Executive Editor: Chris Colton

Authors: Florian Gebhard, Phil Kregor, Chris Oliver

Distal femur Partial articular, frontal/coronal, posterior condyle - ORIF - posterior screws for small fragments

Aftercare following screw 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 weeks postoperatively. After that, touch-down weight bearing progresses to full weight bearing gradually over the next 2 weeks. In general, patients are full weight bearing, without devices (e.g., cane), by 8 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 recommended as all implants are buried, or absorbed.

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

 

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v1.0 2008-12-03