Rehabilitation precautions after bone plate removal

After the removal of the bone plate, the bone strength has not yet fully recovered. A scientific rehabilitation plan is needed to reduce the risk of refracture and promote functional recovery. The following are detailed precautions for postoperative rehabilitation, covering wound care, activity restrictions, rehabilitation training and complication prevention.

First, wound care and observation

Keep the wound clean and dry

Avoid getting the wound wet within 24 hours after the operation. Before the stitches are removed, clean the skin around the wound with a sterile cotton swab dipped in iodophor or normal saline every day. Do not touch the incision directly.

If the wound dressing is bleeding, oozing or contaminated, it should be replaced in time to prevent bacterial growth.

Monitor the healing of the wound

Observe whether the wound is red, swollen, hot, painful, oozing or has an unpleasant smell. If any of the above symptoms occur, it may indicate an infection and immediate medical attention is required.

The suture removal time is usually 10 to 14 days after the operation (adjusted according to the wound healing condition). After the suture removal, the wound still needs to be protected for 1 to 2 weeks to avoid vigorous exercise that may cause cracking.

Avoid scratching or rubbing the wound

Itching may occur during the wound healing process. Do not scratch to prevent damage to the new tissue or infection.

Second, activity restrictions and weight-bearing management

Early immobilization (1-4 weeks after surgery)

Removal of the upper limb bone plate: Avoid lifting heavy objects (such as wringing out towels or carrying heavy objects) within one week after the operation. Light physical activities (such as making fists and flexing and extending the elbow joint) can be gradually resumed two weeks after the operation.

Removal of the lower limb bone plate: Avoid full weight-bearing within 1-2 weeks after the operation. Use crutches or walking AIDS to assist walking. Gradually increase the weight-bearing ratio (such as transitioning from 25% to 50%) based on the re-examination results within 3-4 weeks after the operation.

Mid-term transition (4-8 weeks after surgery)

Upper limbs: Daily activities (such as writing and combing hair) can be resumed 4 weeks after the operation. Moderate-intensity labor (such as lifting items weighing less than 5 kilograms) can be attempted 6 weeks after the operation.

Lower limbs: Under the guidance of a doctor, gradually transition to full weight-bearing 6 to 8 weeks after the operation, and avoid high-impact activities such as jumping and running.

Long-term precautions

Avoid strenuous exercise (such as basketball and football) within three months after the operation to prevent re-fracture when the bones have not fully recovered.

Avoid standing or walking for long periods within six months after the operation. Especially for patients with lower limb fractures, it is necessary to balance work and rest.

Third, rehabilitation training and functional recovery

Early rehabilitation (1-2 weeks after surgery)

Joint range of motion training: Perform joint flexion, extension and rotation exercises within a painless range, such as ankle pump exercises (500-1000 times a day) to prevent deep vein thrombosis in the lower extremities.

Isometric muscle contractions: Through training that tights the muscles without causing joint movement (such as quadriceps contractions), it promotes blood circulation and prevents muscle atrophy.

Mid-term rehabilitation (2-8 weeks after surgery)

Resistance training: Use resistance bands or light dumbbells for progressive resistance training to enhance muscle strength.

Balance and coordination training: such as standing on one leg (for patients with lower limb fractures), throwing and catching a ball (for patients with upper limb fractures), gradually restoring motor control ability.

Post-rehabilitation (8 weeks -6 months after the operation)

Functional recovery training: Personalized training plans are designed based on the fracture site. For instance, patients with knee fractures can undergo stair climbing training.

Proprioception training: Enhance joint stability through training with a balance board or an unstable plane.

Fourth, pain management and auxiliary measures

Pain control

Wound pain 2 to 3 days after the operation is a normal phenomenon. It can be relieved by applying ice packs (15 to 20 minutes each time, 3 to 4 times a day) and taking oral non-steroidal anti-inflammatory drugs (such as ibuprofen).

If the pain continues to worsen or occurs at night, be alert to infection or re-fracture and seek medical attention promptly.

Use of assistive devices

Lower extremity fractures: Use crutches or walking AIDS 1 to 2 weeks after the operation. Switch to a cane 3 to 4 weeks after the operation until full recovery.

Upper limb fractures: Use a sling to fix the affected limb within one week after the operation to prevent excessive sagging and swelling.

Physical therapy

From 4 weeks after the operation, physical therapies such as ultrasound and electrical stimulation can be combined to promote soft tissue repair and scar softening.

Fifth, diet and nutritional support

High-protein diet

Consume 1.2 to 1.5 grams of high-quality protein (such as fish, eggs, and soy products) per kilogram of body weight daily to promote wound healing and muscle repair.

Supplement calcium and vitamin D

Consume 1000-1200mg of calcium daily (such as from milk or green leafy vegetables) and 800-1000IU of vitamin D (through sun exposure or supplements) to enhance bone strength.

Control weight

Avoid rapid weight gain in the short term, reduce the burden on the lower limbs, and lower the risk of refracture.

Sixth, re-examination and long-term follow-up

Postoperative follow-up time

Two weeks after the operation: The first re-examination was conducted to assess wound healing and the risk of infection.

Six weeks after the operation: Recheck the X-ray films to confirm the bone healing condition.

Three months after the operation: Conduct a comprehensive assessment of joint function and muscle strength.

Six months after the operation: Final review to confirm whether it has fully recovered to the preoperative level.

Long-term follow-up

If persistent pain, joint stiffness or limited movement occurs after the operation, a follow-up visit should be made promptly to rule out complications such as traumatic arthritis and nonunion of bones.

Seventh, psychological support and living habits

Psychological adjustment

The recovery period for fractures is relatively long. Patients need to remain patient and avoid anxiety or depression affecting the rehabilitation outcome. Stress can be relieved through methods such as meditation and deep breathing.

Quit smoking and limit alcohol intake.

Smoking and excessive drinking can delay wound healing and bone repair. It is necessary to quit smoking completely and limit alcohol intake.

Sleep management

Ensure 7 to 8 hours of high-quality sleep every day. During sleep at night, elevate the affected limb to promote blood return and reduce swelling.