Patient's question:
7 years old, thoracic 12 stability fracture, no surgery performed, has been bedridden for over a hundred days so far, but still unable to get up, or feels lower back stiffness, even, the doctor said to implement rehabilitation exercises. Here, I sincerely hope for some expert and specific guidance on the methods of rehabilitation training...Doctor's answer:
Based on the symptoms and signs you have purchased, it is currently considered that the above symptoms are caused by a fracture of the 12th thoracic vertebra.Recommendations:
The early stage of rehabilitation, which is 1 to 2 weeks after the injury, is characterized by swelling, pain, and instability of the fracture site, making it prone to further displacement. Therefore, the primary goal of functional training during this phase is to enhance blood circulation in the affected limb to facilitate swelling reduction and fracture stabilization. The main form of rehabilitation training is isometric contraction of the injured limb muscles, which involves rhythmic static contractions and relaxations of the muscles without joint movement—what we commonly refer to as "tensing" and "relaxing." Through isometric contractions, muscle atrophy or adhesion can be prevented. During this phase, in principle, except for the joints above and below the fracture site that remain immobile, all other parts of the body should perform normal movements.
The middle stage of rehabilitation, from 2 weeks after the injury to the clinical diagnosis of fracture healing, is characterized by gradual swelling reduction, pain relief, fibrous connection at the fracture site, and the gradual formation of callus, leading to increasing stability. In addition to focusing on isometric contractions of the injured limb muscles, with the assistance of a rehabilitation therapist, gradual and complete restoration of movement in the joints near and far from the fracture site, as well as the joints above and below the fracture site, can be achieved. Gradually transition from passive to active movements to prevent adjacent joint range-of-motion limitations. When the condition permits, it is advisable to start early bed rest with full-body exercises. Additionally, physical therapy can be combined to achieve the goals of swelling reduction, blood stasis resolution, and callus formation.
At 5 to 6 weeks post-injury, sufficient callus has formed, allowing for further expansion of movement range and strength. Gradually enhance active flexion and extension movements of multiple joints to prevent muscle atrophy and joint stiffness. Fractures involving joint surfaces often result in significant joint dysfunction. Therefore, active non-weight-bearing joint movements should ideally begin around 2 weeks after fixation, followed by immobilization. Through the mutual compression and friction between articular cartilage surfaces, joint cartilage repair can be promoted, better shaping achieved, and joint adhesion prevented.
The late stage of rehabilitation occurs after clinical fracture healing or removal of external fixation. At this point, bony callus has formed, X-rays show visible healing, and bones have gained sufficient support. However, most patients still experience reduced joint range-of-motion in adjacent joints, muscle atrophy, and other functional impairments. The goal of rehabilitation during this phase is to fully restore joint range-of-motion in affected joints, increase muscle strength, and restore limb function. The main form of rehabilitation training is active joint movements of the injured limb and weight-bearing training, allowing joints to quickly and fully return to normal range-of-motion and limb strength. During recovery, rehabilitation can be combined with physical therapy and gait training.
Wishing you a speedy recovery. If you have any questions, feel free to consult again next time.