FEMORAL SHAFT FRACTURE P.T. PROTOCOL

PHASE I ( POST-OPERATIVE WEEK 0 - 4 WEEKS )
Inpatient physical therapy program

• gentle range of motion exercise in hip, knee, and ankle and focus in knee extension
• initiation of weight bearing as tolerated ambulationwith either a walker B/L crutch
• lower extremity isometric exercises

Following discharge from the hospital patient utilized a toe touch to 25% weight bearing status

PHYSICAL THERAPY PROGRAM:

1. Modalities such as Faradic stimulation

• muscle reeducation
• swelling control
• pain management

2. Stretching of gastrocnemius, soleus and hamstring muscle (seated)

3. Strengthening exercises

• Quadricep femoris muscle setting
• ankle dorsiflexion, plantarflexion, eversion, and inversionwith theraband
• straight leg raise in 4 planes
• ankle pumping

4. Balance, proprioception and gait retraining activities

• cup walking
• weight shifting with progressive weight-bearing

PHASE II ( WEEKS 4 -8 )

CRITERIA OF PROGRESSION

• Minimal effusion
• 50% weight-bearing
• fair grade strenght on quadricep femoris and hip abductor muscle

PHYSICAL THERAPY PROGRAM:

1. Continue phase I as appropriate

2. Strengthening Exercises:

• knee extension ex. with weight up to 2.25kg
• toe or heel raise
• minisquat
• wall sit (50% WB)
• standing knee flexion with weights
• standing hip abduction and flexion with resistance

3. Balance , proprioception and gait training exercise

• side stepping
• backward walking (guarded)

4. Fitness conditioning exercises include the stationary bicycle and pool therapy

PHASE III (WEEKS 8 - 18)

CRITERIA OF PROGRESSION:

• full weight bearing without assistive devices
• fair to normal grade strenght quadricep femoris and hip abductor muscle
• no effusion

PHYSICAL THERAPY PROGRAM:

1. continue phase I as appropriate

2. Strenthening Exercises

• knee extension exercise with increase weights
• step up forward and lateral
• single leg stand minisquat
• half-lunges

3. Balance, proprioception and gait trainingactivities

• single leg stand
• balance and proprioception activities on stable and unstable platform

4. Fitnes condition exercises include treadmill walking