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Early Rehabilitation Following Surgical Fixation of a Femoral Shaft Fracture

MV Paterno, PT, MS, SCS, ATC, is Coordinator of Orthopaedic and Sports Physical Therapy, Sports Medicine Biodynamics Center and Division of Occupational Therapy and Physical Therapy, Cincinnati Children's Hospital Medical Center, 3333 Burnett Ave, MLC 10001, Cincinnati, OH 45229-3039 (USA)
MT Archdeacon, MD, is Director, Division of Musculoskeletal Traumatology, and Assistant Professor, Department of Orthopaedic Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio
KR Ford, MS, is Research Biomechanist, Sports Medicine Biodynamics Center, Cincinnati Children’s Hospital Medical Center
D Galvin, PT, MHS, OCS, is Director, Summit Physical Therapy, Mt Orab, Ohio
TE Hewett, PhD, FACSM, is Director, Sports Medicine Biodynamics Center, and Associate Professor, Departments of Pediatrics and Rehabilitation Sciences, Cincinnati Children’s Hospital Medical Center, and Assistant Professor, Department of Orthopaedic Surgery, University of Cincinnati College of Medicine

(mark.paterno{at}cchmc.org). Address all correspondence to Mr Paterno

Background and Purpose. The purpose of this case report is to describe the outcome of a patient following fixation of a midshaft femur fracture and an evaluation-based, immediate-weight-bearing approach to rehabilitation. Case Description. The patient was a 28-year-old male manual laborer whose left femur was fractured in a head-on motor vehicle accident. The patient was treated with internal fixation of the left femur by use of an antegrade intramedullary nail. Following surgery, impairments in range of motion, knee extensor and hip abductor strength, and gait were observed. Intervention focused on immediate weight bearing and early progression of strengthening to address the observed impairments. Outcomes. All of the patient’s impairments improved, and he was able to return to work as a manual laborer within 6 months. Discussion. Immediate weight bearing with early strengthening activities following surgical correction of a midshaft femur fracture may result in early resolution of impairments and functional limitations and decreased disability.

Key Words: Femoral fractures • Gait training • Rehabilitation • Treatment outcome