Early rehabilitation

The fragment must be adequately healed and clinically stable before a plaster cast or splint is removed and movement of the affected part is allowed. The effects of prolonged immobilization - disuse osteopaenia of the bones, contracture of soft tissues and stiffness of associated joints, which may take a prolonged period to overcome - must be weighed against too early removal of the splintage before the fracture is solid with subsequent loss of fracture alignment necessitating remanipulation.

With internal fixation, the associated joints are encumbered by external splintage and therefore rehabilitation may begin early but only if the internal fixation is of a satisfactory standard to avoid the problem of loss of fixation.

Regardless of the method of fracture stabilization, once fractures are clinically solid, ancillary treatment (physiotherapy and hydrotherapy) must endeavour to return the affected part to its pre-injury function as early as possible.

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