Radial Ulnar Fracture and Physical Therapy Guidelines


A radial ulnar fracture is defined as a fracture of the two bones that make up your forearm, the radius and the ulna.  A radial ulnar fracture is usually caused by a traumatic impact to the wrist. This may occur during a fall while the arm is extended. In the emergency room one can  expect the forearm to be immobilized in a cast for six to eight weeks. Afterwards, it is necessary to undergo physical therapy in order to rehabilitate the muscles and ligaments that have atrophied i.e. lost size and strength, during the  immobilization period.
At times in the first few days after such a (radial ulnar) fracture, the doctor may place the arm in a sling. This will keep the arm immobilized and allow for swelling to reduce before a cast is placed on the arm. The physical therapy treatment that is used at this time is typically ”cryotherapy”. Cryotherapy consists of placing ice or cold packs over the affected area of the arm in order to reduce inflammation. Inflammation can prevent the body’s natural ability to begin healing. After several days of cryotherapy, the swelling  may subside enough to allow a hard cast to be placed on the arm.
After about 6 to 8 weeks in a hard cast, the bones should normally be sufficiently healed. However, due to several months of immobility, the ligaments that cross the wrist may become stiff, thereby limiting  range of motion. At this time a physical therapist may begin therapy by providing  several types of range of motion exercises. The purpose of these exercises is to increase the range of motion at the wrist joint. The physical therapist may use passive and active flexibility exercises which are designed to  increase the ability to move the wrist with its normal range of motion.
As the ligaments regain their flexibility and the range of motion at the wrist joint increases, one should begin muscle strengthening exercises. After months of not using the forearm and wrist, muscles will lose both size and strength. Every muscle that crosses the wrist joint should be strengthened in order to increase the stability of the joint capsule. The physical therapist will direct the patient through the proper strengthening exercises that are specific to his needs.
Range of motion exercises  needed for increasing the strength and mobility of injured arms and wrists can be accomplished in a comfortable and challenging way by using the ARMTUTOR. The ARMTUTOR is one of several physical therapy products which include the HANDTUTOR, LEGTUTOR and 3DTUTOR that are used extensively in leading U.S. and European rehabilitation hospitals and clinics as well as in the patient’s home through the use of telerehabilitation.
The ARMTUTOR allows the physical and occupational therapists to report on and evaluate the patient’s functional rehabilitation progress. The PT and OT  prescribe the correct customized and motivating intensive exercise practice to the manual rehabilitation therapy.  The system provides detailed exercise performance instructions and precise feedback on the patient’s efforts. Controlled exercise of multijoints within the normal movement pattern prevents the development of undesired and compensatory joint movement and ensures better performance of functional tasks. The TUTOR system has full FDA and CE certification. See WWW.MEDITOUCH.CO.IL for more information.



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