Lower Limb Fractures

Alireza Pishgahi,MDFall 2013

Hip Fractures

Treatment Goals

Orthopedic: Alignment / Stability

Functional Goals» Normalize the patient's gait pattern. Achieve 90

degrees hip flexion for proper sitting position.

Expected Time of Bone Healing» Twelve to 16 weeks.

Expected Duration of Rehabilitation» Fifteen to 30 weeks

Why Surgery?

Most hip fractures would actually heal without surgery, but the problem is that you would be in bed for eight to twelve weeks .

Doctors have learned over the years that placing an aging adult in bed for this period of time has a far greater risk of creating serious complications than the surgery required to fix a broken hip .

Weight bearing

Metal Screw Intramedullary Nail

Non-weight Bearing

Metal plate & Screw Hemiarthroplasy

Exercises

Closed-chained• fixation of proximal and

distal • Wall sides/ squads Open-chained• no fixation of distal • leg or biceps curls

Rehab. Overview

Precautions

WB Gait Exercise ROM

PROMHip Int.Rot.Hip Add.

?? Assistive device/ stand-pivot transfer

Glut-quad isometric and ankle isotonic

AROM 1-7 days

The same ?? The same The same AAROM 2-4 weeks

Excessive Add/Int.Rot

?? The same The same/ hip &knee isotonic

AROM 4-8 weeks

The same Full WB/as tolerated

The same The same/resistive exe.

Free 8-12 weeks

Excessive Add

Full WB Independent

The same Free 12-16 weeks

Exercises

Exercise

Exercise

Exercise

Exercise

ADL

ADL

ADL

ADL

ADL

ADL

ADL

ADL

ADL

Wish you luck…