–Function of lower extremity periarticular fracture after surgery
Hip joint functional exercise
1.What are the things that need to be paid attention to 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 of the Department of Traumatology and Orthopedics of Beijing 301 Hospital should 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° can easily cause dislocation of the prosthesis.
Knee functional exercise 3. When should I start the rehabilitation training after knee fracture? How to proceed?
The first step is to maintain the mobility of the knee joint, which is done in two phases. The first stage is usually 3-5 days after surgery. The affected limb is flexed at 90°, the hands hold the thigh tightly, and the lower leg is slowly lowered 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 takes a sitting position and slowly bends both knees down to 90° and then slowly raises them to the horizontal, 5-10 times per group, 2 groups per day.
Knee flexibility training is also required. 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.
3.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.
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 at 8-10 weeks, followed by one week of full weight bearing on a single crutch.
Ankle functional exercise
4.How to carry out rehabilitation training for ankle fracture?
Exercises to restore the normal mobility of the ankle include dorsiflexion and plantarflexion of the ankle. Dorsal extension ankle activities: 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 exercises 3 days after surgery, 15 times a day. Plantarflexion 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 for 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 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). One feels the anterior calf muscles exerting force, but no foot activity is produced, hold for 10 seconds and relax for 5 seconds. 20 times a day for each exercise 7. When can I start weighted squats?
Weight bearing and squatting after ankle fracture depends on the type of fracture, the stability of the fixation and how well the fracture is healing. Generally, partial weight-bearing will start in 8-10 weeks, then gradually full weight-bearing will start, and partial squatting will start in 10-12 weeks.
5.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, generally 8-10 weeks after surgery for double crutches on the ground, followed by 1 week of single crutch weight-bearing, and after 1 week, you can consider taking off the crutches.