Rehabilitation of late fracture

  Requirements: Early systematic and reasonable functional exercises can not only maintain the normal physiological function level of the body, speed up the fracture healing, prevent the dysfunction of the injured joint adjacent to the end, but more importantly, prevent the permanent dysfunction of the injured joint caused by muscle adhesion, joint stiffness and muscle atrophy, restore the limb function of the patient to the maximum extent, and prevent the disuse atrophy and joint contracture of the limb.  Daily methods: The most important thing for postoperative rehabilitation of limb fractures, especially joint and periarticular fractures, is joint mobility and muscle strength training.  Early joint mobility training should be based on passive activities, and the principle of gradual progression should be mastered, and a continuous passive activity machine can be used for functional exercise when available. Three days after surgery, active joint activities can be gradually strengthened. Rehabilitation training should gradually increase and maintain the maximum degree of joint mobility, avoid small range of fast-paced activities, which not only does not help the improvement of joint mobility, but also has an impact on the fracture local.  Muscle training: The functions of the upper and lower extremities are focused on each other, and the upper extremity focuses on fine movements, and the recovery of these functions is the focus of functional exercise. When exercising, we should pay attention to maximum finger flexion and extension to prevent stiffness and adhesion of the hand joints. The main function of the lower extremity is weight-bearing, but excessive weight-bearing before the healing of the lower extremity fracture may cause the fixation to loosen and break, so the rehabilitation of the lower extremity fracture must follow the principle of “early activity and late weight-bearing”. The quadriceps muscle is an important muscle in the front side of the thigh, which is prone to atrophy after injury or surgery if it is inactive for a long time, and once atrophy is difficult to recover, it directly affects the functional rehabilitation results.  Key points: Inappropriate muscle training and joint movement training can aggravate spasticity, and appropriate rehabilitation can relieve this spasticity, so that limb movement tends to be coordinated.  According to the National Institutes of Health, nearly 20% of clinical patients with extremity fractures are left with varying degrees of disuse atrophy and joint contractures due to faulty limb rehabilitation training, which can have a significant impact on later life. Once the wrong training method is used, such as repeatedly practicing forceful grasping with the affected hand, it will strengthen the flexor muscle synergy of the affected upper limb, making the spasm of the muscles responsible for joint flexion aggravated, resulting in flexion of the elbow, flexion of the wrist and rotation of the front, flexion of the fingers deformity, making the recovery of hand function more difficult. In fact, muscular dystrophy limb movement disorder is not only a problem of muscle weakness, but also the uncoordinated muscle contraction is an important cause of motor dysfunction. Therefore, it should not be mistaken that rehabilitation training is strength training.  In the rehabilitation of post-fracture limb muscle strength and limb function recovery, the traditional concept and method only focus on restoring the patient’s muscle strength, neglecting the rehabilitation of the patient’s joint mobility, muscle tone and coordination between antagonism, even if the patient’s muscle strength is restored to normal, it may leave abnormal movement patterns, thus hindering the improvement of their daily life and activity. Experimental and clinical studies have shown that the use of a multi-functional home exercise rehabilitation device is generally recommended for daily home care rehabilitation after limb fracture to restore the movement of damaged muscular atrophy limbs. In addition to directly exercising the muscle strength of the limb, it also coordinates and governs the functional state of the limb through the passive antagonism of the simulated movement to restore the dynamic balance; meanwhile, the repeated movements can provide feedback to the brain to promote the information, so that it can achieve the maximum functional reconstruction as soon as possible and break the spasticity pattern and restore the autonomous motor control, especially easy to operate at home. This method can make the limb muscle training and joint mobility of fracture patients recovered as soon as possible and completely, avoiding the long-lasting disuse atrophy and joint contracture of the injured joint caused by muscle adhesion, joint stiffness and muscle atrophy.