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Anja Cafuta (Author), Sonja Hlebš (Reviewer), Mojca Divjak (Mentor)

Abstract

Uvod: Zlom proksimalnega dela nadlaktnice je pogosta poškodba in predstavlja tretji najpogostejši zlom med posamezniki starimi nad 65 let. Včasih omenjeni zlom spremlja še izpah ramenskega sklepa, ki je na splošno najpogostejši izpah oz. dislokacija velikih sklepov. V večini primerov se lahko takšne zlome in izpahe zdravi konzervativno z imobilizacijo in fizioterapijo. Cilji fizioterapevtske obravnave so vzpostavitev funkcije, mišične zmogljivosti in gibljivosti, kot pred poškodbo ter krepitev dinamičnih stabilizatorjev ramenskega sklepa in stabilizatorjev lopatice ter izboljšanje pacientovega živčno-mišičnega nadzora ramenskega sklepa. Namen: Namen diplomskega dela je prikazati fizioterapevtsko obravnavo pacienta po konzervativnem zdravljenju zloma proksimalnega dela nadlaktnice s sprednjim izpahom ramenskega sklepa. Metode dela: Izvedli smo anamnezo in fizioterapevtski pregled, ki je zajemal: inspekcijo, palpacijo, goniometrične meritve pasivne gibljivosti, oceno mišičnih skrajšav, oceno artrokinematike sklepa, meritve obsegov udov, manualno mišično testiranje, testiranje zmogljivosti prijema roke, oceno bolečine in oceno drže. Program fizioterapevtske obravnave je zajemal: metode in tehnike kinezioterapije in manualne terapije ter zdravstveno vzgojo. Rezultati: S fizioterapevtsko obravnavo smo dosegli povečanje obsega gibljivosti prizadetega ramenskega sklepa v vseh smereh gibanja in sicer v smeri antefleksije za 5˚, abdukcije za 5˚, retofleksije za 10˚, zunanje rotacije za 15˚ in notranje rotacije za 10˚. Pri elevaciji skozi antefleksijo se je obseg gibljivosti povečal za 15˚, pri elevaciji skozi abdukcijo pa za 10˚. Za pol ocene sta se izboljšali zmogljivost mišic notranjih rotatorjev in antefleksorjev. Dosegli smo povečanje obsega prizadete nadlakti za 0,5 cm ter izboljšanje zmogljivosti grobega prijema za 5 kg. Bolečina med aktivnostjo v končnih obsegih gibljivosti se je zmanjšala za 1,5 točke. Razprava in sklep: Na podlagi rezultatov, ki smo jih pridobili po zaključeni fizioterapevtski obravnavi je vidno, da je bila naša fizioterapevtska obravnava uspešna, saj smo dosegli zastavljene kratkoročne cilje.

Keywords

diplomska dela;fizioterapija;ramenski sklep;nadlaktnica;izpahi;zlomi;

Data

Language: Slovenian
Year of publishing:
Typology: 2.11 - Undergraduate Thesis
Organization: UL ZF - University College of Health Studies
Publisher: [A. Cafuta]
UDC: 615.8
COBISS: 5484139 Link will open in a new window
Views: 1473
Downloads: 633
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Other data

Secondary language: English
Secondary title: Physiotherapy treatment of patient after proximal humerus fracture with anterior dislocation of shoulder
Secondary abstract: Introduction: Fracture of proximal humerus is a common injury and it is third most common fracture among individuals above the age of 65. Sometimes a fracture like that is accompanied by dislocation of shoulder, which in general is the most common dislocation of all joints. In most cases, those kinds of fractures and dislocations can be treated conservatively, with immobilisation and physiotherapy. The main goal of physiotherapy in both cases is achieving same function, muscle performance and range of motion as prior to injury and strengthening of dynamic stabilizers of shoulder, stabilizers of scapula and improving neuromuscular control of shoulder. Purpose: Purpose of this thesis is to present physiotherapy treatment of patient after conservative treatment of proximal humerus fracture with anterior dislocation of shoulder. Methods: We looked into patient’s medical history and performed physiotherapeutic examination, which included: inspection, palpation, goniometric measurements of passive range of motion, assessment of muscle shortening, assessment of joint arthrokinematics, measurements of limb girth, manual muscle testing, assessment of hand grip strength and assessment of posture. Program of physiotherapy treatment consisted of methods and techniques of kinesiotherapy and manual therapy as well as health education. Results: Performed treatment programme improved range of motion in all directions, anteflexion improved for 5˚, abduction for 5˚, retroflexion for 10˚, external rotation for 15˚ and internal rotation for 10˚. Elevation through anteflexion improved for 15˚and elevation through abduction for 10˚. Performance of internal rotation and anteflexion muscles both improved for half grade. Limb girth of injured upper arm increased for 0,5 cm, while hand grip strenght improved for 5 kg. Pain during activity in end range of motion decreased for 1,5 point. Discussion and conclusion: Based on the results obtained after the physiotherapy treatment, we can conclude that our treatment was successful, since we achieved all short-term goals we defined before treatment.
Secondary keywords: diploma theses;physiotherapy;shoulder joint;humerus;dislocations;fractures;
Type (COBISS): Bachelor thesis/paper
Study programme: 0
Thesis comment: Dipl. delo (bolonjski študij), Univ. v Ljubljani, Zdravstvena fak., Oddelek za fizioterapijo
Pages: 36 str.
ID: 10959391