Сучасні уявлення про фізичну терапію пацієнтів після оперативного лікування переломів кісток гомілково-надп’яткового суглоба

Abstract

The purpose of the study is to determine and analyze modern means of restoring motor functions used for patients with fractures of the ankle joint bones after surgical treatment. Materials and methods. The work is the result of analysis and generalization of special scientific and methodological literature of domestic and foreign authors and Internet data on the features of the use of modern methods of physical therapy for patients with fractures of the ankle joint bones after surgical treatment. Results and discussion. Physical therapy for patients with fractures of the ankle joint bones is integral to a speedy recovery. Due to the fact that after surgery, it is mandatory to apply a plaster cast or a fixator to the joint for about 6 weeks – the strength of the lower extremities is lost, joint contracture appears, there is aching pain and a decrease in the range of motion. It is necessary to start classes with a physical therapist as early as possible, already on the second day after the operation, if the general condition of the patient is satisfactory. Patients require early postoperative functional physical therapy under the supervision of a physical therapist to improve joint function and proprioception, and to promote edema regression (lymphatic drainage). Patients with fractures associated with ligament injuries especially require proprioceptive neuromuscular facilitation to protect them from the risk of chronic ankle instability. Generally, recovery for patients with this trauma is slow and requires patience. There is some evidence that early introduction of activity during the immobilization period may be beneficial for patients. By doing light ankle exercises, the range of motion is improved, pain disappears and the function of the joint improves. Also, early stress on body weight is associated with many benefits, including better mobility, shorter hospital stays, and earlier return to work. However, there are other claims that early exercise increases the risk of surgical site infection, reoperation, and surgical fixation failure. Given the lack of evidence to determine it should be noted that additional research is needed to address this issue. Conclusions. Current evidence on the physical therapy of fractures of the ankle joint bones after immobilization shows that separate physical therapies do not accelerate the recovery process. This suggests that physical therapy must be comprehensive and must necessarily focus on a progressive and structured exercise program. Also, recent studies have shown that exercise is an effective mean of physical therapy, especially balance exercises