This rehabilitation guide is suitable for patients with direct suturing of the sciatic nerve, common peroneal nerve, nerve graft repair or nerve release 3-6 months postoperative Most patients’ questions Patient A (with an anxious face): Hello, Dr. Zhang, how can I exercise for foot drop now? Dr. Zhang (touched his head and straightened his hair): Hello, please give a brief medical history, including the time of injury, treatment, current symptoms, and preferably discharge summary and EMG. I had a fracture of the tibial plateau with foot drop 6 months ago, and I had a fracture repositioning and internal fixation done at the local hospital. I still have foot drop and my muscle atrophy has not improved. What exercises should I do? Dr. Zhang (sitting down and answering seriously): There is no hurry, you are only 3 months post-surgery, it is a normal phenomenon. The nerve is like a small child, where it falls down, it has to get up (injury site), it can only crawl 1-2mm per day (regeneration speed). At this stage, you need to do four key tasks (home rehabilitation): wear foot slippers correctly: wear foot slippers when you go out during the day, and remove them when you rest or sleep at night to passively move your ankle joint. To prevent complications such as ankle stiffness and Achilles tendon contracture, you need to soak your feet in warm water every day, and have your wife or husband or parents help you to passively flex and extend your ankle joint and rub your calf muscles after soaking your feet (here you have to thank your family members who have been silently working for you). (here you have to thank your family members who are silently working for you). You can also lean against the wall and stand more on the inclined board. Use low frequency electrical stimulation to promote nerve regeneration and delay muscle atrophy. Enhance active awareness training: Use your brain to imagine that your ankle and toes can move dorsally and extensively 1500 times a day, 500 times in the morning and 500 times in the evening. The possible principles of action are: 1) By strengthening the brain’s awareness training, the silence of the cerebral cortex that originally governed the dorsiflexion of the ankle joint is inhibited (the brain is like a general in a castle, the muscles are soldiers on the far frontier. Muscle atrophy, like soldiers killed in action, the general in the castle learned that soldiers are killed in action, time, he will not give orders, the castle may also be plundered by other troops. (Awareness training, the general has been in a state of excitement to give orders, so that as soon as a soldier (ps: the muscles are re-innervated), his orders can be carried out). 2) strengthen awareness training, it is possible to promote nerve regeneration, but also conducive to brain function remodeling. Our nerves are like messengers that carry the general’s orders. (The general can always give orders to the messenger, telling him to run faster while guiding the direction of his message) 6-12 months post-op Patient A (tapped his brain before asking a question to clear his mind): Hello Dr. Zhang. I had a fracture of the tibial plateau with foot drop 9 months ago, and I had a fracture repositioning and internal fixation at the local hospital. I seem to be able to tilt my ankle a little bit now, but the muscle atrophy is very serious. Can my atrophied muscles grow back? How should I exercise? Dr. Zhang (relieved to see the question and gave a thumbs up inwardly): First of all, congratulations, you have reached the first stop. To restore normal gait, patients with common peroneal nerve injury have to fight and upgrade a total of 3 times. Level 1 is ankle dorsiflexion, level 2 is 2-5 toe dorsiflexion, and level 3 king is big toe dorsiflexion. Each upgrade takes about 2-6 months or so and varies from person to person. My main emphasis at this time is movement maintenance: that is, focusing on the quality of each activity rather than the number of movements. Try to maintain each dorsiflexion (toe dorsiflexion) at the maximum dorsiflexion angle you can achieve for more than 30 seconds, 3 times a day, for a duration of 20 minutes or more each time. In addition, muscle atrophy is irreversible, so I recommend early surgical intervention once it is clear that the common peroneal nerve is severed, or if the disease has not progressed significantly for more than 3 months. This will both speed up the rate of recovery and improve the quality of recovery (more normal muscle fibers remain). 12 months and older after surgery Patient A (question out of habit): Hello, Dr. Zhang. I had a tibial plateau fracture with foot drop 15 months ago, and I had a fracture repositioning and internal fixation done at the local hospital, and I was treated conservatively with oral mecobalamin for 3 months without significant improvement. According to the method you taught me before, I am now king through, I can do all the movements, and my gait is close to normal, but I just get tired easily after walking more, and I still trip occasionally. How do I exercise, please? Dr. Zhang (heart overjoyed): Congratulations on your successful passage, the crown is just around the corner, you just need the last step. At this point I emphasize strength training: the main use of resistance training, you can use homemade incense rubber bands, fitness equipment or family members to assist, while you do foot back extension exercise, apply a certain amount of force against it, exercise 3 times a day, 3 times in the morning and 3 times in the evening, 10 minutes each time, and gradually increase the strength. I wish you good health as soon as possible Patient A: Thank you, Dr. Zhang. Is my back stable and will I have a relapse? Do I need to be rechecked later? Dr. Zhang: The nerve repair surgery is guaranteed for life as long as you get well, but you should avoid re-injury and be careful in the future. Although you don’t need to be reviewed later, don’t forget to send me a little video of you walking every three months, I’ll miss you.