Table Of ContentPHYSIOTHERAPY IN
MUSCULOSKELETAL
CONDITIONS
Shweta Aggarwal
PEEPEE
PUBLISHERS AND DISTRIBUTORS (P) LTD.
Physiotherapy in Musculoskeletal Conditions
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Pawaninder P. Vij and Anupam Vij
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First Edition (Reprint): 2019
ISBN: 978-81-8445-170-2
This book is dedicated to my mother,
who I know will always be my strength and
supports me from
wherever she is.
Preface
Physiotherapy is an integral part of rehabilitation of patients with musculoskeletal disorders in order to
restore the full functions at the earliest and re-integrate the patient to daily routine.
As a Musculoskeletal Physiotherapist, I have tried to line out the basic clinical conditions dealt in
clinical practice with relevant signs and symptoms, diagnostic criteria and orthopaedic management.
The physiotherapeutic intervention has been explained in a detailed manner related to both conservative
and surgical management of the conditions. Many of the treatment facts and schedules are based on
the latest studies and research guidelines. Musculoskeletal physiotherapy is a vast subject and I have
tried to cover the majority of topics, although I know there are still important topics that are left out
which will be covered in next edition if given a chance.
The book will hopefully provide a good amount of knowledge and guidance to the students of physiotherapy
and practising physiotherapists.
Any criticism and suggestion to improve the value of the book will be most welcome and highly
appreciated. I have made all possible attempts to keep the mistakes to minimum but if you find any
mistakes or need any clarification you can mail me at [email protected].
Shweta Aggarwal
Acknowledgements
This book is a result of constant encouragement from my husband and mother-in-law who always
wants to see me at the highest peaks in my life shining as a star.
I cannot forget to mention my mentor Ms. Shallu Sharma whose continuous guidance and encouragement
throughout my postgraduation and after has build up the confidence and a better Physiotherapist in me.
Special thanks to Mr. C.S. Ram who encouraged me to initiate this work under his guidance and to the
publishing team for making this book a reality.
Long list of thanks to family and friends for their constant encouragement and appreciation.
Contents
Unit One : Fractures and Dislocations
1. Introduction to Fractures ---------------------------------------------------------------------------- 3
2. Fractures of Upper Extremity----------------------------------------------------------------------- 8
3. Dislocations of Upper Extremity ------------------------------------------------------------------36
4. Fractures of Lower Extremity ---------------------------------------------------------------------48
5. Dislocations of Lower Extremity------------------------------------------------------------------76
Unit Two : Deformities
6. Congenital Deformities------------------------------------------------------------------------------85
7. Acquired Deformities --------------------------------------------------------------------------------96
8. Spinal Deformities---------------------------------------------------------------------------------- 107
Unit Three : Degenerative Arthropathies
9. Osteoarthritis---------------------------------------------------------------------------------------- 121
10. Spondylosis ------------------------------------------------------------------------------------------- 129
Unit Four : Inflammatory Arthropathies
11. Ankylosing Spondylosis --------------------------------------------------------------------------- 143
12. Rheumatoid Arthritis ------------------------------------------------------------------------------ 151
Unit Five : Shoulders Complex Conditions
13. Shoulder Complex ---------------------------------------------------------------------------------- 161
Unit Six : Elbow and Wrist Complex Conditions
14. Elbow and Wrist Complex------------------------------------------------------------------------- 189
Contents vii
Unit Seven : Hip Joint Conditions
15. Hip Joint Conditions------------------------------------------------------------------------------- 209
Unit Eight : Knee Joint Conditions
16. Knee Conditions------------------------------------------------------------------------------------- 223
Unit Nine : Ankle and Foot Conditions
17. Ankle Conditions ----------------------------------------------------------------------------------- 245
Unit Ten : Replacement Surgeries
18. Hip Replacement------------------------------------------------------------------------------------ 257
19. Knee Replacement---------------------------------------------------------------------------------- 263
20. Shoulder Replacement----------------------------------------------------------------------------- 268
UNIT ONE
FRACTURES AND
DISLOCATIONS
1. INTRODUCTION TO FRACTURES
2. FRACTURES OF UPPER EXTREMITY
3. DISLOCATIONS OF UPPER EXTREMITY
4. FRACTURES OF LOWER EXTREMITY
5. DISLOCATIONS OF LOWER EXTREMITY
CHAPTER
INTRODUCTION TO
1
FRACTURES
DEFINITION OF FRACTURE • Undisplaced fractures: The fractured fragments
are not displaced from their anatomical
Fracture is defined as a break in the continuity of
positions.
the bone which may either be complete, incomplete
or a crack.
On the Basis Of Relationship with External
Environment (Fig. 1.1)
CLASSIFICATION OF FRACTURES
• Closed fractures: This type of fracture is also
Fractures are classified clinically on the basis of
known as simple fracture. The fractured
the causative factors. They are categorized into
fragments have no communication with the
following categories:
external environment. There is no obvious
• Traumatic fractures.
external injury at the fractured site i.e. overlying
• Fatigue fractures.
soft tissue and skin are intact.
• Pathological fractures.
• Open fractures: This type of fracture is also
• Greenstick fractures.
known as compound fracture. In this type of
fracture the fractured fragments communicate
Traumatic Fractures
with the external environment. The overlying
A normal healthy bone can withstand a great skin and soft tissue are injured and the fractured
amount of pressure, so a tremendous amount of fragments are visible. These types of fractures
force with greater momentum is required to are prone to infections.
produce a break in the bone. These are the most
common type of fracture seen in day-to-day life.
The fracture is caused by trauma to the bone
previously free from the disease. The traumatic
force could either be:
• Direct violence.
• Indirect violence.
The fractures caused by trauma are further
classified on the basis of displacement and
relationship with external environment.
On the Basis of Displacement
• Displaced fractures: The fractured fragments
are displaced from their anatomical position either
due to gravity, muscle pull or fracturing force. Fig. 1.1: Closed and open fractures
