Occupational Therapy for Upper and Lower Limb Fractures
Upper and lower limb fractures refer to breaks or cracks in the bones of the arms (upper limbs) and legs (lower limbs). These injuries can range from minor cracks to complete breaks that can affect mobility and require immediate medical attention.
Classification
There are several common types of Upper and Lower Limb Fracture including;
Clavicle - commonly known as a broken collarbone.
Radial and Ulnar - bones in the forearm.
Hip - breaks in the upper part of the thigh bone.
Tibial and Fibular - fractures of the lower leg bones.
Cause
There are several causes of Upper and Lower Limb Fracture including;
Falls
Sports Injury
Car or Motorcycle Accidents
Direct Impact
Overuse/Stress
Risk Factors
There are several risk factors for Upper and Lower Limb Fracture including Osteoporosis, age, medical conditions such as Osteogenesis Imperfecta, vision impairments and lifestyle factors such as poor nutrition.
Symptoms
Common symptoms of Upper and Lower Limb Fracture include;
Pain
Swelling
Bruising
Deformity
Limited Mobility
Occupational Therapy Specialism
Occupational Therapists who specialise in assessing and treating people who have Upper and Lower Limb Fractures are based in a branch of Occupational Therapy for Orthopaedics.
Common Difficulties associated with Upper and Lower Limb Fracture
Upper and lower limb fractures can lead to a range of difficulties and complications, affecting not just the physical state of an individual but also their emotional well-being and daily life.
Physical Difficulties
Pain and Discomfort: One of the most immediate effects of a fracture is significant pain, which can persist even after the initial treatment, especially during movement or physical therapy.
Reduced Mobility: Fractures can severely limit the mobility of the affected limb. For upper limb fractures, this might mean difficulty in performing everyday tasks such as dressing or cooking. Lower limb fractures can impair the ability to walk, stand, or bear weight, affecting independence.
Muscle Atrophy: The immobilization of a limb following a fracture can lead to muscle weakness and atrophy due to disuse. This can extend the rehabilitation process needed to regain strength and functionality.
Stiffness in Joints: Prolonged immobilization can also cause joints near the fracture site to become stiff, reducing their range of motion and flexibility.
Delayed Union or Nonunion: Some fractures may take longer than usual to heal (delayed union) or may not heal at all (nonunion), necessitating further medical intervention, possibly including surgery.
Malunion: In some cases, bones may heal improperly, leading to malalignment. This can affect the function of the limb and may require surgical correction.
Anxiety and Depression: The impact of a fracture and the subsequent limitations on daily life and activities can lead to feelings of anxiety and depression, particularly if there is a long recovery ahead or permanent damage.
Dependency: Individuals with severe fractures may become temporarily dependent on others for basic needs, leading to feelings of frustration and a loss of independence.
Fear of Re-Injury: After experiencing a fracture, some individuals may develop a fear of engaging in activities that led to the injury, which can hinder recovery and return to normal activities.
Social and Economic Difficulties
Time Off Work: Significant injuries may require extended periods away from work, leading to financial strain and concerns about job security.
Rehabilitation Costs: The costs associated with medical care, physical therapy, and potential surgeries can be substantial, especially if the individual does not have adequate insurance coverage.
Impact on Social Life: Restrictions on mobility and activities can lead to social isolation, as individuals may find it difficult to participate in social gatherings, hobbies, or sports they previously enjoyed.
How can Occupational Therapy help?
Occupational Therapy (OT) plays a crucial role in the rehabilitation process for individuals recovering from upper and lower limb fractures. OT focuses on improving patients' ability to perform everyday activities, enhancing their quality of life during the recovery process.
Assessment and Goal Setting
Personalized Care: Occupational therapists begin by assessing the patient's specific needs, limitations, and goals. This personalized approach ensures that therapy is tailored to help individuals return to their daily activities, work, and hobbies as efficiently as possible.
Improving Functional Mobility
Adaptive Techniques: For upper limb fractures, OTs teach adaptive techniques for dressing, grooming, cooking, and other activities of daily living (ADLs) to ensure independence despite injuries.
Mobility Aids: For lower limb fractures, therapists may recommend and teach how to safely use mobility aids like crutches, walkers, or wheelchairs.
Strengthening and Conditioning
Exercise Programs: OTs design specialized exercise programs to strengthen muscles weakened by immobilization and improve joint flexibility and range of motion, crucial for both upper and lower limb fractures.
Pain Management
Therapeutic Activities: Occupational therapists introduce activities and exercises that help manage pain and swelling, often incorporating techniques such as manual therapy, heat/cold therapy, and electrical stimulation.
Sensory Re-education
Nerve Damage Recovery: Particularly in cases where there is nerve damage or a risk of sensory loss, OTs can guide patients through sensory re-education exercises to help regain sensation and reduce sensitivity issues.
Hand Therapy
Specialized Intervention: For fractures in the hand or wrist, certified hand therapists (a specialization within OT) provide detailed, skilled therapy aimed at regaining fine motor skills, strength, and dexterity.
Environmental Modifications
Adapting Living Spaces: Occupational therapists advise on modifying living, work, and school environments to accommodate the patient's needs, promoting safety and independence.
Psychosocial Support
Coping Strategies: OTs provide emotional and psychological support, teaching coping strategies to deal with the frustration, depression, or anxiety that can accompany recovery from a fracture.
Educational Guidance
Injury Education: Patients receive education on their injury and recovery process, including how to prevent future injuries and manage their current condition effectively.
Assistive Devices
Tools for Independence: Occupational therapists recommend and train patients to use assistive devices that can help with daily tasks, from special utensils for eating to devices that aid in dressing.