What is a burst fracture and how is it treated orthotically?
Answer
Burst fractures start out frequently as anterior compression fractures. The difference is that the bones actually break, explode, and go through and out, sometimes going into the spinal canal or the foramen. It can cause numbness, tingling, and even spinal cord injury. Burst fractures are carefully assessed. If there is more than two columns involved, typically they are treated surgically or fixated surgically because of the potential damage to the spinal cord. If the burst fractures are less risky or mostly stable, they can be treated with a custom molded or molded TLSO (Thoraic Lumbar Sacral Orthosis). In a burst fracture, it is particularly important that we stop transverse rotation as well as a lot of lateral flexion. We do not want those bone fragments to migrate into places we do not want them. We arrest virtually all motion of the spine through the use of a custom molded body jacket or TLSO. These are plastic devices and they are providing increasing intracavitary pressure because they consist of a circumferential wrap which provides equal compression all around, squeezing the soft tissues. We typically add lordosis or take away lordosis in the lumbar section if we want to offload or unload the vertebral bodies or we can take out some of the lordosis if we want to offload the posterior section of the spine.
Jared Howell, MS, CPO, LPO
Jared’s current professional role is in Houston, Texas where he serves as the Director of Baylor College of Medicines Master of Science in Orthotics and Prosthetics. Jared continues to be involved in clinical practice practicing prosthetics at least 1 day per week to maintain his skills and relevance in a rapidly evolving profession. Prior to creating and building the program at Baylor, Jared served as the Assistant Director of Prosthetics at Northwestern and started a clinical practice in PA.
Jared’s education includes an undergraduate degree in Manufacturing Engineering from Brigham Young University, Prosthetic and Orthotic Education from Northwestern’s Feinberg School of Medicine, and a graduate degree from Northwestern University’s McCormick School of Engineering in Product Design and Development.
Related Courses
1https://www.physicaltherapy.com/pt-ceus/course/trauma-informed-care-principles-for-3975Trauma Informed Care Principles for Rehabilitation ProfessionalsAcute and chronic trauma is very prevalent in the United States, and have been tied strongly to adverse health behaviors and outcomes. This course provides the rehabilitation professional with an overview of the physiology of trauma, as well as practical tools to work with patients who are experiencing trauma. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.auditory, textual, visual
Acute and chronic trauma is very prevalent in the United States, and have been tied strongly to adverse health behaviors and outcomes. This course provides the rehabilitation professional with an overview of the physiology of trauma, as well as practical tools to work with patients who are experiencing trauma. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.
2https://www.physicaltherapy.com/pt-ceus/course/utilization-ankle-foot-orthoses-in-3489Utilization of Ankle Foot Orthoses in Patients with Neurological DysfunctionThis course will provide participants with essential tools for determining appropriate orthotic management with an ankle-foot orthosis (AFO) based on detailed gait analysis. Evidence-based orthotic interventions will be presented and participants will have opportunities to see orthotic examples and practice application of information through video/paper cases. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT and PTA.auditory, textual, visual
This course will provide participants with essential tools for determining appropriate orthotic management with an ankle-foot orthosis (AFO) based on detailed gait analysis. Evidence-based orthotic interventions will be presented and participants will have opportunities to see orthotic examples and practice application of information through video/paper cases. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT and PTA.
3https://www.physicaltherapy.com/pt-ceus/course/static-splinting-series-4063Static Splinting SeriesThe static splinting 4-course series consists of an overview of the history of splint fabrication, the advances in the splinting and orthotics arena, and an anatomical review of key structures and landmarks. A detailed demonstration of wrist orthotics is presented as well as radial gutter/thumb spica splints, dorsal and volar wrist cock-ups, functional position with an intrinsic plus modification option, hand-based thumb spica, finger gutter and MP joint blocking splints. The application and use of a spring finger extension splint, oval 8 splints as well as static progressive finger flexion and extension splints are included.Finally, the fabrication of a footplate for external fixator application, the application of lower extremity splints and orthotics as well as splinting considerations for specific diagnoses including burn injury occurs in part 4. Please note: This course series is comprised of the following individual recordings: #4018, #4020, #4022, and #4024 auditory, textual, visual
The static splinting 4-course series consists of an overview of the history of splint fabrication, the advances in the splinting and orthotics arena, and an anatomical review of key structures and landmarks. A detailed demonstration of wrist orthotics is presented as well as radial gutter/thumb spica splints, dorsal and volar wrist cock-ups, functional position with an intrinsic plus modification option, hand-based thumb spica, finger gutter and MP joint blocking splints. The application and use of a spring finger extension splint, oval 8 splints as well as static progressive finger flexion and extension splints are included.Finally, the fabrication of a footplate for external fixator application, the application of lower extremity splints and orthotics as well as splinting considerations for specific diagnoses including burn injury occurs in part 4.
Please note: This course series is comprised of the following individual recordings: #4018, #4020, #4022, and #4024
4https://www.physicaltherapy.com/pt-ceus/course/we-underserving-pediatric-ankle-supporting-3832Are We Underserving the Pediatric Ankle? Supporting Development Through a Multi-System ApproachThis course will instruct on examination and treatment of foot and ankle involvement for patients with pediatric health conditions including cerebral palsy, muscular dystrophies, and toe walking. Evidence-based interventions will be covered, including joint and soft tissue mobilizations to promote adaptive relative flexibility; improving intrinsic stability through progressive strengthening of the "foot core"; interventions to positively impact neuroplastic changes; and design of orthoses to support function and optimal development. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.auditory, textual, visual
This course will instruct on examination and treatment of foot and ankle involvement for patients with pediatric health conditions including cerebral palsy, muscular dystrophies, and toe walking. Evidence-based interventions will be covered, including joint and soft tissue mobilizations to promote adaptive relative flexibility; improving intrinsic stability through progressive strengthening of the "foot core"; interventions to positively impact neuroplastic changes; and design of orthoses to support function and optimal development. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.
5https://www.physicaltherapy.com/pt-ceus/course/supporting-lgbtq-senior-in-healthcare-4096Supporting the LGBTQ Senior in HealthcareThis training describes the required elements for responding to the emerging needs of long term care communities to provide sensitive and respectful services to LGBT elders. The training reviews definitions related to sexual orientation and gender identity challenges experienced by LGBT older adults, and strategies for communication and policies that honor residents' rights. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT and PTA.auditory, textual, visual
This training describes the required elements for responding to the emerging needs of long term care communities to provide sensitive and respectful services to LGBT elders. The training reviews definitions related to sexual orientation and gender identity challenges experienced by LGBT older adults, and strategies for communication and policies that honor residents' rights. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT and PTA.
