This document discusses fracture diseases that can result from prolonged immobilization following fracture treatment. The principal fracture diseases include musculoskeletal issues like muscle weakness, atrophy, soft tissue contractures, osteoporosis, and joint stiffness. Prolonged immobilization can also lead to cardiovascular complications such as increased heart rate, circulatory dysfunction, orthostatic hypotension, and venous thromboembolism. Prevention of these fracture diseases focuses on proper fixation, early and frequent mobilization, muscle stretching and contraction, range of motion exercises, use of leg stockings, anticoagulant drugs, and changing patient positioning regularly.

1. Fracture diseases
Dr. Arhab Alshabi
Resident Orthopaedic Surgery

2. Definition:
it is the complication of fracture treatments due to
prolong immobilisation .

3. Principle of fracture treatment:
- anatomical reduction
- rigid fixation
-preservation of soft tissue
-Early Active Mobilisation

5. The fracture Diseases include:
- Musculoskeletal.
-Cardiovascular.

6. Musculoskeletal:
-muscle weakness, atrophy
- Soft tissue Contracture.
- Osteoporosis
- Joint Stiffness.
- Skin Atrophy
Cardiovascular:
- Increase the hart rate ,circulatory dysfunction.
- Orthostatic hypotension.
- venous Thromboembolism, pulmonary problem.

7. Muscle weakness:
- it is the most obvious effect of prolonged Immobilisation
,muscle at complete rest loss about 10-15 % of it’s strength
in each week.
- Half of normal strength loss within 3-5 weeks of
immobilisation .
- First muscle become weak and atrophy are those of lower
extremities .
- muscle strength can be maintain without loss or gain with
daily muscle contraction.
- Unfortunately the rate of recovery from weakness is slower
than rate of loss.

8. Muscle Atrophy :
-It is the loss of muscle mass.
normal muscle at rest loss half of their bulk after 2 months .
Soft tissue Contracture :
The connective tissue contain collagen fibbers that maintain
the muscle length if frequently stretching , but shorten if
immobilised which lead to contracture.

10. Disuse Osteoporosis:
Like connective tissue ,bone is dynamic tissue ,the constant
equilibrium is maintain between the bone formation and desorption of
bone density depend on force that act upon bone.
Joint stiffness:
- it’s limitation of movement , after periods of inactivity.
Skin atrophy :
- decrease circulation in skin due to pressure in immobilisation
patient then ischemia ,skin breakdown and ulcer .

12. Cardiovascular:
Prolonged immobilisation stimulate sympathetic nerve system
activity ,increase the heart rate ,less diastolic filling time ,shortened
systolic ejection end by circulatory dysfunction.
venous thromboembolism and pulmonary
problem :
Due to venous stasis in the leg following decrease contraction of
Gastrocnemius ,solus muscle the emboli formation.
may occur within 7-10 days of immobilisation.
characteristic by pain, tenderness, swelling, venous distension, in
the calf muscle and confirm by Doppler study .

14. Prevention:
-Proper fixation (rigid fixation)
-free pain early mobilisation and as soon as pt.'s can.
-Daily muscle stretching ,contraction for 20-30 seconds.
- ROM of adjacent joint below and above the fracture.
-leg stocking to prevent DVT
-anticoagulant ,antiplatelet drugs
-change patient position every 2H.

16. Thank You
Prepared by :Arhab Alshabi