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Good healing is essential for fracture healing

BY Iris Wheatley 2020-08-01

  From the orthopedic theory, the three principles for the treatment of fractures are reduction, fixation, and functional exercise. Therefore, for patients with fractures, scientific functional exercise and active rehabilitation are indispensable.

  In orthopedics clinics, sometimes found Clearly reduced fractures that are perfect and firmly fixed, but dysfunction due to negligence of rehabilitation exercise, which reduces the effectiveness of treatment. This situation is also known as "fracture disease"-caused by fractures and their treatment The joint swelling and stiffness, dysfunction, muscle atrophy, osteoporosis and other bone and joint fixation syndrome.

  Theoretically speaking, the start time of fracture rehabilitation should be as early as possible. Generally, the fracture can be started after reduction and fixation. Its purpose is to restore the affected limb muscle as soon as possible without affecting the fixation and healing. , Tendons, ligaments, joint capsule contraction and contraction activities to prevent muscle atrophy, osteoporosis, tendon contractures, joint stiffness complications, while applying swelling, blood circulation, bone supplement drugs to promote fracture healing. Among them, functional exercise is the core and main method of fracture rehabilitation treatment.

  Fracture rehabilitation is divided into three time windows: 1) early functional exercise (inflammation reaction period); 2) mid-term functional exercise; 3) late phase of functional exercise.

  Among them, during the middle period of functional exercise, that is, from 2 weeks after injury to the clinical healing of the fracture, the local swelling of the injured limb gradually disappears, the pain relieves, and the fibrous connection appears at the fractured end of the fracture, and the callus gradually forms. The fracture site is stable. During this period, correct and high-load rehabilitation exercises are most meaningful for fracture healing.

  At this stage, in addition to continuing to strengthen the isometric contraction of the muscles (that is, on the basis of immobilization of the joints, the muscles of the affected limbs do rhythmic static contraction and relaxation. That is what we often say Tighten and relax to prevent muscle atrophy or adhesion), with the help of medical staff and healthy limbs, you can gradually restore the functional activities of the proximal and distal unfixed joints and the activities of the upper and lower joints of the fracture. And gradually change from passive activity to active activity, increase active joint flexion and extension activities, prevent muscle atrophy, avoid joint stiffness, and reduce dysfunction.

   For example, after a forearm fracture, the movement of the wrist joint and elbow joint is restricted by plaster or splint, but the finger joint is allowed to move, and it can be used for gripping and other actions to promote blood circulation and improve peripheral circulation; For example, after the operation of the femoral fracture, the exercise of the knee joint should be strengthened to avoid the quadriceps tendon contracture, adhesion, and knee dysfunction.

  Rehabilitation exercise is important, but it also needs to pay attention to the exercise. It should be action-oriented, passive-assisted, step-by-step, not blind and rough, eager to achieve success, pay attention to avoid side injuries, do not increase body weight Activity and inconsistent rotation between the upper and lower ends of the fracture (unfavorable for the stability of the fracture); avoid focusing on practicing more parts in the rehabilitation exercise, while ignoring the other parts of the exercise, and fully consider the joints, muscles, and various functions; in addition For patients who have been in bed for a long time, they are prone to dizziness when they stand up suddenly.

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