Abstract
The purpose of the paper is to prove the efficacy of a kinesitherapeutic program intherecovery of a patient with trimalleolar fractureofthe left lower limb.We present a 42-year-old patient with a trimalleolar fracture and paresis of n. peroneus communis. Kinesitherapy was performed after thirteen weeks of surgery for ten consecutive days. The kinesitherapeuticmeans included: cryotherapy, lymphatic drainage massage, isometric contractions for the femur muscles, active exercises with and without resistance, active exercises with and on gymnastic apparatuses, post-isometric relaxation for the sciatic musculature and m. triceps surai, training in walking.As a result of the kinesitherapeutic exercises, the ankle swelling decreased.The volume of movement increased, pain was reduced as well as the muscle spasm in the ankle joint. The gait improved.
Highlights
It must be able to absorb the forces of the reaction of the support and adapt to the unevenness of the ground, as well as and stand as a rigid mechanical lever, which performs the body propelling force in walking and running (Holevic 2008). Trimalleolar fractures affect both malleoli and the calcaneus These fractures are due to high energy trauma
The pain symptom reduced due to improved afferentation (Abeilon et al 2007), at the end of the course of treatment, the pain manifested itself only in the final volume of motion in plantar flexion.(Popov 2009b)
Despite the partially improved stabilizer function of mm. fibularis lonqus et fibularis brevis, postural reactions were disturbed in the lateral direction, and we recommended to the patient ankle-foot orthosis, which contribute to the improvement ofresponses to all perturbations to the affected side (Cikajlo et al 2016)
Summary
The ankle structure is consistent with providing stability and mobility in the distal part of the lower limb (Becheva et al 2016a).The foot should be a stable base and take the body weight while standing with minimal expenditure of muscle energy. It must be able to absorb the forces of the reaction of the support and adapt to the unevenness of the ground, as well as and stand as a rigid mechanical lever, which performs the body propelling force in walking and running (Holevic 2008). Trimalleolar fractures affect both malleoli and the calcaneus These fractures are due to high energy trauma. The mechanism of sustaining a trimalleolar fracture can be attributed to forces acting on the longitudinal axis of the shank with strong foot flexion. The talus exerts a strong pressure on the back of the joint surface, causing a fracture at the back of Volmann (Vladimirov 2000)
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