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Closed injuries of bones of the Shin is first among all fractures and, despite various proposed treatment methods, still provide the greatest percentage of disability. Damage to the bones of the leg are divided into fractures of the tibia, the fibula fractures, fractures of both bones of the tibia and malleolus fractures. When diaphyseal fractures of the tibia without displacement or with a slight difference of fragments that do not require the reduction treatment is carried out by a plaster bandage from the toes to mid-thigh. Fractures with displacement of bone fragments simultaneously treat exercise and fixation of plaster cast without extraction or with skeletal traction for the heel bone. If you are unable to match simultaneously or fragments by skeletal traction, resorting to surgery - the debris is fixed with a compression of Ilizarov, metallocenes a nail, rod, screws, plate. Physical therapy is carried out by the same procedure as that for hip fractures, depending on the chosen method of treatment.
In the immobilization period of the physiotherapy sessions performed General developmental and breathing exercises (static and dynamic) exercises to promote the training of the vestibular apparatus; to strengthen the muscles of the shoulder girdle and upper extremities, to maintain the supporting ability of the healthy lower limb, alternating with special. For damaged limbs recommend active finger movements of the foot, isometric muscle tension femur and tibia, active movements in the hip joint, ideomotor exercises for ankle joint. To improve circulation and reduce edema, it is necessary to periodically lower an injured leg from the bed, giving her exalted position. 3-5 days after the injury it is allowed to move within the chamber, and then into the office with crutches.
In postmobilization the period of physical exercises are applied with the aim of restoring movement in the ankle joint, the spring function of the foot, struggle with swelling of the damaged limb, for the prevention of traumatic flat feet and curvature of the fingers, the acquisition of skills for independent movement. In the class along with respiratory and General developmental exercises covering all muscle groups, include special. In the early days all special exercises should be performed in light conditions (under a foot down a sliding surface, use roller carts, skid-mounted unit, a special rocking, webbing). Recommended active finger movements of the foot and the ankle and knee joints (capture small items, their contents, the movement of the foot, dorsal and plantar flexion, supination and pronation, the foot rolls a tennis ball, etc.). Gradually the amplitude of movements increases. Exercises associated with muscle tension, on duty with the relaxation of muscles. Exercises are performed in their original positions supine, prone, side, standing on four legs, sitting. It is desirable to perform exercises in warm water.
further included in the procedure of medical gymnastics swing limb movements, exercises with weights and resistance, gymnastic wall, with gymnastic items. Significant place in the recovery period, pay to the exercises in different versions of walk: on toes, on heels, on the outer arch of the foot, forward, sideways, crossover step, in a crouched position; exercises with the support of the foot on the crossbar gymnastic wall, a stationary bike, etc.
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