The neurovascular status of the extremity must be carefully monitored. Impaired blood supply or developing neurological loss must be investigated as an emergency and dealt with expediently.
Unless there are other injuries or complications, mobilization may be performed on post OP day 1. Static quadriceps exercises with passive range of motion of the knee should be encouraged. Early active range of motion of knee and ankle is encouraged.
The goal of early active and passive range of motion is to achieve a full range of motion within the first 4 – 6 weeks. Maximum stability is achieved at the time of surgery. A delay beyond a few days to allow swelling to subside is illogical and harmful.
A hinged brace is used with non-weight bearing for 6 weeks.
Wound healing should be assessed on a short term basis within the first two weeks. Subsequently a 8 week follow-up is usually performed.
Implant removal is optional after retrograde lag screw fixation and suturing.