Can I walk after 65 days of lumbar fracture?

Many people are more concerned about fractures in their daily lives. In fact, fractures are very harmful. First of all, they will cause our bones to break and be damaged. Fractures are also divided into many types. The recovery of the disease is observed according to the condition of the fracture. Generally, for serious cases like lumbar fractures, whether you can walk in about 65 days depends on the recovery of the disease.

Postoperative Care

1. Vital signs monitoring.

2. Observation of spinal nerve function.

3. Incision drainage tube care: 1-2 negative pressure drainage tubes are placed on the patient's incision. The incision should be closely observed for redness, swelling, exudation, bleeding, etc., and the skin tension around the incision should be checked for increased tension. If increased tension is found, the doctor should be notified and dehydration and swelling treatment should be given. Maintain effective negative pressure drainage to prevent tube blockage and retrograde infection. Record the drainage volume, color and properties. If the bloody drainage fluid is >100 ml per hour for 3 consecutive hours, it indicates possible bleeding and you should report to the doctor immediately. If the drainage fluid is light bloody or meat-washing water-like in color and exceeds 500 ml in 24 hours, cerebrospinal fluid leakage should be considered.

4. Diet care: Start drinking liquid food with water 6 hours after posterior approach surgery. If there is no discomfort, start drinking semi-liquid food after 12 hours, and eat normal food after 2 days. Anterior approach surgery requires fasting and intravenous nutritional support. After the anus is exhausted, liquid, semi-liquid, and normal food can be gradually introduced. Encourage patients to eat light, easily digestible, fiber-rich foods and fruits, and eat small, frequent meals. Avoid foods that cause intestinal gas, such as milk, soy milk, etc.

5. Posture care: Lie flat without a pillow within 6 hours after surgery. When assisting the patient to turn over to lie on the side 6 hours later, it is important to keep the upper and lower body consistent. Hold the patient's shoulders and hips with your hands and turn the patient at the same time. Keep the waist fixed without bending or twisting to prevent waist sprain. Two weeks after surgery, after the stitches are removed, you can wear an anterior-posterior support brace for the thoracolumbar region and perform activities in the order of 90°—sitting → standing beside the bed → walking around the bed → walking within the ward.

Health Education

1. Functional exercises: For patients receiving conservative treatment, the necessity and importance of lying on a hard bed and early back muscle exercises should be explained in detail to gain their cooperation. A thick pillow can be placed on the fracture site to hyperextend the spine, and the treatment goal can be achieved through lumbar and back muscle exercises. After the incision drainage tube is removed, patients undergoing surgical treatment can perform contraction and relaxation exercises on the quadriceps femoris on both sides of the lower limbs and gradually start strength training of the waist and back muscles. It should be done according to the patient's age, injury, physical condition and mental state. Strive to fully meet functional training requirements within 3-6 weeks after injury.

2. Self-psychological adjustment After 2-3 months of the disease, some functions of paraplegic patients improve slowly, and they are prone to despair that they will never recover and become disabled. At this time, the patient's self-psychological adjustment ability and the care and encouragement of family members are particularly important. Nurses should inform patients that functional recovery of such diseases requires a long process. With the cooperation of patients and their families, they should develop an effective rehabilitation plan and training methods for patients, explain the expected goals, enhance patients' confidence, and recommend that those who are eligible transfer to community rehabilitation treatment.

3. Prevention of lung infection: Paraplegic patients may develop aspiration pneumonia due to long-term bed rest with few changes in body position and shallow breathing. Change body positions frequently to allow the lungs to move on their own; encourage patients to do whole-body exercises, such as chest expansion exercises, deep breathing, effective coughing movements, and regular turning over and patting the back to promote the elimination of secretions and phlegm in the lungs.