Fettered by traditional concepts such as “one hundred days of injury to muscles and bones”, some fracture patients choose to slowly “rest” after the operation, and think that this is recovery. As a result, these patients will ask this question during the 1 to 2 months postoperative review: “How can my affected limb become smaller and not flexible?” Some people also reported that the affected area felt pain and swelling. In fact, the above situation is caused by neglect of rehabilitation training. So, how should rehabilitation training be carried out after fracture?
The treatment principle of fracture is reduction, fixation and functional exercise. Therefore, rehabilitation treatment is a continuation of surgery. It is through targeted training to promote the recovery of body function after fracture, prevent complications and secondary diseases, effectively improve and promote blood circulation, eliminate swelling, accelerate fracture healing, and avoid Tissue adhesion, scar formation, muscle atrophy, and joint stiffness all restore the patient to the best condition in terms of physical, mental, life, and work.
Rehabilitation training is mainly divided into the following stages-
It mainly refers to the training of the patient during the first to two weeks of injury. At this time, the affected limb has symptoms such as poor stability, pain, and swelling at the fracture end, and it is also prone to ectopic. Rehabilitation training at this stage is mainly to promote venous and lymphatic drainage of the limbs, reduce adhesion between muscles, eliminate swelling, and prevent muscle disuse atrophy. Specific methods include: (1) Elevate the affected limb to eliminate swelling; (2) Perform finger-fisting activities for upper limb fractures, and perform dorsiflexion and flexion of toes for lower limb fractures. Move as many times as possible; (3) Fix limb muscle Perform isometric contractions for 15-20 minutes each time, as many times as possible.
Don’t be too blind when carrying out rehabilitation training. Don’t think that as long as the training is done, the rehabilitation of the fracture will be accelerated; at the beginning of the rehabilitation training, you should do light activities first according to the stability of the fracture, and slowly increase the time and amount of activities. , Don’t be too anxious to avoid the situation where the bone end is displaced again due to sudden strenuous exercise.
In the first 2 to 3 weeks after the injury, the swelling of the affected limb gradually subsided, fibrous connections began to appear at the fracture site, callus gradually formed, and the fracture gradually stabilized. At this stage, in addition to strengthening muscle contraction and relaxation exercises, other joints can gradually increase the active range of motion. The affected limb on the traction frame can also be used to drive the movement of the affected limb through muscle contraction, relaxation and other body movements. Through relevant training, it is possible to achieve the goal of shifting from passive activities to active activities and prevent the decline of adjacent joint mobility.
Four to six weeks after surgery, there is basically a preliminary healing of limb fractures. This stage is a critical period for fracture rehabilitation. Some people call it the “honeymoon period”. The specific implementation of rehabilitation exercises at this stage is best to follow the guidance of the rehabilitation teacher. The method: gradually increase muscle strength exercise, and under the control of muscle strength, increase the range of joint motion. Due to the initial healing of the fracture, be cautious when flexing the joint forcefully or passively flexing and extending the joint, and remember not to use violence. For fractures involving the articular surface, it is necessary to implement non-weight-bearing active exercises and fix the joints after exercises to achieve the effect of repairing the articular cartilage and avoid intra-articular adhesions.
From 6 weeks to 3 months after surgery, it is the “golden period” of rehabilitation after fracture. In addition to continuing the isometric contraction of the affected limb muscles and the extension and flexion of the unfixed joint, it can also be assisted by a healthy limb or a therapist. Gradually start the movement in the plaster of the upper and lower joints of the fracture, and the movement in the opposite direction to the displacement of the fracture.
At this stage, the fracture is basically healed or the fixation is removed, and the bones have the ability to support, but the patient may also have low mobility and muscle atrophy. The main purpose of rehabilitation training at this time is to restore the mobility of the affected joints, enhance muscle strength, and restore limb function. The main method is to carry out active activities and weight-bearing training for the operated joints (such as lifting weights on the upper limbs, lifting the legs with sandbags on the legs and walking, etc.) to ensure that each joint can gradually return to normal functions.
It should be noted that rehabilitation training should be carried out under the guidance of professionals, and actively learn and master the correct methods, so that you can slowly transition to training yourself. Be careful to avoid activities that are detrimental to fracture recovery. For example, adduction activities should be avoided for adduction fractures, abduction activities should be avoided for abduction surgical neck fractures of the humerus, and flexion activities should be avoided for flexion fractures.