Vastus Intermedius Dry Needling for Knee Stiffness Resulted From Surgically Managed Femoral Fractures With Open Reduction & Internal Fixation.

The vastus intermedius will be approached with DN from the lateral aspect and the pincer approach will be followed. The Hong fast-in and fast out technique with multiple rapid needle insertions will be performed following previous recommendations (Chou, et al., 2014). The control group will receive the rehabilitation program alone. A headless 0.25 × 25-mm needle (Stainless steel, Agupunt A1038P, 158 Caspe, Barcelona, Spain) will be used. The penetration depth will be varied according to the patient. Hemostasis will be performed for 1 minutes. DN will be performed medial to the sartorius muscle limit to avoid saphenous nerve adverse effects during DN (Henry et al., 2016).