The method of rehabilitation of patients with fractures of the pelvis

 

(57) Abstract:

The invention relates to medicine, namely to physiotherapy, and is intended for the rehabilitation of patients in the treatment of fractures of the pelvis. Use Selenomethionine fluctuosa noise currents in the frequency range from 0.5 to 10000 Hz, close to the physiological modulated low frequency 57 to 10 Hz for electrical stimulation. In this first impact on biologically active points BA Liao in the "running" of a wave with a frequency of amplitude modulation (AM) of 0.5 Hz, with amperage to moderate asynchronous vibration. Then stimulate the muscles of the hip joints from damage to the pelvic bones and the intact limb in modes pulse generation with sending a pause of 1:2-1:3 and "running" wave AM 0.5 Hz at current strength to weak contractions of the muscles of the pelvic complex. The treatment is 8-15 daily procedures, and the total duration of the procedure is 8-15 minutes Method allows you to create optimal conditions for reparative processes in the zone of fracture due to the stimulation of the muscle and ligaments of the pelvic complex in the early rehabilitation period, to increase the effectiveness of rehabilitation.

The invention relates to a medical is CLASS="ptx2">There is a method of treatment of fractures with the use of calcium - and phosphorus-electrophoresis galvanic current (Milbrath I. M., Grigorieva C. D. damage to the locomotor organs // Balneology and physiotherapy. So 2. M.: Medicine, 1985, c.377; Cornelius C. M., Orlov, A. N., Kornilov, I. and other Rehabilitation of patients with bone fractures // Medical rehabilitation. So 2. M - Perm: IPK “Star”, 1998, c.386). Medicinal electrophoresis, resulting from the reflex and humoral effects of DC and farmakologicheski money, good for travelinformation in the tissue and increases tissue metabolism, reducing inflammation and pain in the damaged area.

However, continuous supply galvanic current causes adaptation phenomena in tissues to this current, which, in turn, reduces the reparative processes in travmaticheskii damaged formations, in addition, it eliminates the possibility electrostimulation effects on the musculo-ligamentous apparatus.

Also known is a method of treatment of fractures by formirovaniya calcium and phosphorus sinusoidal modulated currents - CMT (Milbrath I. M., Grigorieva C. D. damage to the musculoskeletal Delov A. N., Kornilov, I. and other Rehabilitation of patients with bone fractures // Medical rehabilitation. So 2. M - Perm: IPK “Star”, 1998, c.388).

However, the ITC did not differ physiological effects on the neuro-muscular and musculo-ligamentous apparatus of warm-blooded animals, in the form of a sinusoidal or half-sine of an electrical signal, is not characteristic of living excitable systems (Krasnogorsk N. In. The electromagnetic field in the biosphere. So 1. M.: Nauka, 1984, S. 5-11). The exponential signal is used without padding pulse carrier frequency. Rectified CMT mode and constant exponential pulses, which are formirovanie and muscle stimulation, are quite hard and, in some cases, poorly tolerated by patients. In addition, the rhythmic effect of the same character pulses and oscillations of currents causes a rapid onset of adaptation tissues, reduces positive sanogenetic shifts, in particular in the treatment of fractures of the pelvis, i.e., the reparative processes in the fracture area slowed down.

There is a method of rehabilitation of patients with bone fractures by acting on the area of corruption currents of low frequency with exponential pulse shape and frequency, However, the mode of stimulation of the muscles constant exponential current is quite “rough” effect, the same procedure in the late recovery period does not affect the reparative processes in the fracture area, and only helps to restore muscle tone, improves circulation and removes blood stagnation.

The task is to optimize conditions for reparative processes in the zone of fracture due to the stimulation of the muscle and ligaments of the pelvic complex in the early rehabilitation period.

In the proposed method of rehabilitation of patients with fractures of the pelvis by electrostimulation of muscles currents of low frequency according to the invention is used Selenomethionine fluctuosa noise currents in the frequency range close to the physiological, from 0.5 to 10000 Hz, modulated by a low frequency from 57 to 10 Hz, with the first impact on biologically active points BA Liao in the “running” of a wave with a frequency of amplitude modulation (AM) of 0.5 Hz, with amperage to moderate asynchronous vibration, then the muscles of the hip joints from damage to the pelvic bones and the intact limb in modes pulse generation with make-break 1:2-1:3, and “running” wave AM 0.5 Hz at current strength to weak contractions of the muscles of the pelvic complex. When treatment status is the scrap of bone in the area of injury occurs the source of irritation, which puts in place mechanisms of reparative regeneration - bone healing wounds. The process of bone regeneration is a very complex interweaving of the overall impact on the system level and local changes in tissue metabolism, and, in addition, it is closely related to environmental conditions, resulting in the fracture area (Balneology and physiotherapy/edited by Professor C. M. Bogolyubov. So 2. M., 1985, S. 371).

The study authors showed that the impact flucturion currents (with the specified parameters) on the musculo-ligamentous apparatus of the damage zone after mapping and durable fixation of bone fragments help to create optimal conditions for reparative processes. When arrhythmic contractions of the muscles is restored lost function, improved nervous regulation, improves blood and lymph circulation, activates the enzymatic activity, increased phagocytic activity of leukocytes, accelerate the process of regeneration. Electrical signal slozhnolegirovannyh fluctuating noise currents in the frequency range close to the physiological (from 0.5 to 10000 Hz), consistent with its biological rhythms neuromuscular apparatus, and the modulation of its low frequencies from 57 to 10 Hz provides the actor pulses. The use of fluctuating currents analgesic, anti-inflammatory, resolving action that reduces the risk of suppurative inflammation in the zone of fracture. Such use of electric current in the beginning of the procedure on biologically active points BA Liao in the “running” of a wave with amplitude modulation 0.5 Hz held up to moderate asynchronous vibration activates the human body and affects the muscles of the pelvic complex in General. Impact on the hip joint from damage and on the intact limb is called current mode pulse generation with make-break 1:2-1:3 (change of pulse durations noise current is performed automatically, creating a constant squareknot output and maximum energy characteristic of the electrical impulse), and “running” wave with amplitude modulation 0.5 Hz provides electrical stimulation of the neuromuscular tissue of the pelvic region at any depth, stimulating the process of osteoreparative. Thus the penetration depth of the electric current in the tissues of the musculo-ligamentous apparatus depends on the type of its modulation.

Thus, when using the organization of reparative processes, and, consequently, the effectiveness of rehabilitation.

The method is as follows. Use the device electro-therapy slozhnolegirovannyj fluctuating currents “EMIC-1” manufactured by the company MAGNON, ,Yekaterinburg (License of RF Ministry of health No. 42/99-531-0808 from 20.05.99,), which can work together with the unit “running” waves.

Rehabilitation patients spend in the early stages after closed reduction and reliable fixation of bone fragments pelvic bone with external fixation device. First, produce the effect of electric current on biologically active points (BAP) BA Liao within 1-2 minutes For this data BAHT, located in the lumbar area, establish special local electrodes not exceeding 0.5-1 cm in diameter. The number of electrodes can be from 3 to 5, depending on the severity of the fracture. The electrodes serves the electric current in the “traveling wave” with a frequency of amplitude modulation (AM) of 0.5 Hz. Then spend physiotherapy hip joints in the modes of pulse generation and the “traveling wave”, first by damage to pelvic bone, and then the intact limb, the duration of the procedure 6-15 minutes For this two plate electrode ROCOM with parameters: frequency fljuktuirujushchee current - 0.5 to 10000 Hz, frequency of modulation - 57-10 Hz, pulse generation is 1:2-1:3, amplitude modulation “traveling wave” - 0.5 Hz, the amplitude value of the current - to moderate severe asynchronous vibration, bring to a weak contractions of the muscles of the pelvic girdle (current 8-25 mA). The total duration of the procedure is 8-15 minutes treatment daily and is 8-15 procedures.

Example. Patient S. was admitted to the hospital, UNITO with a diagnosis of fracture of the right pubic and ischial bones with damage to the ligaments of the pubic and the right sacroiliac joint. On the 3rd day after receipt conducted transosseous osteosynthesis damage pelvic external fixation device. 2 days after the operation assigned to the treatment slozhnolegirovannyj fluktuiruyushchimi currents above described method. Treatments were carried out daily, the rate amounted to 10 treatments. Patient activated on the 5th day after the operation, are allowed to walk with crutches. Radiographic control showed that the fracture in the area of fractures and breaks connections pelvis came at the optimal time to 8 weeks after injury. Distant anatomical and functional result is good.

The method of rehabilitation of patients with fractures of the pelvis by electros the bathrooms fluctuosa noise currents in the frequency range from 0.5 to 10000 Hz, close to the physiological modulated low frequency 57 to 10 Hz, with the first impact on biologically active points BA Liao, in the mode of travelling waves with a frequency of amplitude modulation (AM) of 0.5 Hz amperage to moderate asynchronous vibration, then stimulate the muscles of the hip joints from damage to the pelvic bones and the intact limb in modes pulse generation with sending a pause of 1:2-1:3 and "running" wave AM 0.5 Hz at current strength to weak contractions of the muscles of the pelvic complex, when this treatment is 8-15 daily procedures, and the total duration of the procedure is 8-15 minutes



 

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