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How to prevent orthotic ankle joint deformity after amputation

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How to prevent orthotic ankle joint deformity after amputation

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[Abstract]:
How to prevent orthotic ankle joint deformity after amputation
1. Keep good posture. 2. Eliminate the swelling of residual limbs.Establishment of psychological rehabilitation system

How to prevent orthotic ankle joint deformity after amputation

1. Keep good posture. Keep the correct position of the residual limb and prevent the contracture and deformity of the residual limb joint. Because some muscles are cut off after amputation, it will cause muscle force imbalance and orthotic ankle joint contracture. For example, hip flexion, hip abduction, knee flexion and ankle metatarsal flexion will affect the alignment of prosthesis. After the operation, the joint should be placed in the functional position, and early functional exercise should be carried out to make the orthotic ankle joint flexible without deformity. The pillow can be placed under the affected limb within 24 hours after the operation to reduce swelling. The pillow should be removed after 24 hours to prevent joint contracture and deformation. Therefore, the amputee should pay attention to the extension of the residual limb (hip extension), and try to close to the middle of the body (hip adduction). Amputees can lie prone twice a day for 30 minutes. When lying on your back, you should not try to be comfortable or raise the affected area to relieve the pain, or raise the residual limb, or put a pillow on the perineum to make the thigh outspread; you should take a wheelchair for a long time, use a wooden crutch to lift the residual limb, etc.; you should not separate the residual limb outwards or raise the waist; after the leg amputation, you should pay attention to placing the knee joint of the residual side in the straight position, and should not put a pillow under the thigh or knee, You should not lie on the bed with your knees bent, or sit in a wheelchair with your knees bent, or put your limbs on the handle of a crutch.

2. Eliminate the swelling of residual limbs. Postoperative trauma, muscle contraction and venous reflux can cause swelling of the residual limbs. This kind of edema is temporary. It can be relieved after the circulation of the residual limb is established. It usually takes 3-6 months. But using elastic bandage and bandaging the stump properly can reduce the swelling and promote the shaping. In recent years, in the world, prostheses are installed immediately after amputation, that is, on the operating table, when the anesthesia is not clear after amputation, temporary prostheses can be installed for amputees. One or two days after the operation, they can get out of bed to practice walking or other functional training. This method not only has great psychological inspiration for amputees, but also helps to accelerate the design of disabled limbs, reduce phantom limb pain and other pain. There are also environmental control therapy, that is, after the operation, the stump without any dressing is put into a transparent air bag connected with an air conditioner to practice walking. The pressure in the vessel can be adjusted to make the residual limb contract and shape, and promote the early shape of the residual limb.

How to carry out psychological rehabilitation after installing prosthesis

In addition to the preparation before the prosthesis installation, some psychological rehabilitation should be done. The psychological rehabilitation after the prosthesis installation needs systematic theory and method. The implementation of psychological rehabilitation mainly includes the following aspects:

Establishment of psychological rehabilitation system

1. The process of establishing individual psychological adjustment mechanism is to let the disabled establish individual psychological adjustment mechanism, Let the disabled gradually adapt to the changes in life, study, family or work and face various difficulties through systematic psychological intervention, and form a positive psychological adjustment mechanism on this basis to cope with various possible psychological problems and maintain mental health.

2. Establish assistance and support system for relevant personnel (colleagues or family members, etc.) the disabled live in a certain group, The attitude of relevant personnel has an important influence on their mental state, especially the attitude of family members, colleagues, patients and other closely related personnel is very important for the adjustment of their mental state. Therefore, psychological rehabilitation should not only pay attention to the patients' own psychology and changes, but also pay attention to the psychological counseling work of these personnel, so that they can understand the disability In order to create a good psychological atmosphere for the psychological rehabilitation of the disabled, we should relieve the psychological pressure caused by the disabled patients in families and small groups.

3. It is a long-term adjustment process to establish expert assistance and support mechanism for psychological rehabilitation. In this process, the disabled should receive the guidance and help of experts, gradually get rid of the influence of negative psychology, and establish a positive life goal. Psychological doctors are specially trained personnel. They must master the theory and method of psychological consultation and treatment, have the skills and clinical experience of psychological treatment, and have the ability of extremely sensitive observation, analysis and problem-solving. Different from other clinical treatments, psychotherapy has its own special side. Only the specially trained personnel can do this work.

4. The rehabilitation of disabled people is often accompanied by the whole life process of disabled people. When disabled people return to their families and society, the support of the community assistance system is very important. We should play the role of relevant experts and relevant personnel in the community, and give necessary support and help at any time when disabled people have psychological problems, so as to better serve the hearts of disabled people Provide guarantee for rehabilitation.

5. The use of psychotherapy is the principle and method of psychotherapy used by psychologists to treat various psychological problems of patients, including emotional, cognitive and behavioral problems, so as to solve the psychological obstacles faced by patients, reduce mental symptoms such as anxiety, depression and panic, improve patients' non adaptive social behaviors, establish good interpersonal relationships, and promote positive personality Grow up often, face life better, and adapt to society well.