Results of early manipulation under general anesthesia in intra articular distal femur fractures

Author(s): Dr. Ketan Khatri and Dr. Mangesh Panat

Abstract: Background: Post operative knee stiffness after intra articular distal femur fracture causes significant disability affecting daily activities of the patient and causing concern for the surgeon. Although the importance of early post operative mobilization is emphasized to all patients, many patients, especially those from rural areas have no access to specialized physiotherapy and do not understand the importance of the same. These patients also do not visit the hospital on scheduled days of follow up due to various socio economic reasons. Hence, such patients can have restriction of knee movements (flexion as well as extension) very early during the post operative period. We present our study protocol of early MUGA & suture removal at 3 weeks after surgery of these fractures. At 3 weeks, the soft tissue healing of the trauma as well as the surgery has occurred to a great extent. The surgical site pain and inflammation has also reduced. All patients who are operated will always come to hospital for suture removal. We planned to do a MUGA for the knee along with suture removal at 3 weeks for these patients. Material and method: A prospective study carried at our institution for patients admitted and operated for intra articular distal femur fracture. These patients were evaluated for knee range of motion (ROM) at 3 weeks and posted for MUA & suture removal. Results: 15 patients who were operated for intra articular distal femur fracture underwent Early MUA at 3 Weeks. The mean pre manipulation mean knee flexion was 60°. On manipulation mean knee flexion of 110° was achieved. At the time of follow up at 3 months mean knee flexion was 123°.The average time for MUA was 15 minutes. No complication occurred during manipulation procedures. Conclusion: Early MUA is suitable and effective non-invasive treatment modality for post-operative stiffness in cases of intra articular distal femur fractures.

DOI: https://doi.org/10.22271/ortho.2019.v5.i4e.1683