Tibial Plateau Fracture

One Patients Story to Treatment and Recovery

““After falling and fracturing my leg, I was only able to bear 50 pounds of weight through my leg. I was scared at first, but it was amazing; I felt like I was floating on air. I couldn’t believe I was walking and not in pain. The AlterG is definitely helping me reach my rehabilitation goals. Next week, I can start to bear more weight and the AlterG will really help me add weight slowly and safely as I continue to regain strength. I can see myself walking the way I used to.””

Sandra Jaquis, Patient, Southlake Village Rehabilitation and Care Center

One Patients Tibial Plateau Fracture Rehabilitation

J.C.A. Noorduyn, Msc

Introduction

An 41 year old female was diagnosed with a fractured left lateral tibial plateau after an high impact moment during horseback riding. The high impact moment occured with a fully extended leg when trying to step off as the horse was reared up. After a visit to the emergency room, the patient was sent home with a cast for two weeks before surgery was performed. Thereafter, the fracture was internally fixated with osteosynthetic material and the patient was referred to physiotherapy directly after surgery. A non-weight bearing policy was applied for the first 6 weeks post-surgery, thereafter weight bearing could be increased guided by the pain.

To download this Case Study click here. 

Goals

The treatment goals set by the patient and therapist were as follows:

 

Main goals:
  • Return to normal daily activities
  • Return to sport activities (horseback riding)

  • Subgoals:
  • Full weight bearing at 12 weeks post-surgery.
  • Restore normal range of motion (ROM)
  • Restore normal gait pattern
  • Restore normal strength
  • Restore cardiovascular condition
  • History / Progression

    Initially, the patient showed loss of range of motion (ROM) of flexion and extension of the knee (90/5/0), extra- and intra-articular edema and muscle atrophy of the left lower extremity. During the non-weight bearing phase, the physical therapy treatment consisted mobilizing exercises, non-weight bearing strengthening exercises and soft tissue mobilization. After 3 weeks full ROM (140/0/5) had been restored and edema was reduced.  

    At 4 weeks post-surgery treatment focused on dynamic mobilizing exercises such as cycling, and increasing muscle strength using the Biodex system pro 4 isokinetic dynamometer (Biodex Medical Systems, Inc., Shirley, New York, USA) for quadriceps and hamstring strength.

    At 6 weeks post-surgery, weight bearing gait training was started at 20% of body weight using the AlterG Anti-Gravity Treadmill® walking forward at 2.5 km/u for 10 minutes. The gait training progressed over the next 5 weeks increasing the weight, speed and duration up to 100% at 5 km/u for 30 minutes (see progression table).

    Besides gait training a progressive exercise program was performed consisting of strength training, stabilization exercises and coordination exercises. After each exercise session the involved knee was treated with a cooling and compression system (Game Ready®) to enhance soft tissue recovery.

    To see the progression table, please click here. 

    Objective Data

    Three measurements were conducted at onset of the AlterG progressive weight bearing program, 6 weeks post-surgery (Baseline). The measurements were repeated at 9 weeks post-surgery (T1) and at 12 weeks post-surgery (T2).

    Measurement:
  • Range Of Motion (ROM)
  • Knee injury and Osteoarthritis Outcome Score (KOOS)
  • Patient Specific Complaint questionnaire (PSK); Dutch questionnaire to determine the effort of specific tasks. Consisting of three items:
  • PSK 1: lying in bed
  • PSK 2: working
  • PSK 3: standing for a long period
  • Back

    We use cookies to offer you a better browsing experience, analyze site traffic, personalize content, and serve targeted ads. Read how we use cookies and how you can control them in our “Cookie Settings”. By using our site, you consent to our use of cookies.

    Agree