Fratura Diafisária do Fêmur TRATAMENTO FISIOTERAPIA PÓS OPERATÓRIO COMPLETO Clínica Dr. Robson Sitta

▼ Dr. ROBSON SITTA PHYSIOTHERAPY CLINIC (11)2528.4661 Call and schedule your appointment Rua Coriolano 1480 - Vila Romana (Lapa), SP JOIN MY SOCIAL NETWORKS: ▼ SUBSCRIBE on YOUTUBE: https://www.youtube.com/channel/UCb7a... ▼ Visit OFFICIAL SITE: www.fisiositta.com.br ▼ LIKE on FACEBOOK: https://www.facebook.com/fisiositta?f... ▼ ADD on LINKEDIN:   / robson-sit.  . ▼ FOLLOW on INSTAGRAM:   / robson.sitta   SPECIALIZED PHYSIOTHERAPY in ORTHOPEDICS & MANUAL THERAPY Post-Operative Physiotherapy Treatment for Diaphyseal Fracture of the Femur Fixed with Intramedullary Nail ........... Post-Operative Physiotherapy Treatment for Diaphyseal Fracture of the Femur with Intramedullary Nail INTRODUCTION The classic indication for intramedullary nails developed by Küntscher(13,14) are transverse and short oblique femoral fractures at the level of the isthmus. However, the treatment of diaphyseal fractures located above and below the isthmus represents a more difficult problem, since the medullary canal is wider and the nail does not provide stability. Currently, femoral fractures are more complex, because the injuries result from traumas with a high degree of kinetic energy. As a result, the fractures have become more comminuted, more unstable and, generally, are not isolated, with other body segments also being affected. On the other hand, the soft tissues surrounding the fractures should be treated in a less aggressive manner. The minimal manipulation of this bone envelope is important in maintaining the irrigation of the fragments, while the hematoma is important in the bone consolidation process. The use of the intramodular locked nail for the treatment of comminuted diaphyseal fractures of the femur aims to restore the function of the affected limb, provide early mobilization for polytrauma patients, reduce the risk of cardiopulmonary complications, and allow for small mobility at the fracture site, stimulating the formation of secondary bone callus. By using closed-focus techniques, the hematoma of the femoral fracture and its periosteal blood supply are minimally damaged and the consolidation process progresses more quickly with a low risk of infection, delayed consolidation, and shortening. In most comminuted femoral shaft fractures, non-locking intramedullary nails, although they can be inserted in a closed focus, are unable to control rotation and telescoping between the fragments. Locking intramedullary nails combine closed focus intramedullary nailing with the insertion of screws that lock the bone and the nail. The method allows static locking that controls rotation and telescoping, while allowing conversion to dynamic locking when necessary. Physiotherapy treatment is based on passive manipulation techniques, active-assisted, active-free exercises, active-resistance exercises, metabolic exercises, gait training at the appropriate time, positioning in bed, cryotherapy and electrotherapy, in addition to maintaining lung integrity through breathing exercises. It is extremely important to perform isometric exercises of the quadriceps, glutes and hamstrings, thus avoiding the reduction of muscle trophism (THOMSON, SKINNER & PIERCY, 1994; LIANZA, 2000). Physiotherapy also includes metabolic exercises and ankle exercises to improve venous return and also sliding massages to increase the pain threshold (THOMSON, SKINNER & PIERCY, 1994). Early joint mobilization and exercise in patients undergoing orthopedic surgery to correct a femoral shaft fracture is important to prevent atrophy and possible deformities in the joints of other organs and body systems, thus allowing for a shorter hospital stay and faster functional rehabilitation in the outpatient phase (KENDALL, 1995; KISNER & COLBY, 2004). The primary objectives of rehabilitation in fractured patients should primarily aim to relieve pain, reduce edema, maintain or restore joint range of motion, preserve the speed of fracture consolidation through activity, and return the patient to function as soon as possible. It is of fundamental importance that this treatment be given as soon as possible after surgery, so that the results are more significant and faster.