Intensive physical therapy after fractures of the femoral shaft.

22 patients with fractures of the femoral shaft were divided into 2 groups. One group (12 patients) were given the standard postoperative physiotherapy and the remainder (10 patients) received intensive physiotherapy. Clinical examination of the knee joint was performed 2, 4 and 9 weeks postoperatively. The patients' mean age was 31 years; 15 of them were men. The fractures in 18 patients were treated with intramedullary nailing, 2 with a long-shanked Jewett nail and 2 with AO-nailing. Mobilisation and quadriceps atrophy of the injured limb of the patients given intensive physiotherapy appeared to improve faster than in the patients of the routine physiotherapy group. Nine weeks after the operation the range of knee movement had normalised in the cases given intensive physiotherapy. The flexion strength of the knee in the operated limb was close to the values for the normal limb after nine weeks, but the extension strength was still 40-66% below the values for the healthy limb. The greatest increase in muscle power occurred during the first four postoperative weeks. Intensive physiotherapy seems to hasten the recovery of quadriceps strength of the patients with fractures of the femoral shaft, and to shorten the duration of sick leave of the patients operated on by closed intramedullary nailing.