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