Knee Fractures in Seniors: Recovery and Rehabilitation Insights

Patellar fracture

Hello, Doctor! My friend's 66-year-old mother suddenly fractured her right leg at the knee while walking last Tuesday.
She was rushed to the hospital, where they inserted pins for stabilization, and she was discharged after three days.
She is worried about another fracture.
Doctor, is a sudden leg fracture in the elderly simply a straightforward fracture? Would it be beneficial for her to see a rehabilitation specialist post-surgery for quicker recovery? At what degree of knee flexion can she start walking? Thank you! Kvein

Kvein, 30~39 year old female. Ask Date: 2006/09/17

Dr. Chen Xianchang reply Rehabilitation

1.
There may be several possibilities including simple fractures, osteoporosis, knee ligament damage, and bone cancer.

2.
Three days post-surgery, you can schedule an appointment with the rehabilitation department for laser therapy or other phototherapy, and receive health education.

3.
Post-operative rehabilitation follows a specific plan, assessing muscle strength, balance, and range of motion, gradually progressing from strength training to standing, and then to walking.

Reply Date: 2006/09/17

More Info

Kvein, thank you for your question regarding knee fractures in seniors, particularly concerning your friend's mother who recently experienced a fracture. Knee fractures in older adults can be quite complex due to several factors, including bone density, overall health, and the presence of comorbidities.
Firstly, it's important to understand that a sudden fracture in an elderly individual, especially in the knee area, can often be attributed to osteoporosis, a condition that weakens bones and makes them more susceptible to fractures. In many cases, these fractures are not simply due to a fall or trauma but can occur with minimal or no trauma at all, especially in those with significantly reduced bone density. Therefore, it is crucial to evaluate the underlying causes of the fracture, including bone health assessments and potential osteoporosis treatments.

Regarding the surgical intervention, it sounds like your friend's mother underwent a procedure to stabilize the fracture using pins or screws. This is a common approach to ensure proper alignment and healing of the bone. Post-surgery, rehabilitation is essential. Engaging in physical therapy can significantly enhance recovery outcomes. Rehabilitation helps to restore mobility, strength, and function, and it is generally recommended to start as soon as it is safe to do so, often within a few days after surgery.
The timeline for recovery can vary widely among individuals, particularly in seniors. Factors such as age, pre-existing health conditions, and the severity of the fracture all play a role. Typically, after a knee fracture, patients may begin to bear weight on the affected leg within a few weeks, depending on the surgeon's recommendations and the stability of the fracture.
As for knee flexion, the ability to bend the knee is crucial for walking. Generally, achieving a knee flexion of around 90 degrees is a good milestone before a patient can start walking with assistance. Full range of motion, which is typically around 120 degrees or more, is ideal for normal walking and functional activities. However, the exact degree of flexion required can vary based on individual circumstances and the specific nature of the fracture.

In terms of rehabilitation, a physical therapist will typically guide the patient through exercises designed to improve range of motion, strengthen the muscles around the knee, and enhance overall mobility. This may include gentle stretching, strengthening exercises, and balance training. The therapist will also monitor the patient's progress and adjust the rehabilitation program as needed.

It's also important to address the patient's fears about re-injury. Education on fall prevention strategies, such as using assistive devices (like walkers or canes), ensuring a safe home environment, and engaging in balance exercises, can help mitigate the risk of future falls and fractures.

In summary, while a knee fracture in an elderly individual can be concerning, with appropriate surgical intervention and a structured rehabilitation program, many patients can achieve significant recovery. It's essential to work closely with healthcare providers to ensure a tailored approach to recovery that considers the individual's unique health status and rehabilitation needs. Regular follow-ups with the orthopedic surgeon and physical therapist will be crucial in monitoring progress and making necessary adjustments to the rehabilitation plan.

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