Recovery periods and exercise therapy after a displaced patellar fracture

A fracture of the patella (kneecap) is a fairly rare fracture and most often occurs when a person falls on a bent knee.

After removing the cast, rehabilitation is necessary, gradually engaging all the muscles and returning the mobility of the injured leg.

Specially selected exercises will help to effectively restore soft tissues and strengthen the muscles and ligaments of the knee joint.

Clothes should be loose, it is advisable to remove shoes. Perform all exercises (especially the first days) smoothly and gradually. Remember the important principle: “Endure mild pain, do not allow severe pain.”

Perform all exercises only after your doctor has approved the exercise!

Do these exercises daily for at least 2 weeks.

Lying leg stretch

Lying on the floor, next to the door. The healthy leg is pressed as close as possible to the doorway, and the one being worked out is raised up and rested with the heel on the wall next to the door. Try to keep your raised leg as straight as possible. You should feel a stretch in the back of your thigh and hold it for 15-30 seconds. Repeat 3 times.

Fracture of the knee joint.

Every day the knee joint experiences enormous stress. Therefore, it is quite easy to get a fracture. Considering that thanks to the legs a person has the ability to move, a fracture of the knee joint will force him to lead a sedentary lifestyle for several months. Moreover, of all types of fractures, injuries to the knee joint are the most common.

The knee joint is the most vulnerable joint to injury. When a person falls, quite often it is not possible to avoid fractures of the kneecap. This happens because a person, having slipped or tripped, usually falls on his bent leg. This most often causes a horizontal fracture. However, in sports or in production, injuries of a different kind also occur - when a blow of great force is applied to the straightened knee (most often this leads to a comminuted fracture), or when the trained muscle is extended too much, which leads to a separation of the lower part of the patella. The latter is often found among people who are serious about long and high jumps.

The patient's condition with such fractures is very serious. The ability to move independently is completely lost. Recovery from such an injury is difficult and difficult.

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Quadriceps strain

Stand at arm's length from a wall or other fixed support. Hold onto the wall with one hand. With your other hand, grab the leg you are working on by the ankle and pull your heel toward your buttock until you feel a stretch in the anterior thigh muscle. Keep your back straight and your knees together. Hold the stretch for 15-30 seconds. Repeat 3 times.

Rehabilitation after a fracture of the knee joint and patella

A splint, which is prescribed by most specialists, helps immobilize the knee joint. The principle of operation of a splint is similar to that of a cast, but the former has a significant advantage: it provides comfort. Also, its operation does not require professional knowledge.

The rehabilitation process after a knee fracture takes from 4 to 6 months. During this period, it is necessary to follow all the recommendations of a traumatologist, who will help make recovery more effective. Failure to take the necessary measures can lead to even more serious consequences, such as arthritis, the formation of adhesions and other serious complications.

There are also a number of exercises that the patient should perform in the first stage of rehabilitation after a knee fracture:

• Breathing exercises to improve blood circulation.
• Simple turns in bed or lifting of the body.
• Moving the toes of both feet, bending and straightening the fingers, swinging the legs in different directions.
• Self-massage the muscles of the cervical and shoulder regions, since walking on crutches leads to unnecessary stress.

Thus, we can say that the most important thing in any recovery period will be movement. Mobility of the whole body will prevent the muscles from forgetting their basic functions. You should always move, both while lying in bed and when walking with support.

A few words about the knee joint

Few people know the fact that in the list of movable joints of human bones, the knee joint is the most fragile. At first glance, everything is very simple: people squat, ride bicycles, and run every day. It is during these habitual exercises that the knee joint works: the knees bend.

In addition to its fragility, the knee joint is the largest. It consists of three bones:

• femoral
• fibular;
• tibial.

The two lower bones are connected by the miniscus. In turn, the femur is connected to the lower bones using ligaments and tendons, and the articular cartilage covering the bone of the intraknee joint ensures the soft operation of this natural “mechanism”.

Knee fractures: types

There are two types of fractures:

• closed;
• open.

In the second case, not only damage occurs to bone tissue, but also to muscles and skin. The closed type of fracture is characterized by intact skin.

Main causes of knee fracture

As practice shows, most fractures occur due to excessive physical exertion. That is, a fragile joint is not able to withstand the load that the human body requires of it.

The main causes of fractures should also be highlighted:

• blows of various types;
• bruises;
• injuries resulting from a fall.

As a result of the injuries, sharp pain, bruising, changes in the size and shape of the joints in the form of swelling and deformities are observed. An elevated body temperature is often observed. The only way to avoid problems with the knee joint is to consult a doctor in a timely manner. Lack of medical care can cause the development of arthrosis. Treatment with alternative medicine is strictly contraindicated.

Recovery after a fracture

We can talk about rehabilitation of the knee joint if the medical treatment was comprehensive. We are talking about a whole set of tools intended for therapeutic and self-treatment.

The maximum effect is possible only if all therapeutic and rehabilitation techniques have been used. These should include the following:

• treatment based on medication;
• treatment with physical education;
• massage treatments;
• use of physiotherapeutic methods.

It is possible to talk about the relevance of all methods or the exclusion of some only on the basis of a specific situation. In any case, rehabilitation after a knee fracture should be supervised by a specialist.

Rehabilitation using medications

At the first stage, the main issue is the elimination of pathological signs that are of a pronounced nature. Thus, rehabilitation after a fracture of the patella is accompanied by therapeutic exercises. In some cases, the patient may experience pain, which is a sign of inflammatory processes, as well as more serious causes, for example, insufficient recovery of muscles, tendons and ligaments.

Therefore, it is necessary to use medications:

• Analgesics (Nimesil, Diclofenac).
• Decongestants (capillary stabilizing) agents (L-Lysine escinate).
• Means for reducing muscle tone (“Mydocalm”).
• Vitamin preparations.
• Drugs that promote tissue resorption (Lydase).

Special balms, gels and ointments are also widely used. At the same time, after a fracture, all medications, with the exception of vitamin complexes, should be prescribed by a specialist. Otherwise, adverse consequences may occur.

Joint development: physical exercises

Therapeutic gymnastics is a mandatory means of rehabilitation after a knee fracture. Classes should be started only after the doctor’s recommendations. If the knee has been immobilized, special types of gymnastic exercises are required.

Basic exercises after a fracture are carried out in the early stages of rehabilitation. We are talking about the following exercises:

• passive movements of the joint (flexion and extension). They can be performed using hands or improvised materials, such as straps;
• circular movements of the foot;
• movements of the toes;
• grabbing small objects with your toes;
• lifting a limb from a lying position.

For complex fractures, rehabilitation is performed in a lighter version. A little later, you can move on to weights and performing gymnastic exercises while standing, providing axial load on the knee joint.

Reviews from our clients

I decided to recover in the Baltiysky center, since I live nearby and going to the clinic was not at all convenient, especially since there were queues.
I was prescribed an individual program with physical therapy, massages, and I also chose swimming as a restorative. The rehabilitation took about a month, the result was excellent. Victoria

She took me to the rehabilitation center to select individual recovery programs for each patient based on the characteristics of the injury. Accuracy and smoothness are the key to a quick and successful recovery.

Massage and physiotherapy

Massage will help develop the knee joint after a fracture. You should begin to implement it while wearing a cast, at the stage of immobilization. This can improve blood circulation and also reduce discomfort and pain in the knee. The muscles will remain toned, and the swelling will gradually begin to go away.

After the cast is removed, massage will help prepare the knee for subsequent physical activity. It is important to knead and rub not the joint itself, but the soft tissues that are around it. Manual or hardware lymphatic drainage and hydromassage help well against edema.

Additionally, the doctor may prescribe;

• UHF and magnetic therapy;
• Electrophoresis;
• Paraffin and laser sessions.

Symptoms

Typically, this type of injury occurs after a person falls on the kneecap and may be accompanied by tendon rupture. The presence of a patellar fracture will be indicated by:

• severe swelling of the soft tissues in the area of ​​the kneecap;
• severe pain when feeling the injury site;
• the presence of a gap in the knee joint, which can be felt by palpation;
• accumulation of blood (a soft formation with unclear boundaries is palpated);
• often – pathological mobility of the knee and a clearly visible crunching of the bones.

If a non-displaced fracture of the patella occurs, the victim can walk, but will limp and feel severe pain. Even a slight displacement of bone fragments leads to the fact that the joint will not bend.

What is the danger of a hip fracture?

Doctors believe that a hip fracture is not so dangerous as the complications it leads to. In older people, after injury, a number of concomitant diseases begin to appear.

A hip fracture disrupts the integrity of the muscles and vessels through which blood circulates, delivering nutrients and oxygen to cells. Due to injury, blood circulation in the injured limb is disrupted. Necrosis of the head of the bone occurs due to lack of nutrition. This situation leads to its decomposition and complete disappearance - aseptic necrosis.

Not every elderly patient can be cured surgically. If surgery for an injury is contraindicated for medical reasons, the person is treated with immobilization. A pensioner with a hip fracture remains in a supine position for about 6-8 months. He must not roll over on his side or stand up.

Being immobile increases the risk of developing pressure sores on protruding bones: the sacrum and heels. Mucus accumulates in the lungs, which can lead to pneumonia. A sedentary lifestyle causes intestinal atony. This is fraught with constipation and general intoxication of the body. Inflammatory processes may begin in the stomach, intestines, and bile ducts.

A recumbent lifestyle provokes the development of thromboembolism - the formation of blood clots on the walls of the main arteries. At any moment, a blood clot can break away from the walls, rush through the bloodstream to the heart and lead to death.

Mental complications are observed. Limited movements and space, pain, and one’s own powerlessness to change the situation negatively affect a person’s emotional state. Against this background, psychosis and depression develop. Some patients with a hip fracture cannot withstand conservative treatment and die.

Classification and description

There are several types of this injury:

• closed fracture of the patella - there is damage to the bone, but it does not communicate with the external environment;
• open - in this case there is a communication between the fracture area and the external environment.

Depending on the projection in which the patella fracture occurred, it can be longitudinal or transverse.

A comminuted fracture of the patella is defined as bone fragments forming at the fracture site.

In addition, a displaced fracture of the patella is distinguished - this diagnosis is made if the bone fragments have shifted after a fracture of the patella.

Clinical picture

The injury is accompanied by a number of characteristic signs.

• It is always intra-articular.
• Hemarthrosis is present.
• The damaged area swells.
• The victim is forced to hold his leg in a certain position, slightly bending it at the knee and pointing it to the side.
• If the ligamentous apparatus is damaged due to mechanical impact, it is impossible to lift the leg, and movements in the lower leg are also impossible.
• On palpation, the patella balls out.
• If a fracture occurs with the appearance of fragments, they are located at a certain distance from one another and cause sharp pain.

Remember! Only a specialist can make an accurate diagnosis. To determine the specifics of the injury, X-ray diagnostics is required. This is the only way to determine the complexity of the damage, the number of fragments and the degree of their displacement.

Signs of a hip fracture

Elderly people fall from their own height causing injuries. A person does not immediately understand that a hip fracture has occurred because he retains general mobility. If a pensioner lives alone, he may not seek medical help for several days. And at this time, the vessels located next to the wound will be injured by the sharp edges of the debris.

Typical signs of injury include the following:

• Persistent pain in the groin. It is not pronounced, a person is able to tolerate it for some time. Pensioners often mistake painful sensations for a manifestation of osteoporosis or arthrosis. Gradually, the pain intensifies, especially when supporting the heel area of ​​the foot or active movements.
• Turn the foot outward. Rotation becomes noticeable when carefully examining the position of the foot in relation to the knee.
• Leg length difference. The affected limb is shortened by about 4 cm. The unusual phenomenon is explained by the contraction of muscles that are grouped next to the injured joint.
• Inability to keep the foot in a horizontal position. The leg retains the function of flexion-extension, but is not held in a horizontal plane by weight and slides down.
• The appearance of a hematoma in the fracture area.
• Pain and discomfort when tapping and pressing on the heel of the injured leg.
• Crunching in the injured leg when trying to change its position.

The presence of even one of the listed signs indicates serious disorders that require medical attention. Before the ambulance arrives, the pensioner is placed on a hard surface, given an analgesic, and the injured leg is fixed from the inside and outside, starting from the groin area, with splints or improvised materials.