ISSN 2415-3060 (print), ISSN 2522-4972 (online)
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УЖМБС 2017, 2(4): 59–63
Clinical Medicine

Physical Rehabilitation of Psychonevrological Assylum Elderly Patients with Femoral Neck Fracture without Complications

Gutareva N. V.1, Gutarev V. V.2

Problems of curing various types of injuries are quite widely covered in the Ukrainian and foreign literature but quite insufficiently. The organization of trauma and orthopedic care and the prevention of injuries are not fully discussed. Trauma rehabilitation is the process of using physical therapy, manual therapy, physical exercises, traction stretching and other exercises aimed at restoring the ability to continue moving either independently or with the help of any device. As a rule, rehabilitation courses are conducted in hospital under the strict supervision of doctors. It is difficult to overestimate the importance of rehabilitation to restore full physical capacity, since there is a high probability of repeated trauma or development of complications without effective rehabilitation. To understand how the femoral neck fracture occurs in the elderly and old people, one must know the structural features of this part of the body. The site is prone to injury, covered only by the joint capsule covering the periosteum. The arteries responsible for supplying the head and neck with blood pass through the lower edge of the joint capsule. Directly to the head there is only one artery, which is in a bundle, connecting it and the hollow of the joint. But it is overgrown in the elderly. Here the blood supply goes only from below, from the cervical spine. If the bone is refracted close to the head, then it ceases to receive blood. As a result, the tissues die and eventually dissolve. Certain pathological changes occur in damaged tissues. This fact must be taken into account before starting treatment. So, in the case of muscle injury, tendons, the initial reaction is a microcirculation that occurs when the capillaries break around these structures, which quickly spreads to neighboring tissues, increasing the traumatized zone. This initial stage leads to a local inflammatory response, the severity of which determines the duration of the recovery process. As is known, the process of inflammation in the tissues is accompanied by edema, local hyperthermia, hyperemia, pain and impaired function. Thus the task of therapeutic influence is reduced to minimizing these manifestations and accelerating the process of regeneration of damaged tissues. Immobilization of the injured limb is recommended for the first 3 days. Like any other damage of bone tissue, the presented trauma is accompanied by the development of a serious pain syndrome. The main localization of discomfort is the inguinal region. Here the pain is progressive. The leg is visually shortened with the femoral neck fracture. This leads to a reflex reduction in muscle mass. The strained musculature automatically pulls the limb upward, reducing its length. A direct sign of injury is the lack of the possibility of raising the leg in a supine position. At the same time, the foot can unnaturally turn outward. In the best case, it will only be possible to flex the limb slightly in the knee. Sometimes with a femoral neck fracture the pain is completely tolerated. While retaining the ability to lean on the leg, the injured may assume that the discomfort is caused by a dislocation or a slaughter. The result of untimely detection of the problem and the lack of appropriate therapy is often complications in the form of suppuration, inflammation of soft tissues, necrosis of bones and joints. Rehabilitation of patients after the trauma pursues several goals; the main one of them is the most rapid restoration of the body's functions, which should take place in the shortest possible time. The tasks of rehabilitation in general are individual as everything depends on the following factors: the nature of the injury; dynamics of the recovery process; data obtained after the survey; a type of activity in life. The rehabilitation program should always be individual and developed according to different criteria. The peculiarity of this program is that it is able to quickly return the patient to the previous activity. Regular physical exertion is an indispensable condition for the injured, who count on early restoration of activity. During the therapy, specialists develop a complex of motor and respiratory exercises, with the help of which rehabilitation after the operation of a femoral neck fracture occurs. The transition to the cane with the gradual complication of training is possible in a few months from the start of the rehabilitation program. The practice shows that the terms of successful rehabilitation after femoral neck fracture depend on the effectiveness of treatment methods, the competent development of a therapy program. The timely first aid is also significant for restoring limb mobility. It is necessary to begin rehabilitation 2-3 days after the operation. To consolidate the results, it may be necessary to undergo several consecutive courses of restorative therapy.

Keywords: physical rehabilitation (FR), exercise therapy, elderly patients, femoral neck fracture

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