number has steadily increased both in active young and in the elderly over the past decades.
The orthopedic treatment may be conservative or involve surgical fixation, reduction and immobilization, depending on the severity of the fracture presented. Recalling that, in all cases, the physiotherapist in Janakpuri will act in the recovery process of the functionality and decrease the symptoms of inflammation for early return to activities of daily living.
The best physiotherapist in Dwarka starts already in the immobilization treatment period using various techniques in order to rehabilitate a patient. So that the patient can return safely to their activities, including leisure and work, getting better their quality of life.
Ankle fractures can be caused by several mechanisms of action, and the forces that may contribute to the occurrence of injury are external rotation, vertical compression, abduction and adduction. But the most common cause of this type of fracture is the misstep associated with a twist. There are other possibilities as in contact sports, car accidents, falls, strong strokes among other situations.
This type of fracture is observed generally that the ankle may have broken bones in the medial tibial malleolus, the posterior margin of the tibia (posterior malleolus) and the lateral malleolus to the lower end of the fibula.
Often the fracture occurs along with the tear of the medial ligament, lateral collateral and lower tibiofibular, presenting five degrees of severity of injury:
- ligament injury in isolation;
- ligament injury fracture of a malleolus;
- ligament injury to fracture two malleoli;
- ligament injury fracture three malleoli;
- ligament injury more diastasis of more lower tibiofibular joint fracture.
Treatment of Ankle Fractures
The treatment of ankle fracture may be surgical or conservative, with reduced foot maintenance goal and inversion of the movement that caused the injury. Seeking to maintain good standing in line, since at times a good position is only achieved through manipulation.
Already in the surgical treatment internal fixation will promote bone reconstruction and ligament repair. Its main objectives to create a joint that is stable and reconstitute articular cartilage. Note that reaching the goals early movement can be started and need not restraint, otherwise it will be cast.
Upon conservative treatment the patient is often monitored by radiological examinations to make sure stability. It is important that the patient be maintained with the plaster cast for at least eight weeks. In the case of the present stability weight support is allowed for at least four weeks.
Types of physical therapy in Ankle Fracture
The physiotherapeutic treatment on ankle fracture will develop according to the type of treatment performed. Treatment can be conservative or surgical, which depend on the health conditions of the patient.
In physical therapy is initially included pipelines to reduce pain, swelling, inflammation and prevention of future injuries. Then ducts order to increase muscular strength, range of motion gain, increased mobility. And at the end of the treatment is working the body burden, proprioception, gait training and neuromuscular training of the ankle.
It is observed in functional association with the physiotherapy in Dwarka, other therapeutic modalities for the purpose of accelerating the patient recovery. Some resources used, as the contrast bath, shortwave, ultrasound. In some competing therapies such as pacing electroplating, dynamic and interference current therapy. Always remembering that the choice for the resource to be used as regards the electrotherapy is important to note the type of surgery performed and whether there was use of synthesis for fracture fixation.
Best techniques for mobility recovery
A major problem after removing the plaster cast is the lack of joint mobility. It is observed that the time of immobilization to consolidate the fracture causes muscle atrophy, proprioceptive deficits and capsular restrictions. In conducting exercises to gain mobility should have knowledge about the mechanics of injury or surgical fixation to avoid excessive stress on the initial injury.
The manual therapy techniques facilitate the process after the injury because of the normal remodeling and tissue regeneration depends on mechanical stimulation.
The mobilization extends through drifts and normalizes shortened tissues promoting the following results:
- Increased range of motion;
- Reduction of abnormal voltages;
- Reduction of the above pain and edema;
- Aids in the repair process;
- Dynamic and facilitates flow of fluids in the tissue;
- Stimulates removal of the inflammation process byproducts.
Here are some techniques to restore movement to articulate:
- Traction the ankle joint to increased mobility of the ankle;
- With the patient in the prone position above the slide stem to increase range of motion in plantar flexion;
- With the patient in the lateral position, the medial heel slip for increasing eversion;
- With the patient in supine position, the rear sliding stem to increase range of motion in dorsiflexion;
- With the patient in a prone position, traction subtalar joint to increased mobility of the subtalar joint;
- With the patient in the prone position, the heel slid laterally to increase the inversion;
- Increased mobility of the calf and myofascial release of the plantar fascia;
- The stretching of the soleus and gastrocnemius;
- ankle mobility exercises as active assisted and active dorsiflexion, plantar flexion, inversion and eversion, while respecting the conditions of the patient.
The Physical Therapist Practice in Treatment
The physiotherapy in Janakpuri in ankle fractures will promote a very positive effect on the patient's functionality due to the recovery of movement, mobilization and load-bearing on the affected limb.
After all, long periods of standing can cause bone loss and bone properties, leading to weak growth. Furthermore, they can also occur in the cartilage tissue ulceration, weight loss, volume and cartilage proteoglycans.
Therefore, it is noted that physical therapy will work satisfactorily in all functional changes caused by ankle fracture through the pain reduction, increased muscle strength and range of motion, improved functionality, increased gait quality, return to activities of daily living, becoming a great therapy for the improvement of dysfunction caused by the injury.