|Rehabilitation of femoral neck fracture involves physical therapy designed to promote ambulation, increase range of motion and muscle strength. Therapy will depend on the method used to stabilize the fracture, such as percutaneous pinning, open reduction and internal fixation (nailing), or (partial) joint replacement.|
The primary goal of rehabilitation is early mobilization which includes ambulation and resumption of activities of daily living (Koval). To achieve this goal the patient may require assistive devices for gait training with weight bearing determined by the physician's protocol. Ideally, partial to full weight bearing can be expected immediately after surgery (Koval). The progression from walker to crutches to cane is based on weight bearing status, balance and strength.
General conditioning of the upper extremities and uninvolved lower extremity may help to facilitate early mobilization and transfers. Ankle range of motion exercises of the involved extremity promotes circulation.
The pre-operative status of the patient and physician protocol will dictate the amount of reconditioning needed after surgery. For most patients who sustain a femoral neck fracture, gait and transfer training will be sufficient to regain their preoperative status. Insufficient evidence exists regarding the need for targeted reconditioning of the involved lower extremity (Handoll). If necessary the therapist can initiate general conditioning exercises. The goal is to achieve full range of motion, strength and balance in the involved leg.
Additional information may provide greater insight into the rehabilitation needs of these individuals (Cameron; Handoll).
FREQUENCY OF REHABILITATION VISITS
|Physical Therapist||Inpatient: daily|
|Physical Therapist||Outpatient: up to 8 visits within 4 weeks|
|The table above represents a range of the usual acceptable number of visits for uncomplicated cases. It provides a framework based on the duration of tissue healing time and standard clinical practice.|
Source: Medical Disability Advisor