Postoperative function of upper limb periarticular fracture Functional exercise of shoulder joint 1. What are the main functions to restore after functional exercise of shoulder joint fracture? The shoulder joint is the most flexible ball and socket joint in the body, and it can perform flexion, extension, retraction, extension, rotation and rotation movements. 2.What is the function of “pendulum-like movement”? How to do it? What is the range of exercise? The pendulum-like exercise is a self-relaxation method for the shoulder joint, which can reduce shoulder pain and promote the recovery of shoulder joint disease, and is suitable for patients with frozen shoulder, rheumatoid arthritis and shoulder trauma. When exercising, the healthy hand holds the table, the body bends forward, and the upper body is at an angle of about 90 degrees from the lower body; the hand with the disease hangs on the outside of the table, the arm relaxes, and begins to slowly sway back and forth, left and right, as in a pendulum-like movement, in addition, when doing this movement, small weights (small dumbbells) can be added to the hand to assist the activity. However, it is important to note that if this movement increases pain or if the mobility of the shoulder joint becomes less after doing it, you should stop the exercise. Try to expand the range of motion during exercise without pain. 3.What is a pseudo subluxation of the humeral head? How does it relate to the functional exercise of the shoulder joint? Pseudodislocation of the humeral head is mainly due to violent trauma to the shoulder joint and the relaxation of the muscles, ligaments and joint capsule around the shoulder joint caused by prolonged fixation, traction and suspension after trauma. Postoperative functional exercise of the shoulder joint is not the root cause of pseudodislocation of the humeral head. If structural instability of the shoulder capsule is found to exist during functional exercise, muscle strength training of the shoulder joint stabilizing muscles can be considered to be strengthened along with mild joint mobility exercises. By improving the strength of the deltoid muscle and the tension of the rotator cuff, the purpose of stabilizing the shoulder joint can be achieved. If the joint capsule relaxation is serious, surgery should be taken in time. Elbow joint functional exercise 4.How to do the elbow joint rehabilitation? What is the general angle to be restored? Functional exercises should be actively carried out after elbow surgery, based on the principle of early, continuous, painless, and full course. Generally, elbow flexion and extension exercises should be performed about 3 days after surgery. Take a flat position, place the affected limb on one side of the body, and put a towel under the elbow joint. First, slowly and actively flex the elbow to painful inability to move, by family members to help slowly increase the flexion angle, the action should be slow and gentle, moderate force, activities to pain, can wait in place for 30 seconds and then continue to move, the whole flexion time can last five minutes to complete. After flexion, patients take the initiative to slowly straighten the elbow joint, family members assist in controlling the arm to avoid straightening too fast, to not continue to actively straighten, can be placed on the patient’s hand to place a heavy object (such as a thick book) to gradually and slowly add pressure to assist in straightening. Flexion and extension exercises are done twice a day, three sets each time, and ice is applied to the upper and lower elbow joint for 20 minutes after the exercise. The edema can be reduced by applying pressure, applying cold packs, and elevating the elbow joint, and analgesic medication can be used to improve patient compliance. Rehabilitation training includes normal range of elbow joint activities: 0~150° for flexion and extension, 80° for anterior rotation and 85° for posterior rotation; for rehabilitation training after elbow fracture, the minimum activities are: 30~130° for flexion and extension, 50° for anterior rotation and posterior rotation. 5.What is ossifying myositis? Why is it possible for elbow rehabilitation to cause ossifying myositis? Osteomyositis is a disease of muscle sclerosis caused by the deposition of progressive bony structures in the muscles and connective tissues. After a traumatic injury to the elbow joint, causing soft tissue rupture, bleeding and hematoma formation can be secondary to ossifying myositis. Improper methods in the rehabilitation process, such as excessive force and repeated rough movement of the elbow joint may cause ossifying myositis. Functional exercise of wrist joint 6.How to carry out rehabilitation training after wrist fracture? The rehabilitation training of the wrist is mainly to restore the dorsiflexion, palmar flexion, rotation and fist clenching activities of the wrist joint. Training of dorsiflexion function: fold your hands together, from the top of your head to your chest, lower your arms while unfolding them, keep the palm surface of your hands unseparated, stop at the painful area, and increase the dorsiflexion angle every three days. Training of palmar flexion function: the backs of both hands are close to each other, gradually lift up, keep the backs of both hands not separated, stop at the painful area, and increase the palmar flexion angle every three days. Rotation and fist movement training: Bilateral forearms on the table, four-finger fist, thumb as straight as possible, gradually rotate inward to the limit for 3 seconds, and gradually rotate outward to the limit for 3 seconds. Within 3 weeks, the above three exercises were performed 3 times a week with 2 sets of exercises each time, and after 3 weeks, each movement was performed 5 times a week with 2 sets of exercises each time. Before performing the above three exercises, prepare a 45° hot water bag and place it on the dorsal side of the affected limb for 10 minutes, and after completing the above exercises, place an ice pack wrapped in a towel on the dorsal side of the affected limb for 5-10 minutes. Patients who are immobilized in a cast or external fixation frame should undergo rehabilitation of the wrist joint as soon as the fixation is removed, preferably on the day of removal. For patients with incisional internal fixation, finger flexion and extension activities can be performed within 24 hours after surgery, and active flexion and extension of the wrist joint can be performed 3-5 days after surgery, and standardized exercises can be started 5-7 days after surgery. Soak in hot water at 45° for 4 minutes and then in cold water for 1 minute before bedtime, alternating 4-5 times, with the need to move the joint in the middle of the soaking process. After the immersion is completed, apply 75px of futalin ointment to the affected area. 7. Do all fractures that do not reach the angle need to be broken hard? Will compression crush the forearm fracture healed by rehabilitation exercises without reaching the angle? The intensity of functional exercise should depend on the firmness of the surgical fixation and the bone quality of the fracture site. If the internal fixation is very strong during the surgery and the surrounding bone is stable and strong, you can break it with moderate force. However, if the fracture site is severely crushed and the bone is unstable and cannot be firmly fixed, it should not be broken with brute force. If you break it with force without providing enough strength, it will cause the fracture end to be re-displaced and even cause the breakage of the internal fixation and the loosening of the screw, which will eventually lead to the failure of the operation. In addition, the process of breaking should not be much, and repeated bending many times may lead to fatigue fracture of the metal material of internal fixation.