胫腓骨骨折术后分期康复治疗效果分析

Background: Joint movement disorder and even stiff joint often occurs after external fixation for fracture of tibia and fibula, the reason of which is usually the intra joint adherence and the adherence and atrophy of the extra joint muscles. Objective: To discuss the treatment effects of post- operational staged rehabilitation for fracture of tibia and fibula. Unit: Second People Hospital of Ningxia. Subject: There were 65 cases including 45 male and 20 female ones. They were from 16～ 70 years with the average of 43 years. The fractures were all unstable, fragmental and open. Intervention: Three- staged rehabilitation was applied after external fixation: (1) Early rehabilitation treatment (3～ 6 weeks after operation): ① The fractured limb was elevated to diminish the swelling; ② To exercise the joints at the end of the limbs, as to exercise the toes for multiple times every day; ③ Fix the muscles of the limbs and contract them isometricly, do it for 15～ 20 minutes each time and for multiple times every day. (2) Middle rehabilitation treatment(8～ 10 weeks after operation ) muscle force exercises were increased gradually, the anti resistance exercises were added gradually after the muscle force got over degree III, the joint movement ranges were added gradually with the muscle under control. (3) Late rehabilitation treatment ( the fracture had healed).① Muscle force exercises: Anti resistance exercises such as sandbag kicking and pedaling. ② Joint movement exercises including active and passive exercises, such as extension and flexion of knee joint, dorsiextension and planter flexion of ankle joint, the exercises should be increased gradually to form some rhythm and speed. Also electric treatment, heat treatment, ultrasonic treatment and massage etc may be added in this period. Result: The follow up periods for the 65 cases were 3～ 12 months and the time for the fractures to heal completely was 8～ 16 weeks ( the average was 12 weeks). The function condition of the ankle and knee joints was as follows: knee flexion 150° , knee extension 0° ; ankle dorsiflexion 20° , ankle planter flexion 40° , ankle inversion 30° , ankle extroversion 20° . Conclusion: Manipulative reduction combined with rehabilitation exercises may have excellent effects on facture of tibia and fibula.