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

2020 ◽  
Vol 8 ◽  
pp. 205031212096531
Author(s):  
Efthymios Iliopoulos ◽  
Nikiforos Galanis
Keyword(s):  
Range Of Motion ◽  
Fracture Fixation ◽  
Tibial Plateau ◽  
Negative Impact ◽  
Plate Fixation ◽  
Weight Bearing ◽  
Early Weight Bearing ◽  
Post Surgery ◽  
Plateau Fracture ◽  
Tibia Plateau

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.

scholarly journals Knee joint stability following fixation of tibial plateau fracture by angular locking plate fixation

2021 ◽  
Author(s):  
Jahidul Bari ◽  
Wang . ◽  
Wu .
Keyword(s):  
Knee Joint ◽  
Tibial Plateau ◽  
Locking Plate ◽  
Tibial Plateau Fracture ◽  
Plate Fixation ◽  
Weight Bearing ◽  
Joint Stability ◽  
Locking Plate Fixation ◽  
Plateau Fracture ◽  
The Mean

<p class="abstract"><strong>Background:</strong> Injuries to the tibial plateau generally occur because of a force directed either medially or laterally an axial compressive force or both an axial force and force from the side. Tibial plateau fractures resulting frequently in functional impairment.</p><p class="abstract"><strong>Methods: </strong>The total of cases included in the study was 47 in number. More than 20 years old patients of both sexes with tibial plateau fractures attended in the study. Proper informed consent was taken from the patients under the study and purpose of the study was explained. Ethical approval was obtained from the Institutional Ethics Committee. All data were processed, analyzed, and disseminated by MS Office and Statistical package for social sciences (SPSS) version 26 as per need.</p><p class="abstract"><strong>Results: </strong>In this study, for majority (51%) patients &lt;12 weeks were in needed for union. Besides these, for 23.40% and 21.28% patients, time for union were 12-14 and &gt;14 weeks respectively. Unfortunately, in 4.26%% cases (n=2) incidence of non-union was occur. The mean period of radiological union was 12.75 weeks (12-16 weeks). Most of the patients were allowed complete weight bearing at 11 to 14 weeks. Average time gap for complete weight bearing was 13.5 weeks. In assessing the knee stability of the participants, we observed, the mean (±SD) angle of knee joints was 112.08 ±12.32 degree. The mean (±SD) Knee Society Score (KSS) was found 77.51 ± 8.16. As per the functional outcomes among all the participants, majority of them (57.45%) got ‘good’ results whereas 29.79% got ‘Excellent’ and 8.51% got ‘Poor’ results.</p><p class="abstract"><strong>Conclusions:</strong> Satisfactory knee joint stability for patients with tibial plateau fracture angular locking plate fixation technic may be considered as an effective treatment method for orthopedic surgeons.  </p>

scholarly journals Treatment of Isolated Posterolateral Tibial Plateau Fracture with a Horizontal Belt Plate through the Anterolateral Supra-Fibular-Head Approach

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Sunjun Hu ◽  
Shiyi Chen ◽  
Shimin Chang ◽  
Wenfeng Xiong ◽  
Rujan Tuladhar
Keyword(s):  
Tibial Plateau ◽  
Tibial Plateau Fracture ◽  
Plate Fixation ◽  
Weight Bearing ◽  
Case Series ◽  
Operation Time ◽  
Fibular Head ◽  
Plateau Fracture ◽  
One Year ◽  
Partial Weight

The posterolateral tibial plateau fracture was not easy to be exposed and fixed with usual techniques. The aim of this study was to investigate the biomechanical stability and clinical outcome of the isolated posterolateral tibial plateau fracture fixed with a single horizontal belt plate through the anterolateral supra-fibular-head approach. Fracture models were created by 18 synthetic tibias and fixed with three different fixation modes. Each group was fixed and tested on the loading machine, and final vertical displacement of the fragment was detected and calculated. Clinically, a retrospective analysis of 12 cases of posterolateral tibial plateau fracture from January 2013 to December 2017 was performed. There were 8 males and 4 females, aged 33-72 years, with an average age of 49.6 years. Isolated posterolateral tibial plateau fractures were identified according to preoperative X-ray and computed tomography scan. Through the modified anterolateral supra-fibular-head approach, the fracture was reduced and fixed by a prebending T-shaped distal radius plate and rafting screws, with bone substitute grafting or autogenous iliac bone implantation. Patients were followed up to a minimum one year of time period, and the outcome was evaluated clinically and radiologically. The biomechanical study shows that horizontal belt plate fixation for the isolated PL tibial plateau fracture can provide sufficient stability, allowing early knee functional exercise and partial weight bearing. For clinical case series, the average operation time in this group was 73.3 ± 10.2   mins (range: 55-90), and the average duration of hospitalization was 9.1 ± 3.3 days (range: 5-16). Patients were followed up for 12-24 months with an average of 16.5 months, and all patients achieved radiological fracture union after an average of 13.7 weeks. At one year after operation, the average knee score of the Hospital for Special Surgery (HSS) scale was 93.2 ± 4.2 points(range: 90-98), the average score of SMFA was 21.1 ± 5.6 points (range: 14-31), and the average knee range of motion (ROM) was 121.48 ° ± 8.88 ° (range: 105°-135°). There were 8 cases that were very satisfied and 3 cases that were satisfied with the operation. For an isolated posterolateral tibial plateau fracture, the supra-fibular-head approach can fully expose the fracture site; the horizontal belt plate fixation of the fracture is stable and reliable to allow for early-stage knee rehabilitation, and the outcome of medium-term clinical follow-up was satisfactory.

An intact fibula may contribute to allow early weight bearing in surgically treated tibial plateau fractures

2017 ◽  
Vol 26 (3) ◽  
pp. 756-761 ◽  
Author(s):  
Ion Carrera ◽  
Pablo Eduardo Gelber ◽  
Gaetan Chary ◽  
Mireia Gomez Masdeu ◽  
Miguel A. González Ballester ◽  
...  
Keyword(s):  
Tibial Plateau ◽  
Weight Bearing ◽  
Tibial Plateau Fractures ◽  
Early Weight Bearing

Risk Factors for Knee Stiffness Surgery After Tibial Plateau Fracture Fixation

2018 ◽  
Vol 32 (9) ◽  
pp. e339-e343 ◽  
Author(s):  
G. Bradley Reahl ◽  
Dimitrius Marinos ◽  
Nathan N. OʼHara ◽  
Andrea Howe ◽  
Yasmin Degani ◽  
...  
Keyword(s):  
Risk Factors ◽  
Fracture Fixation ◽  
Tibial Plateau ◽  
Tibial Plateau Fracture ◽  
Knee Stiffness ◽  
Plateau Fracture

scholarly journals Biomechanics of Osteoporotic Fracture Fixation

2019 ◽  
Vol 17 (6) ◽  
pp. 363-374 ◽  
Author(s):  
Marianne Hollensteiner ◽  
Sabrina Sandriesser ◽  
Emily Bliven ◽  
Christian von Rüden ◽  
Peter Augat
Keyword(s):  
Fracture Fixation ◽  
Mechanical Stability ◽  
Weight Bearing ◽  
Osteoporotic Bone ◽  
Fixation Failure ◽  
Early Weight Bearing ◽  
Elderly Individuals ◽  
Fixation Stability ◽  
Correct Application

Abstract Purpose of Review Fractures of osteoporotic bone in elderly individuals need special attention. This manuscript reviews the current strategies to provide sufficient fracture fixation stability with a particular focus on fractures that frequently occur in elderly individuals with osteoporosis and require full load-bearing capacity, i.e., pelvis, hip, ankle, and peri-implant fractures. Recent Findings Elderly individuals benefit immensely from immediate mobilization after fracture and thus require stable fracture fixation that allows immediate post-operative weight-bearing. However, osteoporotic bone has decreased holding capacity for metallic implants and is thus associated with a considerable fracture fixation failure rate both short term and long term. Modern implant technologies with dedicated modifications provide sufficient mechanical stability to allow immediate weight-bearing for elderly individuals. Depending on fracture location and fracture severity, various options are available to reinforce or augment standard fracture fixation systems. Summary Correct application of the basic principles of fracture fixation and the use of modern implant technologies enables mechanically stable fracture fixation that allows early weight-bearing and results in timely fracture healing even in patients with osteoporosis.

Can locking plate fixation of symphyseal disruptions allow early weight bearing?

Injury ◽  
2020 ◽  
Author(s):  
Pradeep Kankanalu ◽  
Georgios Orfanos ◽  
Jonathan Dwyer ◽  
Justin Lim ◽  
Bishoy Youssef
Keyword(s):  
Locking Plate ◽  
Plate Fixation ◽  
Weight Bearing ◽  
Locking Plate Fixation ◽  
Early Weight Bearing

Efficacy of a Biphasic Ceramic Bone Substitute in Management of Complex Tibial Plateau Fractures — Clinical and Radiologic Medium-Term Results

2014 ◽  
Vol 614 ◽  
pp. 190-195
Author(s):  
Paul Dan Sirbu ◽  
Grigore Berea ◽  
Tudor Petreus ◽  
Rares Sova ◽  
Razvan Tudor ◽  
...  
Keyword(s):  
Bone Substitute ◽  
Tibial Plateau ◽  
Plate Fixation ◽  
Tibial Plateau Fractures ◽  
Medium Term ◽  
Promising Alternative ◽  
Plateau Fracture ◽  
Primary Bone ◽  
Fast Healing ◽  
Biphasic Ceramic

The purpose of this retrospective study is to evaluate the efficacy of a biphasic synthetic ceramic bone substitute (Eurocer) combined with plate fixation in treating collapse tibial plateau fractures. 32 patients were included in the study. The surgical protocol consisted of: elevation of the articular depression through a limited cortical window using a curved bone compactor and image intensification, filling the defect with Eurocer granules and fixation with plates. Clinical and radiologic follow-up after 36 to 48 months revealed uneventful primary bone healing, excellent osseous integration of Eurocer and a mean Neer score of 87, 5 points. We conclude that Eurocer400® combined with plate fixation in managing collapsed tibial plateau fracture is a promising alternative in this difficult lesion regarding a fast healing, a good quality osseointegration, preventing secondary collapse and improving medium term results.

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