Transcript
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…
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