Fractures of the lower leg require long-term treatment with immobilization of the injured leg: a closed fracture of the lower leg without displacement or with a slight displacement of fragments is treated by applying a plaster cast for an average of 2-2.5 months, with an open fracture and fractures with longitudinal displacement, it becomes necessary in longer immobilization after skeletal tension or surgery.
Therapeutic exercises for a fracture of the lower leg should begin from the first days in the absence of pain at the fracture site and with a good general condition of the patient. The next day after traction is applied, recovery procedures begin in the form of massage and exercises of the uninjured leg, superficial massage of the thigh of the injured leg and movements in the ankle joint. Lower leg fractures heal faster with early transition to minor active movements in the knee joint (by pulling up the weight). The resulting tensile stress in the fragments contributes to the activation of regeneration processes. After about 4 weeks, knee flexion to almost a right angle is possible.
From the moment the plaster cast is applied, the patient gradually stays in an upright position. The next day, you can sit up in bed with your leg dangling, and also put your foot on the floor without load. On the third day, it is allowed to stand by the bed, holding on to a support (chair or bed frame). At the end of the exercises, be sure to give the leg an elevated position. Proper walking with crutches is started in 4-5 days.
From the first days of walking, you should rely on a plaster cast. This creates an axial load of the injured limb, which is necessary for the functional training of the callus. Due to the micro-movement of fragments, rapid fusion occurs with the formation of a massive callus. In the absence of such a load, consolidation slows down and severe osteoporosis develops.
The goal of physical therapy after a fracture of the lower leg at this stage is the transition from a dosed constant load of the sore leg when walking with crutches to constant and full loads, allowing movement without crutches. With an increase in load, one should focus on the appearance of pain: walking should be accompanied by minor pain sensations, in which protective reparative processes are activated, aimed at eliminating the irritant. Excessive pain indicates a significant traumatization of the callus, which leads to a slowdown in regeneration.
Fractures of the lower leg are treated more effectively when performing special therapeutic exercises (6-8 movements each):
- In the supine position isperforming back and plantar flexion of the feet, isometric tension of the thigh muscles (up to 5 times for 5 seconds), alternate flexion and extension of the legs at the knee joint when sliding the foot on the bed, alternate abduction and adduction of the leg when sliding on the bed, grabbing and holding small objects with the fingers feet, circular movements of the feet and imitation of walking in bed.
- Lying on the stomach, bend and unbend the leg at the knee joint, take the straight leg back and to the side.
- Lying on your side, take your straight leg to the side and hold it in this position for up to 5 seconds.
- In the sitting position, bend and unbend the toes, roll the medicine ball back and forth with the fingers, roll the foot from heel to toe.
Fractures of the lower leg are treated effectively only with the active participation of the patient in rehabilitation measures, one of which is physiotherapy exercises. Only with a clear understanding of the goals and details of rehabilitation treatment will the patient be able to mobilize his will for regular and persistent exercise.
