Monday, November 14, 2011

Wrist fractures and osteopathy

An osteopath needs to be aware of the consequences of a patient's fractured bones. A Colle's fracture, fracture of the distal end of the radius, is one of the commonest fractures and so it is likely to present at an osteopathic clinic.

Colle's fractures are normally the result of a fall on the outstretched arm. If the wrist is strong the impact of the fall is likely to reach the shoulder and may dislocate it. However, if the wrist is weak such as in people with osteoporosis then it can result in a fracture. For this reason it commonly occurs in women above the age of 40.

The fracture occurs transversely roughly 2 cm across the distal end of the radius. The fractured segment is displaced posteriorly and laterally resulting in the classic “dinner-fork” deformity. Colle's fractures usually recover rapidly but the functional results are often dissapointing. This suggests that the extent of the soft-tissue injury in Colle's fractures are an important consideration to acheiving a positive functional outcome.

The tendon of extensor-pollicis-longus curves around the dorsal radial tubercle and over the radial wrist extensors to the thumb so it is naturally a place of abrasion and wear and tear. Rupture of extensor-pollicus-longus can occur naturally but occurs more frequently between 4-8 weeks after a fracture of the radius. Rupture of extensor-pollicis-longus leads to the inability to extend the distal joint of the thumb.

Osteopathic treatment may be able to improve the recovery by helping to restore flexibility to the wrist and tendons which are likely to have scar tissue and tension after the fracture. Osteopathic soft tissue massage to the wrist extensors and flexors combined with articulation of the carpel and radio-ulnar joints could improve the blood supply, facilitate recovery of the soft tissues and help to restore good function and reduce abrasion.

For more information:
http://www.osteopath.co.il/home-eng.php
http://www.osteopath.co.il/elderly-heb.php