postoperative management of hip fractures severe, persistent groin, thigh knee pain that increases...
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Postoperative Management of hip fractures
Severe, persistent groin, thigh knee pain that increases with limb
movement or weight bearing progressive limb length inequality Persistent external rotation of the
operated limb A positive Trendelenburg sign during
weight bearing
Signs and Symptoms of Possible Failure of the Internal Fixation Mechanism
Postoperative Management
Exercise: Maximum Protection Phase Prevent vascular and pulmonary complications. Improve strength in the upper and sound lower
extremities. Prevent postoperative reflex inhibition of hip and
knee musculature Restore active mobility and dynamic control of
the involved hip and adjacent joints
Postoperative Management
Exercise: Moderate and Minimum Protection Phases
Increase flexibility of any chronically shortened improve strength and muscular endurance in
the lower extremities for functional activities. Improve postural stability and standing balance. increase aerobic capacity/cardiopulmonary
endurance
PAINFUL HIP SYNDROMES/OVERUSE SYNDROMES:
NONOPERATIVE MANAGEMENT
• Related Pathologies and Etiology of Symptoms
• Tendinitis or Muscle Pull
• Trochanteric Bursitis
• Psoas Bursitis
• Ischiogluteal Bursitis (Tailor’s or Weaver’s Bottom)
Common Impairments and Functional
Limitations/Disabilities
• Pain• Gait deviations.• Imbalance in muscle
flexibility and strength.
• Decreased muscular endurance.
Management: Protection Phase
• Control Inflammation and Promote Healing
• Develop Support in Related Areas
Management: Controlled Motion Phase
• Develop a Strong Mobile Scar and Regain Flexibility.
• Develop a Balance in Length an Strength of the Hip Muscles.
• Develop Stability and Closed-Chain Function.• Develop Muscle and Cardiopulmonary
Endurance.• Patient Education
Management: Return to Function Phase
• Progress Strength and Functional Control
• Return to Function
Techniques to StretchRange-Limiting Hip Structures
To Increase Hip ExtensionModified Fencer Thomas Test Stretch
Stretch
Techniques to StretchRange-Limiting Hip Structures
Self-stretching of the
adductor muscles
with the hips
at 90
Techniques to StretchRange-Limiting Hip Structures
Self-stretching the tensor
fasciae latae occurs as the
trunk bends away from
and the pelvis shifts
toward the tight side.
Techniques to StretchRange-Limiting Hip Structures
Tensor fasciae latae self-stretching: side-lying position
EXERCISESTO DEVELOPANDIMPROVE MUSCLE PERFORMANCE
AND FUNCTIONAL CONTROL
Isolated training and strengthening of the gluteus maximus.
EXERCISESTO DEVELOPANDIMPROVE MUSCLE PERFORMANCE
AND FUNCTIONAL CONTROL
Training and strengthening the hip adductors.
Closed-Chain Weight-Bearing Exercises
Training the hip abductor and hiker muscles for frontal plane strenthening and stability.
Closed-Chain Weight-Bearing Exercises
Closed-chain exercise with elastic resistance around the
opposite leg
Closed-Chain Weight-Bearing Exercises
Training and strengthening the hip extensor muscles using
bridging exercises.
Closed-Chain Weight-Bearing Exercises
Lunge with cane assistance to develop balance and control
for lowering body weight.
Closed-Chain Weight-Bearing Exercises
Wall slides/partial squats to develop eccentric control of body
weight.
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