Immobilisations involve stabilising and resting an injury by preventing the affected muscle, joint or limb from moving or bearing weight. For example; if you’ve fractured your wrist or fibula, then the area that has been affected will be placed into a plaster of Paris (POP) which restricts the use of that limb. Therefore immobilising the joint and surrounding musculature.
Forms of immobilisation
Broken bones will usually be placed in a cast; the cast will be fitted once the two ends of the bone have been re-aligned. Casts are usually made of fibreglass or plaster. Once a cast has been fitted it will hold the bone in place and allow it to heal. Casts are designed to fit the individual person.
Splints are used for smaller fractures, such as broken fingers and dislocations. A splint helps to stabilised the bone or joint and can be used as a temporary measure before a cast is fitted.
A sling is used to immobilise the arm after an injury to the arm, wrist or shoulder. Commonly, slings are used in conjunction with a cast.
Collars are used to stabilise and support the neck after an injury. The collar also limits the movement of the head, which prevents further harm to the neck.
Braces are commonly used for spinal, leg and arm injuries; braces are used to hold bones in place and support the surrounding area. Braces are usually removable.
Benefits of immobilisation
The immobilisation of an injured limb is based upon the principles of general musculoskeletal injury management stated previously in this chapter. Through the application of splinting there are a number of benefits to the patient that are based upon sound pathophysiological reasoning. Splinting is applied as a method of reducing the movement of broken bone ends and to support the fracture site. Through the movement of broken bone ends pain is commonly experienced alongside an increased risk of damage to nerves, blood vessels, muscles and overlying skin. This can potentiate the injury increasing both mortality and morbidity; therefore the reduction in movement of the injured limb can reduce this risk. Immobilisation may reduce the occurrence of bleeding through allowing the formation of clots in damaged blood vessels and reduce the likelihood of potentially fatal fat emboli.
Predisposing factors that immobilisations can cause
After musculoskeletal injury it was often thought that immobilisation was the best action to promote healing. With the exception of fracture healing, most soft tissue injury is now treated with frequent low-strain movement to endorse correct repair and remodelling.
However, if these healing phase occurs within being placed in a application of immobilisation, there could be detrimental effects;
1. A decrease in tissue fluid which allows collagen fibers to approximate (increasing abnormal cross-linkage formation).
2. Abnormal vascularisation (due to a lack of direction gained by the strain movement provides).
3. Stasis of oedema and blood (movement assists blood perfusion and interstitial fluid flow)
4. SYNOVIAL MEMBRANE ATROPHY (leading to reduced joint nutrition)
5. Contracture formation (adhesions + cross linkages + sarcomere loss)
Therefore, the average time spent within an immobilisation application, you should seek professional aftercare work from either a physiotherapist, osteopath or physical therapist to limit these predisposing factors and aid in the rehabilitation of the specific injury.
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