Caution.
1.The methods and data provided in this plan are developed in accordance with the general routine, and the specific implementation needs to be completed under the guidance of the doctor depending on their own conditions and surgical situations.
2, the presence of pain in the functional exercise, is inevitable, but always to the extent that the patient can tolerate.
3, muscle strength exercises should focus on the target muscles. The number of exercises, time and conformity depend on their own situation, and should be practiced on the healthy side at the same time. The improvement of muscle strength is the key factor of joint stability and must be practiced carefully.
4.In addition to the surgical limb training, the rest of the body parts (such as upper limbs, waist and abdomen, healthy side of the leg) should be practiced as much as possible to ensure physical quality and promote the overall recovery of body function.
5.Early joint mobility exercises, daily adhere to complete the training, as far as possible early painless and resistance-free recovery of larger angles, internal fixation instability need to protect the specific situation specific analysis.
6.Ice packs should be applied for 15-30 minutes immediately after the mobility exercise. If you usually feel the joint swelling, pain and fever is obvious, you can ice again, 2-3 times a day.
7, joint swelling will accompany the entire exercise process, swelling does not increase with the angle of the exercise and the amount of activity that is normal, until the angle and muscle strength basically return to normal swelling will gradually subside. Sudden increase of swelling should adjust the exercise, reduce the amount of activity, and in serious cases should be timely follow-up.
8. See appendix for training methods.
The rehabilitation program changes depending on the type of fracture, the degree of fracture, the surgical technique and the fixation method.
Overall rehabilitation goals.
Joint mobility: to restore normal knee mobility and normal ankle and hip mobility as soon as possible.
Muscle strength: to promote and improve the strength of quadriceps, N cord, suture, and thin femoral muscles.
Functional goal: to achieve normal gait and standing phase knee stability.
Contraindication: weight-bearing of the affected limb for 3 months to avoid displacement or collapse of the fracture site.
Preoperative rehabilitation.
Traction elevation of the affected limb, ankle pump, edema control.
Upper and healthy limb strength training (isotonic muscle tension training – resistance to gravity, theraband resistance, etc.).
Postoperative rehabilitation.
Phase I: Maximum protection period
(1 day – 4 or 6 weeks)
Contraindicated: internal and external stress applied to the knee joint, passive joint mobility training of the knee joint.
Objectives: pain relief, swelling control, restoration of knee mobility (0°-90°), restoration of muscle strength of the affected limb, independent walking with a walker.
1-2 days.
Purpose: To reduce pain, control swelling, release muscle spasm, prevent deep venous thrombosis and pulmonary complications, and restore the patient’s ability to transfer position. Patients are able to get out of bed with the help of others into the next small phase.
Rehabilitation content.
1. Elevation of the affected limb above the heart.
2.Ankle pump.
3.Deep breathing and coughing exercises.
4.Ice packs on the knee joint
5.Active joint mobility training for hip and ankle joint, active knee joint
6.Quadriceps femoris, N cord muscle, gluteus maximus and other long muscle strength contraction training.
7.Gently ankle joint isotonic training without resistance
8.Correct body position placement.
9.Sit up and stand up in bed.
10.Strength training of upper limb and healthy side limb.
11.Functional activity: the affected limb can walk with a walker or crutches with two-point gait without weight-bearing.
3 days – 6 weeks
Objective: To restore knee mobility to 90° and muscle strength. 6 weeks x-rays show good healing of the fracture point to the next stage.
Rehabilitation components.
1.Keep ankle pump.
2.Joint mobility training: knee active joint mobility training, assisted-active joint mobility training; reach 90 at the end of 2 weeks, if the target is not reached, increase the intensity and frequency of exercise.
3.Quadriceps femoris, N cord muscle, gluteus maximus and other long muscle strength contraction training.
4.Functional activities: continue to walk with a walker or crutches two-point gait without weight-bearing on the affected limb.
Phase II: Moderate protection period
6-8 weeks
Contraindicated: no internal or external stress is applied to the knee joint.
1. Joint mobility training:: active joint mobility training, assisted-active joint mobility training and passive joint mobility training of the knee joint at least (0°-90°).
2. Muscle strength: gentle resistance training of quadriceps and N cord muscles
Phase 3: Minimal protection period
8 weeks – 3 months
1. Start of progressive resistance plyometric training for quadriceps and N cord muscles.
2.Knee joint flexibility training.
3. Functional activities: weight-bearing transfer and walking with a walker at the end of 12 weeks.
4. Weight-bearing: partial to full weight-bearing (to be decided by orthopedic surgeon depending on fracture healing).