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Pelvis
Fractures of the pelvis are usually caused by direct injury or by violence transmitted longitudinally through the femur. After bed rest to allow for commencement of union of the fracture, as well as relief of pain, the patient can begin to ambulate as pain allows. Hydrotherapy becomes an ideal medium to encourage the patient to move.
Goals for pelvic Hydrotherapy: increase weight-bearing, improve lower limb muscle strength and maintain range of movement of the hip joint.
Considerations: If there has been disruption of the pelvic ring the use of hip abduction should be restricted.
Hip Joint Injury and Total Hip Replacement
Goals of Hip Joint Hydrotherapy: improve joint mobility, strengthen musculature and foster progress towards gait reeducation.
Considerations:
1. Those patients having elective total hip replacements could have had periods decreased mobility as well as several joints affected with osteoarthritis.
Fractured Femur Bone
This type of fracture is usually seen in the younger adult following severe traffic accidents falls from a substantial height, and crushing injuries. Conservative treatment is with traction to overcome the displacement of the fracture and the shortening of the quadriceps and hamstring muscles due to the fracture and muscle spasm.
Aims: To regain confidence in walking, improve joint mobility and strengthen hip musculature.
Considerations:
1. Pain and mood may lead to unwillingness to mobilize so considerable encouragement may be required.
Exercises: Those listed under total hip replacement can be utilized
Fractured Femur Bone (Elderly)
These fractures are seen in the elderly patients who have had a fall directly onto the hip. Most will require surgery with a pin and plate.
Aims: To regain confidence in walking, improve joint mobility and strengthen hip musculature.
Considerations:
1. These patients may have balance problems which caused theft initial fall.
2. Pain will lead to unwillingness to mobilize so considerable encouragement may be required.
Exercises: Those previously listed under total hip replacement can be utilized.
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