Physiotherapists in Twickenham treat many different conditions including the issues profiled below.

Falls and Healthy Bones

Falling in adults is an important matter with involvement of around 30% of people over sixty-five years old and half of those over eighty-five years. There are significant risks to falling for elderly people, with many much older people dying and or suffering loss of mobility or other problems. Ninety percent of hip fractures are caused by falling and this comes with a very high cost both personally and financially. Only twenty percent of people who fracture their hip recover well enough to attain their previous level of functional abilities which includes walking. There may be many reasons for a person falling and the evidence for the many interventions proposed being effective is not very good.

Physiotherapists prescribe exercise programmes as part of their main arsenal of skills, with good evidence that well designed programmes which include training balance and strength can be effective at reducing falls in the community. Patient access to assessment and treatment by a physiotherapist is however variable in the UK, with hip fracture patients likely to receive this (due to admission to hospital) but patients with non-hip fractures are much less likely to receive this even when admitted. Physios have a much greater role in this matter which they have not taken up.

Internal Fixation for Fractures

Many fractures can be managed by immobilisation if not displaced or can be repositioned and maintained in position by a plaster cast. Some fractures cannot be maintained in position, slip out of position once re-positioned or cannot be immobilised because of the length of time required or the awkwardness of the anatomical location. In these cases internal fixation with plates, screws, wires or nails is considered. Internal fixation requires an operation which carries the usual risks including infection so is only performed when required from a clinical standpoint.

Fracture alignment is important to maintain the relative position of the nearby joints so that excessive forces are not thrown onto one part of a joint or another. Wrist fractures which do not remain in a good position can be plated then immobilised until healed. Fractures with many pieces may need re-assembling and maintaining in position by metalwork. Femoral shaft fractures cannot be immobilised except by traction and with the healing period being 12 weeks the decision is usually to place a nail down the femur and get the patient up and out of hospital in a few days. Complex fixation may be used to restore the structure of a badly damaged bone in some cases.