Physiotherapy after tibial plateau fracture fixation: A systematic review of the literature

Abstract

Background: Tibial plateau fractures are frequent injuries that orthopaedic surgeons face. It has been reported that they have a significant negative impact on the patients’ lives, decreasing their quality of live, keeping them of work for long periods of time and reducing their activity levels. Aim: Interestingly, there is not enough focus in the literature about the post-operative rehabilitation of these patients. The aim of the present review is to investigate this field of the literature and try to give answers in four main questions: the range of motion exercises post-surgery, the immobilisation, the weight-bearing status and the ongoing rehabilitation. Materials and Methods: A literature search was conducted using the PubMed and the Google Scholar search engines. A total of 39 articles met the criteria to be included in the study. Results: The literature about this subject is scarce and controversial. Early range of motion exercises should be encouraged as soon as possible after the procedure. The immobilisation after plate fixation does not seem to be correlated with any benefits to the patients. The weight-bearing status of the patients was the most controversial in the literature with the early weight-bearing gaining ground at the most recent studies. Tibia plateau fractures can have significant impact on the patients’ lives, so ongoing rehabilitation with focus on quadriceps strengthening and proprioception exercises is recommended. Conclusion: The present literature review illuminates the controversy that exists in the literature about the physiotherapy following tibia plateau fracture fixation. Early range of motion exercises and early weight bearing should be encouraged. Immobilisation does not seem to provide any benefit. Ongoing rehabilitation should be considered with the view of better clinical outcomes.

Prolonged Application of Continuous Passive Movement Improves the Postoperative Recovery of Tibial Head Fractures: A Prospective Randomized Controlled Study

“…THFs are a type of common and severe injury, and their later developmental complications such as traumatic arthritis, muscle and bone atrophy, and joint stiffness can cause functional problems in the knee of the patients and increase the socioeconomic burden [ 22 ]. A systematic review demonstrated that tibial plateau fractures have a lower return rates to sport compared with other types of fractures, and only 60% patients can recover to the preinjury level of sport [ 23 ].…”

Bridging the Gap between Locking Compressive Plate, Skin Grafting and Rehabilitation for Tibia Fracture: A Case Report

“…The significance of early mobilisation and range of knee joint motion exercises has been apparent in literature in the past 40 years [4,12]. A research performed by Gabriel showed that involvement in physiotherapy has a beneficial effect on gaining confidence, enhancing gait in post-operative physiotherapy [13].…”

“…Intraarticular tibia fractures are widely referred as tibial plateau fractures. The two main age ranges exist, first cohort includes younger men suffering from heavy impact trauma, whereas second is older women suffering from limited injury [4]. Such fractures are linked to adverse results, because of reasons such as the damage of cartilage but also soft tissue envelopes, complications like compartment syndrome, postoperative infection, knee dysfunction or rigidity, or even post-traumatic osteoarthritis.…”

Systematic Team-Approach Rehabilitation After Knee Fracture Surgery Is Associated With Better Functional Outcomes

“…Accelerated rehabilitation is thought to expedite the function recovery and prevent joint conglutination [8][9]. Early knee ROM exercises, quadriceps strengthening and proprioception exercises should be encouraged for a good nal outcome [10,16]. We believe that the best approach to rehabilitation after fracture is a training strategy coordinated by a multidisciplinary team for the individual to achieve the highest possible level of function.…”

“…We believe that the team-based perioperative rehabilitation approach help improved the functional status of patients after knee fracture surgery and shortened the time of postoperative recovery. A recent systematic reviews demonstrated that the fucus on post-operative rehabilitation effect of tibial plateau fracture is scarce and controversial [10]. More research needs to be performed to determine a better postoperative rehabilitation pattern.…”