The importance of functional exercise after fracture surgery

  Early and reasonable functional exercises for fracture can promote blood circulation in the affected limb, reduce muscle atrophy, maintain muscle strength, prevent joint stiffness, and promote fracture healing. Therefore, appropriate muscle contraction and relaxation exercises should be performed on the fixed limbs. For joints that are not fixed, the patient should be encouraged to do active functional exercises in a timely manner, and gradually strengthen the weight-bearing exercises when the fracture end has reached clinical healing.  (a) Active exercise is the main form of functional exercise. According to the patient’s mobility, muscle contraction and relaxation exercise and all-way movement of the unfixed joint should be performed as early as possible without affecting the displacement of the fracture end to promote blood circulation, enhance physical fitness, reduce the systemic reaction to trauma, and prevent joint stiffness. Therefore, active exercise should be carried out throughout the whole fracture repair process. Therefore, the main form of exercise is to relax through muscle contraction and flexion and extension of the upper and lower joints without affecting the re-displacement of the fracture. Therefore, the main form of exercise is to help blood return, promote swelling and prevent muscle atrophy, as well as to enhance the pressure pad effect through muscle contraction and diastole, which has a certain effect on stabilizing the broken end and gradually reshaping the residual deformity.  For example, for ulnar and flexor double fractures, after repositioning and fixation, the flexion and extension exercises of the interphalangeal and metacarpophalangeal joints, finger abduction and extension, elbow flexion and extension and shoulder flexion and extension, abduction and extension, and rotation can be carried out.  After 2-3 weeks of fracture, the pain and swelling of the limb has been significantly reduced, the soft tissue trauma has been basically repaired, the bone scab has begun to form, and the broken end is initially connected. In addition to strengthening the muscle contraction and relaxation exercises, all other joints can gradually increase the active mobility, from single to several joints of cooperative exercises.  2. Phase 2: At this time, the fracture has reached the clinical healing standard, and after the external fixation and traction removal, in addition to the joint activities controlled during the fixation period, some patients may have joint adhesions, joint capsule contracture, limb edema and other symptoms after the fixation removal due to the poor initial exercise, then the patient must continue to encourage the patient to strengthen the functional exercise, with the external Chinese medicine and massage to promote joint The patient must be encouraged to strengthen the functional exercise and to promote the rapid recovery of joint movement and muscle strength with the use of external Chinese medicine and massage. In addition, physiotherapy can also be used as needed, but active exercise should remain the main focus.  (2) Passive exercise: 1. Massage: Applicable to the limb with swelling at the fracture end, to help the swelling subside through light massage.  2.Passive joint activities: In the early stage of fracture fixation, a few patients are afraid to do active exercises due to fear of pain. It is useful to eliminate swelling, prevent muscle atrophy and adhesion, and joint capsule contracture as soon as possible, but the operation should be gentle, so as not to displace the fracture again and aggravate the local trauma.  (C) Functional exercise precautions 1. Functional exercise must be carried out under the guidance of medical personnel.  2, functional exercise should be based on the degree of stability of the fracture, can start from light activity gradually increase the amount of activity and activity time, can not be too hasty, if the sudden violent activity and the bone dislocation, but also to prevent some patients under the correct guidance of medical personnel dare not exercise, such patients should be patient persuasion work.  3, functional exercise is to accelerate the fracture healing and restore the function of the affected limb, so the patient should be encouraged to adhere to the activities that are beneficial to the fracture, and the activities that are unfavorable to the fracture healing should be strictly prevented, such as the abduction activities of the adductor humeral surgical neck fracture, the inversion activities of the inversion fracture, the extension activities of the supracondylar humerus fracture, the flexion activities of the flexion fracture, the rotation activities of the forearm fracture, the tibiofibular stem fracture The dorsal extension and flexion activities of the lower radius extension fracture should be prevented.