Davos Courses

Executive Editor: Chris Colton

Authors: Florian Gebhard, Phil Kregor, Chris Oliver

Distal femur Partial articular fracture, lateral condyle, sagittal simple - ORIF - lag screws

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Glossary

Aftercare following screw (and plate) fixation of partial articular fractures

Functional treatment
Unless there are other injuries, or complications, joint 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 started immediately with crutches, or a walker. This will be continued for 6-8 weeks postoperatively. After that, touch-down weight bearing progresses to full weight bearing gradually over a period of the next 2 to 3 weeks. In general, patients are full weight bearing without devices (e.g., cane) by 10-12 weeks.

Follow up
Wound healing should be assessed at 2 to 3 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, unless there are implant-related symptoms after consolidation.

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

v1.0 2008-12-03