Early weight bearing in tibial plateau fractures treated with ORIF: a systematic review of literature

Abstract

Background To review the current clinical evidence on advantages and risks of early weight bearing (EWB) after internal fixation for tibial plateau fracture. Methods Data source: PubMed and Google Scholar from inception of database to 20 August 2021, using PRISMA guidelines. The included studies were randomized controlled trials, prospective and retrospective observational studies, case reports. Data extraction was performed independently by 2 reviewers. Collected data were compared to verify agreement. Statistical analysis was not performed in this study. Results The literature search produced 174 papers from PubMed and 186 from Google Scholar, with a total amount of 360 papers. The two reviewers excluded 301 papers by title or duplicates. Of the 59 remaining, 33 were excluded after reading the abstract, and 17 by reading the full text. Thus, 9 papers were finally included in the review. Conclusions EWB can be considered safe and effective in selected cases after internal fixation for tibial plateau fractures. Level of evidence Therapeutic Level III.

Tibial Plateau Fracture Surgical Care Utilizing Standardized Protocols Over Time: A Single Center’s Longitudinal View

“…[1][2][3] For patients treated nonoperatively, weight-bearing was restricted for 10-12 weeks and knees were allowed free range of motion in a hinged brace. [4][5][6][7] Minimally displaced or displaced fractures in lower demand patients or pre-existing arthritic knees were treated nonoperatively with bracing and limited weight-bearing.…”

Early Weight Bearing pada Pasien Post Operasi Fraktur Ekstremitas Bawah

“…Indikasi early weight bearing (EWB) pasca operasi bergantung pada beberapa faktor yaitu pola dan bentuk fraktur, jenis osteosintesis, kualitas tulang dan jaringan lunak, cidera terkait, penyakit komorbid, usia, jenis kelamin, dan kondisi implant (Murena et al, 2021). Para penulis menyimpulkan bahwa permissive weight bearing setelah reduksi fraktur aman dan menyebabkan pengurangan waktu yang signifikan untuk mencapai full weight bearing tanpa perbedaan dalam hal komplikasi, nyeri dan kualitas hidup (Canton et al, 2022). Dari penelusuran berbagai penelitian di dapatkan berbagai hasil temuan terkait dengan latihan dini pada pasien post operasi fraktur ekstremitas bawah dan efektifitas latihan dini.…”

“…Weight bearing segera tidak terkait dengan kegagalan fiksasi. Latihan weight bearing dianjurkan segera setelah dilakukan fiksasi fraktur (Canton et al, 2022). EWB yang dilakukan pada pasien post operasi tidak menganggu luka insisi maupun tulang yang mengalami fraktur (Khojaly et al, 2022).…”

“…Penulis menyimpulkan bahwa weight bearing secara langsung pada fraktur aman dilakukan. weight bearing dinamis yang dilakukan pada 2 dan 6 minggu pasca operasi menunjukkan tidak ada korelasi dengan kualitas Hidup terkait lutut pada 52 minggu (Canton et al, 2022).…”

Effect of Schatzker type VI tibial plateau fractures combined with a proximal fibular and/or posterolateral joint facet fracture on early postoperative functional recovery

“…A tibial plateau fracture (TPF) is a complex intraarticular fracture resulting from the combination of axial force and varus or valgus of the knee joint [ 1 ] and accounts for approximately 5–8% of lower limb fractures [ 2 ]. To restore joint stability and achieve ideal healing, surgery is recommended for patients with joint displacement or depression greater than 2 mm, condylar enlargement greater than 5 mm, poor alignment greater than 5 mm, or knee instability during movement [ 3 , 4 ].…”