1. Jose S. Santiago

2. Fracture, lower end of humerus Fracture- break in the continuity of the bone Fracture in the lower end of humerus occurs when there is a break anywhere in the distal region of the humerus.

3. Fracture, lower end of humerus Causes of distal humeral fracture: 1. Direct blow to the humerus 2. Indirect fracture – the patient falls with the arm outstretched Diagnosis is confirmed by X-ray images

4. Fracture, lower end of humerus Non-surgical treatment( Stable fracture): 1. Analgesics 2. Anti-inflammatory drugs 3. Use of cast or splint to hold the elbow in place The elbow becomes very stiff and requires physiotherapy after removal of the cast

5. Fracture, lower end of humerus Indications for surgery: 1. Displaced fracture 2. Open fracture

6. Fracture, lower end of humerus A 25 year-old man who had a fracture of the lower end of the humerus comes to the physical therapy department after one month with stiffness in his elbow and limited range of motion

7. P: Patient T: Therapist P: Good ______. T: Good ______. What is _________? P: I got a fracture in my __________ one month ago. I was given a ____ for that. Now, I removed the _____ but I feel some stiffness in my elbow joint. I _____ the orthopedic doctor and he _______ me physical therapy.

8. P: Patient T: Therapist T: I ____ your chart. Your bones are ______. No problem. We can improve your range by ______. P: Oh. That’s ____ to hear. T: Please ____ to the therapy room. We will start the treatment today. P: Okay. Where can I _____ my bag? T: You can bring it to the therapy room.

9. P: Patient T: Therapist T: Please ______. I will check your range of motion in the ______. The shoulder joint range is _____. There is mild __________ in your elbow joint. You need some _______ for the elbow joint alone. P: Okay. Do I need to _____ here for doing those exercises?

10. P: Patient T: Therapist T: Yes. I will ____ you today, You can do those exercises after ____ here and some exercises you can do at home. At first, you will ________ in this machine. In this instrument, the range of _____ and ____ is fixed. You can just sit in the chair and do the movement. It helps to ______ your range of motion in the _____ and _____ joints.

11. P: Patient T: Therapist P: Oh, I see. T: After finishing the _______, I will _____ you some exercises. P: Okay. T: Yes it over. Did you _____ any pain? P: Yes I had a little pain when my elbow was ______.

12. P: Patient T: Therapist T: You will get the ______ soon. Don’t worry about it. I will ____ you a band now. I will tie one end in the wall. You have to ____ the other end with your hand and pull it. There should be ________ in your elbow. P: Yes, am I doing it ________?

13. P: Patient T: Therapist T: Yes. Do it for ______. When you are ____, you can go home. You can come here again ______ at ______. P: Yes, I will ______ here. Thank you so much for your ______. T: You are welcome. See you ______. Bye.