Upper limb functional exercise and rehabilitation

  Functional exercise during the rehabilitation period is an important way to restore the function of the upper arm.  1.The purpose of exercise is to prevent the loss of function caused by non-movement of the upper limb after closed fracture manipulation and fixation, and to restore the function of the fracture site to the best physiological state.  2.The scope of exercise is the joints and muscles of the upper arm.  3. The method of functional exercise, the implementation of rehabilitation treatment is divided into active and passive exercises.  I. Active exercise is the main rehabilitation exercise method. According to the clinical process of fracture healing and the degree of stability, it is generally divided into four stages.  The first stage is 1-2 weeks after the injury, when the local pain and swelling of the limb are present. The purpose of rehabilitation exercises is to promote the swelling to subside, prevent muscle atrophy, and prevent joint adhesions. The main methods are as follows: fist clenching, arm lifting and shoulder lifting. Clenching the fist is the basic action of upper limb activity. Try to make the fingers completely straight and flexed. Then do arm lifting and shoulder lifting. If the fracture is close to the epiphysis, a certain range of joint movements can be done if the fracture is stable.  The second stage is 3-4 weeks after the injury. If the patient’s muscle strength is restored and there is no pain in the fracture, the patient can do some automatic joint extension and flexion activities in the upper limbs, starting with one joint and then several joints in concert.  The third stage is 5-7 weeks after the injury. Except for the joint activities in one direction which are not conducive to fracture healing, the joint activities in other directions can be increased within the patient’s ability, both in terms of number and range of activities.  The fourth stage is 8-10 weeks after the injury. Patients can be allowed to do some light work within their ability.  Second, passive activities When the patient’s muscles are weak and cannot move on their own, assisted activities can be carried out with the help of medical personnel. For example, patients with multiple fractures of one bone, multiple fractures of the same limb, intra-articular fractures of the articular surface, or other systemic complications that prevent them from moving on their own, can perform auxiliary passive activities. If local massage is applied to the fracture part and the distal limb with severe swelling, its purpose is to disperse blood stasis, promote circulation and prevent adhesions. The operation should be gentle, not to increase the patient’s pain, not to aggravate the local injury, and not to displace the fracture.  The rehabilitation after fracture is not a simple recuperation can be healed, it needs a combination of movement and rest, that is, a combination of recuperation and exercise. First, the growth of bone scab: after the continuity of the human backbone is damaged, osteoblasts and osteoclasts on the periosteum will be activated, and the continuous growth of both types of cells will enable the fractured ends to be repaired and connected, and this process is the process of bone scab generation. The factors that affect the growth of bone scab are: 1. poor connection of the fracture end.  2. Poor nutrition.  3, lack of exercise.  Second, joint mobility: complete restoration of injured joint mobility is the ultimate rehabilitation goal of fracture treatment, which is very important.  Third, functional recovery: actively promote the functional recovery of the affected limb without worrying that it will affect the healing of the fracture by lying still in bed, which will also cause muscle atrophy and decrease in muscle strength, thus affecting the healing of the fracture.