Patellar fractures are relatively common injuries, most commonly seen in bruises or falls. Treatment usually consists of conservative treatment with external fixation in a cast or surgical incision and internal fixation. Treatment of fresh patellar fractures should maximize the smoothness of the joint surface, give a firmer internal fixation, and move the knee early to prevent the occurrence of traumatic arthritis.
The rehabilitation exercise after patellar fracture is an indispensable part of the treatment process, even more important than the surgery itself to some extent. Scientific and reasonable exercise can avoid the occurrence of fracture disuse syndrome, such as muscle atrophy of the affected limb, joint stiffness and limb deformity, which is extremely important for patients after patellar fracture fixation and reset. Here, I have combined my experience to summarize a set of postoperative rehabilitation exercises for patients suffering from patellar fracture, hoping to guide you to carry out reasonable functional exercises.
Selection and wearing of knee brace
I personally recommend wearing an adjustable knee brace after patellofemoral fracture surgery, which can play a certain protective role and also allow for controlled active knee exercises.
Rehabilitation training program
I. 0-4 weeks after surgery
1. After the anesthesia subsides, start to move the toes and ankle joint, as well as ankle pump exercises: 5 minutes/group, 1 group/hour.
2. Isometric training for quadriceps and triceps.
3.Weight-bearing and balancing exercises: stand on both feet, shoulder-width apart; or stand apart in front and behind. Move the center of gravity, so that the feet alternate weight-bearing, gradually transition to the affected leg standing on one foot, 5 minutes / time, 2-3 times / day.
4, to pay special attention to 4 weeks absolutely no straight leg lifting exercises, walking down to wear straight position support, crutches protection.
5. 4 weeks after surgery, review the X-ray to understand the fracture healing.
2. 5-8 weeks after surgery
1.Quadriceps isometric training.
2.The lateral and posterior leg lifts are changed to resistance.
3.Start knee flexion training under the protection of brace, 30 degrees-45 degrees-60 degrees-90 degrees-120 degrees, until 8 weeks, flexion up to 120 degrees.
4. Gradually change from double crutches to single crutches until de-crutching
Third, 9-12 weeks after surgery
1.Strengthen the strength exercises of the affected limb.
2, 12 weeks after surgery, the angle of knee flexion is basically the same as the healthy side.
3, 12 weeks after surgery, outpatient review X-ray to understand the fracture healing, if the fracture healing is good, you can remove the brace.
4. 3 months-18 months after surgery
1, moderate activities to adapt the affected limb to flexion and extension without brace, and reduce joint stiffness.
2.Strengthen the strength exercises of the affected limb.
3, 6 months and 12 months after surgery, review the X-ray to understand the healing of the fracture.
4. If the fracture heals well, a second surgery to remove the internal fixation will be performed 12 to 18 months after surgery.
Treatment process of a typical case