How should rehabilitation after a fracture be carried out?

  The rehabilitation training after fracture can be generally divided into three phases: the early phase of rehabilitation training: this phase is 1-2 weeks after the injury, when the injured limb is swollen, painful, the fracture end is unstable and easily re-displaced. Therefore, the main purpose of functional exercise in this period is to promote blood circulation in the affected limb to facilitate the reduction of swelling and stabilization of the fracture. The main form of rehabilitation training is the isometric contraction of the muscles of the injured limb, that is, under the premise that the joint does not move, the muscles do rhythmic static contraction and relaxation, which is what we usually call tensing and loosening, through the isometric contraction of the muscles can prevent muscle atrophy or adhesion.  During this period of rehabilitation training, in principle, except for the upper and lower joints of the fracture, all other parts of the body should carry out normal activities.  The swelling of the injured limb gradually decreases, the pain decreases, the fracture ends have fiber connections and gradually form bone scabs, and the fracture site becomes more stable. During this period, in addition to continuing muscle contraction training of the injured limb, the movement of the proximal and distal unfixed joints and the upper and lower joints of the fracture can be gradually restored with the help of the rehabilitation therapist, and gradually change from passive to active activities to prevent the decrease of joint mobility of the adjacent joints. When the condition permits, the patient should get up as soon as possible to perform full body activities. In addition, physiotherapy can be used to reduce swelling, remove blood stasis and promote the formation of bone scabs.  At 5-6 weeks after the injury, the fracture has sufficient bone scab formation to further expand the range of motion and strength, gradually increasing active joint flexion and extension activities from one joint to several joints to prevent muscle atrophy and avoid joint stiffness. Fractures involving the articular surface often leave significant joint dysfunction, therefore, it is best to start non-weight-bearing active movement of the articular surface about 2 weeks after fixation, and then fixation after the movement. In this way, the mutual extrusion and friction between the articular cartilage surfaces can promote the repair of articular cartilage and make it have a better shape, and at the same time, can prevent the formation of intra-articular adhesions.  Late stage of rehabilitation training: clinical healing has been achieved or external fixation has been removed, at this time, bony scabs have been formed, X-ray examination has been revealed, and the bones have a certain degree of support, but most of the adjacent joints have decreased joint mobility, muscle atrophy and other functional disorders. The purpose of rehabilitation in this period is to restore joint mobility and muscle strength of the affected joints, so that the function of the limb can be restored. The main form of rehabilitation training is active movement and weight-bearing exercises of the injured limb joints, so that the joints can quickly return to normal range of motion and normal strength of the limbs. The rehabilitation period can be accompanied by physical therapy and gait training.