Davos Courses

Executive Editor: Chris Colton

Authors: Florian Gebhard, Phil Kregor, Chris Oliver

Distal femur Complete articular fracture, simple articular, multifragmentary methapyseal - ORIF - blade plate

back to skeleton

Glossary

Aftercare following treatment of complete articular fractures

Functional treatment
Unless there are other injuries, or complications, knee mobilization may be started immediately postoperatively. Both active and passive motion of the knee and hip can be initiated immediately postoperatively. Emphasis should be placed on quadriceps strengthening and straight leg raises. Static cycling without load, as well as firm passive range of motion exercises of the knee, allow the patient to regain optimal range of motion.

Weight bearing
Touch-down weight bearing (10-15 kg) may be performed immediately with crutches, or a walker. This will be continued for 8-12 weeks postoperatively. This is mostly to protect the articular component of the injury, rather than the shaft injury. Touch-down weight bearing progresses to full weight bearing gradually, over a period of 2 to 3 weeks (beginning at 8–12 weeks postoperatively). In general, patients are fully weight bearing, without devices (e.g., cane) by 16-20 weeks.

Follow-up
Wound healing should be assessed at two to three weeks postoperatively. Subsequently 6 week, 12 week, 6 month, and 12 month follow-ups are usually made. Serial x-rays allow the surgeon to assess the healing of the fracture.

Implant removal
Implant removal is not essential and should be discussed with the patient, if there are implant-related symptoms after consolidated fracture healing.

Thrombo-embolic prophylaxis
Consideration should be given to thrombo-embolic prophylaxis, according to local treatment guidelines.

v1.0 2008-12-03