This is a vast chapter, which includes a variety of injuries, with complex care.
Surgical treatment is often proposed for these knee fractures, because the main goal is the reconstruction of a mobile, quasi-normaljoint, allowing resumption of walking at the same level as before the injury.
Techniques used are multiple and surgical decision takes into account several factors:
– Age at which fracture occurs,
– Type of fracture,
– Complexity of the fracture,
– Existence of associated injuries (vessel, nerve, skin wound)
– Intensity of the trauma,
– Level of osteoporosis,
– Status of the joint and knee before trauma,
– General health condition of the patient, …
It would be too complex to list all surgical techniques that we can use.
The main purpose is to simply recover the articular surfaces of the knee.
I most often use titanium plates with screw that locks in the plate. This material helps avoiding any secondary movement of the synthetic material, allowing swift resumption of the support on the operated leg.
Other techniques may be used:
- – Anterior or retrograde rod,
- – Classic screwed plate
- – External fixator,
- – Knee prosthesis.
The following pictures show some fractures that were treated surgically (open osteosynthesis).
Femur and tibia fracture healing often requires about four months, considering the duration of recovery. We must consider cessation of work for about five months (if all goes well). Duration of the cessation of work is influenced by any associated injuries (other fractures, nerve or vessel injuries).
After a surgical fixation of the fracture, calf is often immobilized with plaster.Total support on the operated leg is rarely advised three months after the intervention. Partial support could be considered, using two crutches, depending on the radiological progress, but rarely before two months after the surgery.
Physical therapy sessions are required rather quickly with joint mobilization, as well as sitting in an armchair.
Stitches are removed on day 14.
The treating physician will receive the instructions needed to follow-up this type of injury.