In addition to routine postoperative treatment such as infection prevention, hemostasis and dressing exchange, early and active functional exercise is particularly important.
I. Within three days after surgery.
1. Observe the bleeding of the diseased area and the tightness of the elastic bandage. (Prevent the bandage from being too tight to pressure injury).
2.Bed rest in free position.
3, as far as possible to reduce the bed activities, with permission can hold the crutches without weight walking to the toilet.
First postoperative day: Immediately after surgery, bind both lower extremities together with a towel or restraint band, and put a soft pillow under the knee. The lower extremities were bent at 15°~20° and the hips were bent at 60° (maintain the nocturnal side-knee bundle until 3 weeks). Observe the amount and nature of drainage fluid after surgery if there is a drainage tube, and remove the tube on the 2nd postoperative day. Active muscle contraction exercise: postoperatively, take both lower limbs and knees in straight position, after awakening from anesthesia, start quadriceps static contraction, foot exercise and hip muscle clenching exercise, each lasting 5 seconds. 3 groups/day, 20 times/group.
The second day after surgery: training methods: 1.
1.Passive double knee cross exercise: the patient lies flat, the assistant helps to cross his one leg over the other leg, the knee is the cross point, alternating left and right, repeatedly. This method can avoid gluteal muscle adhesions. It should be performed no less than 30~50 times a day.
2.Passive double knee flexion exercise: the patient lies flat on his back, the assistant helps to bring his legs together and flex his knees, then instruct the patient to hold his knees with both hands and keep his thighs as close to his chest as possible for a few seconds and then release his legs and repeat. The purpose of this exercise is also to prevent adhesion of the hip muscles, no less than 30 times a day.
Second, 4-5 days after surgery
Walk with weight indoors with double crutches. During the daytime, you can practice hip inversion, that is, the action of crossing the thigh to the opposite side. But the limit is to feel pain that need to stop, the range can not be too large, otherwise it is easy to cause hematoma and prolong the recovery time.
Passive squatting exercise: the patient gets out of bed, holds the end of the bed with both hands, squats with knees, the assistant stands behind and holds his back, instructs the patient not to bend as far as possible, the heel does not leave the ground, lasts 1 to 2 min and then stands up, each exercise is repeated, the number of times can be gradual according to the condition. It should be kept at 30~50 times a day.
Third, 5-8 days after surgery, walking and hip flexion (sitting position) with the help of single crutch or de-crutch.
1.Gait training: encourage patients to get out of bed and practice walking, with the patient’s chest raised, both upper limbs stretched forward, and the assistant holding the patient’s hands with both hands, walking in a straight line with both feet crossed, 3 times/day, walking back and forth along 20 meters each time, and adjusting the patient’s posture at any time to make it coordinated.
2, “a word step” exercise: the assistant facing the patient, holding his hands, ask the patient to walk a word step (that is, walk “cat” step), correct the patient’s abnormal gait, no less than 300 steps per day.
3, and knee squat training: 5-7 days after surgery, instruct the patient to hold the railing active and knee squat training, the height of the railing to level the patient’s waist is appropriate, practice both feet and knees together, the heel does not leave the ground, waist and back straight, bend the knee squat, squatting speed must be slow, prevent hip abduction external rotation, 3 groups / day, 30 times / group, gradually increase the intensity and time of practice.
Fourth, two weeks after surgery to remove the stitches, to encourage the hip inward (crossed legs), without abduction.
1.Cross-leg exercise: assistants assist patients to sit on a chair with a backrest, with the hip against the back of the chair. Upper body and thighs at right angles, put one leg on the other leg, knee for the cross point, adhere to 3~5min and then change the other leg, repeatedly. Should be maintained at 30~50 times a day.
2.Hold knee squat: After the wound is removed, instruct the patient to hold the knee squat training with both hands. 3 groups/day, 20 times/group. At the same time stand with both feet separated front and back, front lower limb knee flexion, back lower limb knee straight, hands pressed on the front knee joint, body leaning forward, adhere to 10s, legs crossed.
V. Instruct patients to run and jump exercises one month after surgery, and follow up regularly to encourage and supervise patients to adhere to the above training for six months to one year in order to promote the recovery of hip joint function.