[The strategy of rehabilitative treatment following surgical intervention in patients with pseudoarthrosis of the extremities].

The objective of the present study was to analyse results of the treatment of 267 patients with pseudoarthrosis of the extremities and to use them for the development of criteria for the choice of methods for rehabilitative therapy. It was shown that stability of fixation of bone fragments by metal devices in patients with false joints (unlike fractures) varies depending on bone tissue condition. With this in mind, the patients receiving rehabilitative treatment were allocated to three groups differing in the degree of immobilization in the postoperative period. One group included the patients who did not need immobilization of the affected extremity. The other comprised those requiring immobilization only in case of axial load. Patients of the third group needed immobilization throughout the entire period until the completion of fragment consolidation. The results thus obtained were used to develop tactical schemes of combined treatment of patients using up-to-date orthotic techniques. It is proposed to divide the postsurgery treatment schedule into the following periods: early postoperative, early rehabilitative, the onset of active functional loading, and the period of functional and vocational rehabilitation. Such a differentiation is believed to enhance efficiency of the above rehabilitative strategy and facilitate the adequate choice of combined remedial treatments. Excellent and good outcome of rehabilitation with the use of this technology have been achieved in 98.9% of the patents.