Medical Dental University

Pryazhnikov DA, Babovnikov AV Rubekina LN Tsypursky IB Moscow State Medical Dental University, Department of Traumatology, Orthopedics and Military Field Surgery The main indication for reconstruction ligament elbow is a chronic ligamentous instability that may occur as a result of various traumatic effects on the ligamentous apparatus of the elbow. These effects include: chronic dislocations, sprains and acute perelomovyvihi at the elbow, damage to the isolated ligament of elbow joint, caused either by a one-time traumatic impact on ligamentous apparatus of the elbow or repetitive micro traumas after the athletes of the sports that involve throwing: baseball, basketball, volleyball. After surgical reconstruction of ligamentous apparatus elbow to hold special rehabilitation measures in order to protect the ligament repaired elbow, while simultaneously allow enough movement in the joint to prevent heterotopic bone formation and contractures. The program consists of three phases: immobilization, mobilization of restricted and limited loads. The first phase begins immediately after surgery and completed within 10-14 days, its objectives are: protection of soft tissue healing and reduce pain. In this phase of the upper limb should be in a triangular bandage.

Allows active exercises wrist joint and isometric in the shoulder joint, active exercises of the elbow with self-care. However, in the first few weeks should not seek to force an increase in the amplitude of active movements "at any cost." The main task of the active exercise of the elbow at this point is not to increase range of motion, and its fixation, ie, in the first 1.5 months of active movements increased there will be little, but there will be no reduction. Typically, after elbow surgery swollen, hyperemic, the movement in it are painful, there is muscle contraction, for the relief of these symptoms show cryotherapy, in which the surface of the skin be cooled to +12 0 C 15, for 5-7 minutes. The objectives of phase limited mobilization are: to increase range of motion and strengthening the muscles around the elbow, it starts in about 2-3 weeks after surgery and the main condition for the transition to this phase is a significant relief of pain, swelling and redness loketvogo joint. This phase may use a hinged orthosis according to the operation, total duration of continuous wear orthoses is usually 6 weeks, after which it can be removed during the "sedentary work" and at night if there is no pain during movement and at rest. Continue to exercise movements of the elbow joint, greatly facilitate patient self-care, and strengthen faith in the complete restoration of upper extremity function that is essential for long-term rehabilitation. Phase Limited load starts at 12 weeks can be extended to 6 months after surgery, all of immobilization and orthoses are removed, allowed to everyday activity, but patients must strictly avoid raising copyright