医学康复学课件：17 Fracture Rehab

1、Fracture RehabilitationOverview Clinical Characteristics of Fracture Trauma Pain and Tenderness Swelling Abnormalities Dysfunction Bony crepitus X-ray Principle of Clinical treatment of fractureRestoration, Fixation and Rehabilitation Promote fracture healing Shorten the course of treatment Reduce a

2、dhesions Avoid muscle atrophy Improve articular range of motion Promote the motor function recovery of the injured limb Rehabilitation Assessment ContentsFracture alignment and bony callus Delayed union or disunion ? Pseudarthrosis or malunion ? Infection ? Vascular nerve injury ? Myositis ossifican

3、s ?Rehabilitation Assessment ContentsFracture alignment and bony callusArticular range of motionMuscle strengthLength and circumference of limbSensory functionActivities of daily livingRehabilitation Assessment ContentsUpper extremity: Self-care ability in life Dressing, Washing, Cleaning, Eating an

4、d Writing Lower extremity: Walking and Loading Activities of daily living骨折康复评定骨折康复评定Rehabilitation Assessment Assessment of fracture healingHealing time Age Physical condition Fracture siteStandard of Clinical Healing No tenderness and no longitudinal percussion pain in the broken ends of fractured

5、 bone. No activity of local anomaly in the broken ends of fractured bone. X-ray showed that the fracture lines were blurred, and there was a continuous bony callus through the fracture line. In the case of removing external fixation, upper extremities can lift the 1kg weight up to 1 minutes. In the

6、case of no crutches, the lower extremities can walk continuously for 3 minutes and not less than 30 steps. No deformities in the fracture site for two weeks.Standard of Bone Union Satisfy all the conditions for clinical healing. X-ray showed that bone trabeculae permeate through the fracture line. R

7、ehabilitation Management Period of Immobilization (early stage) Active Exercise Eliminate edema, Improve venous and lymphatic return Articular full range of motion is permitted for the unfixed joint of proximal and distal end of the injured limb.Active exercise and resistant exercise will be done as

8、 far as possible. If there is any difficulty, assistant exercise and the passive exercise will be done.Rehabilitation Management Rhythmically isometric contraction exercise for the muscle of fracture immobilization. Active exercise could be done for the injured joint with intra-articular fracture in

9、 protection of no weight bearing, after 23 weeks immobilization. The healthy limbs should do normal exercises as far as possible. The affected limb should be elevated. Physiotherapy Period of Immobilization (early stage)Rehabilitation Management Period of Healing (later stage) Joint Range of MotionA

10、ctive exercise, Assistant exercise, Passive exercise, Joint mobilization Muscle strengthResistance exercise, Isometric contraction , Isotonic contraction, Constant speed contraction PhysiotherapyInfrared therapy, Audiofrequency current therapy, Ultrasonic treatment, Cold treatmentRehabilitation Management Period of Heal