Postoperative function of lower limb periarticular fracture Functional exercise of the hip 1. What things need to be noted for functional exercise after hip fracture? First of all, we should pay attention to regular turning and buckling of the back, and instruct patients to carry out breathing training to avoid crushing pneumonia. Zhang Lihai, Department of Traumatology and Orthopedics, Beijing 301 Hospital Pay attention to early activities as allowed, pay attention to changing positions and prevent the formation of decubitus ulcers. To prevent thrombus stasis in the lower limbs, elevate the lower limbs appropriately during bed rest, wear elastic stockings, and perform manual massage for 10-20 minutes three times a day. Patients can also initiate flexion and extension activities of the calf muscle groups. Patients who have undergone hip replacement should prevent dislocation of the prosthesis and avoid movements such as internal rotation and hip flexion over 90°. Avoid premature weight-bearing, and use crutches and other walking aids wisely. When moving to the ground, keep the affected limb out of the booth and avoid falling. 2, hip fracture rehabilitation training, why can not extend the straight leg elevation? After hip replacement, straight leg elevation and hip flexion over 90° may cause dislocation of the prosthesis. Knee functional exercise 3.When to start rehabilitation training after knee fracture? How to carry out? The first step is to maintain the mobility of the knee joint, which is done in two stages. The first stage is usually 3-5 days after surgery. The affected limb is flexed at 90°, hands are held tightly around the thigh, and the lower leg is allowed to sag slowly to form a knee flexion activity, trying to achieve full flexion and extension. This can be done with the cooperation of family members, with each full flexion and extension of the knee 3-5 times, 2 times a day. Ice the knee for 10 minutes after the activity. In the second phase, squat training is started at 10-12 weeks after surgery, depending on the strength of the fixation and fracture healing. The knee is first warmed for 10-20 minutes and the first phase is completed with 5 sets of knee flexion and extension, choosing a support at waist height, with the body about as far from the support as the upper arm or slightly less, and the feet slightly apart at shoulder width. Grasp the support with both hands and slowly squat down, with the center of gravity as far forward as possible, avoiding leaning back. Squat until the knee joint is mildly painful, hold the movement for 10 seconds and then slowly stand up. Repeat 3-5 times, increasing the squat angle every three days. Apply a cold compress to the knee joint for 10-20 minutes after the exercise. Next is knee muscle strength training, which is performed in two phases. The first phase is performed 3 days after surgery, the patient takes a supine position, straightens both knees and tenses the legs, lifts the legs upward to 20-30°, then slowly lowers the legs, the movement requires slow, 10-20 times per group, 2 groups per day. In the second phase, three weeks after surgery, the patient is seated with both knees slowly bent down to 90° and then slowly raised to the horizontal, 5-10 times per group, 2 groups per day. Knee flexibility training is also performed. Starting 3 weeks after surgery, the patient is placed in a flat position, lifts both feet, and does pedaling with both legs in the air, requiring the knee joints to reach 90° when flexed and as straight as possible when straightened. The exercise can be completed with the assistance of family members at the beginning. Do 2 sets of 5-10 times per day. 4.Why do I need to apply heat before rehab after knee fracture? Hot compresses promote blood circulation, relax the knee joint and facilitate subsequent functional exercises. 5.When can I put weight on the ground? The time to put weight on the knee depends on the severity of the fracture, the degree of fixation and the healing of the fracture. Generally, one week of weight bearing on double crutches is started in 8-10 weeks, and then one week of full weight bearing on single crutches. Functional ankle exercises 6. How to perform ankle fracture rehabilitation training? Exercises to restore the normal mobility of the ankle include dorsiflexion and plantarflexion of the ankle. Dorsal extension ankle activity: sit with straight legs, keep the foot vertical on the supporting surface, passively flex the ankle joint upward to the limit or until you feel slight pain, maintain for 10 seconds, then slowly return to the original position for 5 seconds, start the exercise 3 days after the operation, 15 times a day. Plantar flexion ankle activity: sit with straight leg, keep the foot perpendicular to the supporting surface, passively flex the ankle joint downward to the limit or feel slight pain, maintain for 10 seconds, then slowly return to the original position for 5 seconds, start practicing 3 days after surgery, 15 times a day Ankle flexibility training, including gastrocnemius extension training and Achilles tendon extension training. Gastrocnemius extension training: sit with straight legs, fold the towel over the root of the bunion, slowly pull the towel to dorsiflex the ankle joint until the upper part of the gastrocnemius is extended (tense), hold for 20 to 30 seconds. Stretching training of Achilles tendon: sit with knees slightly bent, fold the towel over the root of the palm of the thumb, slowly pull the towel until the lower part of the gastrocnemius and the heel is stretched (tense), hold for 20-30 seconds. All 3 sets of 10 reps per day. Muscle strength training around the ankle joint, including peroneal muscle strength training, ankle inversion muscle strength training and tibialis anterior muscle strength training. Peroneal muscle strength training: put the foot flat on the floor, lean on the wall or bookcase on the outside, push the foot upward with force, feel the outer calf muscles exerting force, but no foot activity, hold for 10 seconds, relax for 5 seconds. Ankle inversion muscle strength training: foot flat on the floor, two feet leaning on each other, pushing hard to the inside. Feel the inner calf muscles exerting themselves, but no foot activity, hold for 10 seconds and relax for 5 seconds. Anterior tibial muscle strength training: place the heel of the normal foot on the back of the injured foot, press the normal foot downward while the injured foot is cocked and pushed upward (i.e., the heel does not leave the ground). They feel the muscles of the front side of the calf in force, but did not produce foot activity, adhere to 10 seconds, relax for 5 seconds. Each exercise 20 times a day 7.When can I start weighted squats? Weight bearing and squatting after ankle fracture depends on the type of fracture, stability of fixation and fracture healing. Generally, you can start partial weight bearing at 8-10 weeks, then gradually start full weight bearing, and start partial squatting at 10-12 weeks. 8.When should I use crutches? When can I take off the crutches? The crutches are used for partial weight-bearing at the beginning of postoperative weight-bearing of ankle fracture, usually 8-10 weeks after surgery for double crutches, followed by 1 week of single crutch weight-bearing, and then 1 week after that for deconditioning.