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

The Structure of Bone

Bone is one of the body.s connective tissue and its cells produce a firm and rigid framework to make the skeleton of the body. It has a good blood supply and is surrounded by nerve endings which are mostly in the soft tissues which enclose the bone. Two types of bone exist, cortical bone which exists in solid masses or sheets and trabecular bone which is a lattice like honeycomb of small bone struts. The mass of bone secreted is five to eight percent water and 60-70 percent Hydroxyapatite, which is composed mostly of calcium and phosphate. The rest of the bone is made up of collagen, a form of fibrous tissue.

The crystals of Hydroxyapatite mean that bone is hard and can withstand compressive stresses while the fibrous tissue reduced the brittleness and resists tension stresses. Bone is laid down in an arrangement of concentric cylinders with a central channel carrying the blood vessels and nerves. The osteocytes or bone maintaining cells lie between the layers of bone. The whole unit of the individual cylinder is known as a Haversian system or an osteon. The periosteum covers the outer surface of the bone, with a tougher outer layer and a cellular inner layer.

Radial Head Fractures

The radial head is a small, rounded structure on the outside of the forearm near the elbow, with a structure a bit like a cotton reel. It is held within a ligament which surrounds it like a cuff and articulates with the elbow and the ulna next to it. The radial head allows the forearm to rotate as it spins within its ligamentous circle, permitting what is known as pronation (turning the palm downwards) and supination (turning the palm upwards). These movements are very important for arm function, palm downwards allowing writing and reaching to pick up objects and palm upwards allowing the acceptance of change in monetary transactions.

Most radial head fractures are undisplaced, with pain as the major symptom and typically caused by a fall on the arm. If the fracture is in place within its ligamentous restriction the treatment is a sling for comfort and mobilisation of the elbow under physiotherapy supervision. Flexion and extension of the elbow and pronation and supination of the forearm are practiced within pain limits to restore the ranges of movement as soon as possible. More vigorous work should be restricted until after the healing period of six weeks for the bone.