Executive Editor: Chris Colton

Authors: Florian Gebhard, Phil Kregor, Chris Oliver

Distal femur Extraarticular fracture, simple - Long leg cast

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Aftercare following long leg cast application

The long leg circular cast is not intended to be a weight-bearing cast, so the patient will need to use crutches, or a walker. The leg should be kept elevated, whenever possible, to prevent additional swelling.

The exercises for the patient should be explained and demonstrated. These include: flexing the toes and lifting the leg.

A major concern with the use of a long leg cast for a distal femoral fracture is knee joint stiffness. Therefore, the duration of treatment in the long leg cast should be as short as possible (4-6 weeks). After this period, the cast will be changed to a hinged knee brace, or hinged knee cast to allow knee flexion and extension. This would be applied as soon as firm callus formation is present.

Weight bearing
Weight bearing would be started at approximately 8-12 weeks following injury.

Radiological review
There should be regular radiological review until fracture union.

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

v1.0 2008-12-03