Topic 7. Spine Fractures .pdf

Topic 8 Vertebral fractures 1 BIOMECHANICAL PRINCIPLES OF VERTEBRAL FRACTURES. . Stability depends MIDDLE/POST column Stable: anterior column. Good pronostic Unstable: middle or posterior column Neurological deficit 2 2 1 SPINE FRACTURES 3 3 SPINE FRACTURES Physiotherapy Treatment object...

Topic 8 Vertebral fractures 1 BIOMECHANICAL PRINCIPLES OF VERTEBRAL FRACTURES. . Stability depends MIDDLE/POST column Stable: anterior column. Good pronostic Unstable: middle or posterior column Neurological deficit 2 2 1 SPINE FRACTURES 3 3 SPINE FRACTURES Physiotherapy Treatment objectives : • Encourage consolidation. • Improve tolerance of immobilization. • Keep the functional capabilities of the regions not immobilized . • Regain mobility and muscle strength in areas immobilized after removal of immobilization. Treatment phases: – 1ª a 8ª weeks. :Inmobilization Xray Control at the end – 8ª a 12ªweeks. Mobilization 4 4 2 Atlas Fracture: • 5% of spine fractures. • Traffic and falls from height. • Types: • Posterior arch: by inflexion. +++ frequent. • Possible neurological deficit. • Consolidation 8-16s. 5 5 RACTURAS VERTEBRALES FRACTURAS CERVICALES. Axis Fracture: • Fracture of the odontoid process: • 10% of cervical spine fractures. • Fracture of the neural arch or "hangman's" fracture. • Frequent cause of disability and death. Fractures C3 - C7: • More frequent in the lower region as it is more mobile. • Cord injuries associated in 25% 6 6 3 CERVICAL SPINE FRACTURES MAXIMAL PROTECTION PHASE • Inmobilizatión : • No Upper Limbs movements above the head. . • Symptomatic treatment of discomfort arising from the immobilization : • Soft MMSS and MMII active mobilizations . • Isometric in abdominals , quadriceps. • Analgesic electrotherapy : is is possible Surgical protocole it´s unusual in neck fractures 7 7 Orthopaedic treatment Halo Device C1-C3 Minerva Device C4-C7 8 4 . CERVICAL SPINE FRACTURES 8ª a 12ª Weeks: MODERATE PROTECTION Active controlated motion PROPICEPTION PATTERNS Active free motion + manual therapy support Postural reeducation 9 9 THORACO LUMBAR SPINE FRACTURES • Originated by high-energy trauma or minor trauma on osteoporotic bone. •D1 –D10 fractures are stable : ribcage •Common injury mechanisms : Compression anterior or lateral flexion. 10 10 5 THORACO LUMBAR SPINE FRACTURES Week 1- 4 • Immobilization: plaster corset , orhesis • In Osteosynthesis. Avoid bending , rotation and any mobilization of the injured area .. • Symptomatic treatment of discomfort arising from the immobilization : Massage therapy in free zones without risk. • MMSS and MMII active mobilizations .and isometric 11 11 THORACO LUMBAR SPINE FRACTURES Week 4ª - 8ª : • Immobilization: progressively removed. • Avoid bending , rotation and passive mobilization • Working isotonic in upper and lower limbs. • Symptomatic treatment of discomfort arising from immobilization.: massage.. etc 12 12 6 THORACO LUMBAR SPINE FRACTURES Week 8ª -12ª :. • Caution before ligamentous instability. • Initiating active movements of flexion, rotation • .Prone to 12 weeks. active - resisted extension work . • Postural changes and complete and independent charge. • Proprioception. 13 13 7