|The goals of rehabilitation after a patella fracture are to reduce pain and to restore function of the involved limb. The rehabilitation protocol depends upon the type, severity, and operative or nonoperative management of the fracture. If the fracture is managed operatively, postoperative rehabilitation is guided by the treating physician.|
Regardless of how the fracture is managed, the knee may be immobilized for a certain period of time (Bucholz). The physician will indicate when the immobilizer can be removed for exercise.
Early rehabilitation includes gait training with assistive devices, such as canes or crutches, as needed. Individuals are immediately instructed in exercises to prevent loss of motion and strength in adjacent joints. Ankle exercises are taught to promote circulation, and individuals are encouraged to perform these intermittently. Modalities including heat and cold can be used to control pain and edema (Braddom). As guided by the treating physician, range of motion, strengthening, and proprioceptive exercises of the involved joint can be initiated and progressed as indicated and tolerated by the individual (Bucholz). Once the fracture is healed, exercises are continued until strength is restored in the knee joint, a normal gait is observed, and full function returns.
A home program should be taught to complement supervised rehabilitation and to be continued after the completion of physical therapy.
Occupational therapy may be recommended to maximize independence in activities of daily living. An ergonomic assessment may be indicated to assess the workplace and suggest adaptations to allow the individual to return to work.
FREQUENCY OF REHABILITATION VISITS
|Physical or Occupational Therapist||Up to 24 visits within 12 weeks|
|Physical or Occupational Therapist||Up to 16 visits within 8 weeks|
|‡ Note on Nonsurgical Guidelines: Rehabilitation may not begin until tissue healing, about 6 to 8 weeks after the fracture.|
|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