tibial plateau fracture rehab protocol pdf
tibial plateau fracture rehab protocol pdf
Immediate Post-Surgical Rehabilitation
Focus on pain management, swelling reduction, and initial immobilization․ Use cryotherapy, medications, and bracing to support healing․ Begin with gentle exercises like quad sets and ankle pumps to maintain muscle activity during recovery․
1․1 Pain Management and Swelling Reduction
Pain management and swelling reduction are critical in the immediate post-surgical phase․ Cryotherapy, such as applying ice packs, is recommended for 20-30 minutes every hour to minimize swelling and discomfort․ Physicians may prescribe pain-relieving medications to manage postoperative pain effectively․ Elevation of the affected limb above heart level helps reduce swelling․ Gentle compression bandages or stockings can also aid in minimizing edema․ Monitoring for signs of complications, such as increased pain or redness, is essential․ Patients should avoid putting weight on the injured leg during this phase to prevent further inflammation․ Early intervention ensures a smoother transition to subsequent rehabilitation stages․
1․2 Initial Immobilization and Brace Usage
Initial immobilization is crucial to protect the fracture and surgical site, ensuring proper healing․ A hinged knee brace is typically used, locked in extension to prevent knee flexion and promote stability․ Patients are advised to remain non-weight-bearing (NWB) for approximately six weeks, using crutches or a walker for mobility․ The brace helps maintain knee alignment and reduces stress on the fracture site․ Regular checks are necessary to ensure the brace fits properly and does not cause skin irritation․ Immobilization duration may vary based on fracture severity and surgeon preference․ Adherence to this protocol minimizes complications and supports optimal recovery during the early healing phase․
Passive Mobilization Techniques
Passive techniques enhance joint flexibility and reduce stiffness․ Early range of motion exercises, wall slides, and heel slides are essential for maintaining knee mobility during the healing process․
2․1 Early Range of Motion Exercises
Early range of motion exercises are crucial for restoring knee mobility post-surgery․ Gentle, supervised movements prevent stiffness and promote healing․ Passive exercises, such as heel slides and wall slides, are often initiated within the first few weeks․ These activities help maintain joint flexibility without overloading the fracture site․ Patients are typically advised to perform these exercises several times daily, gradually increasing the range as pain and swelling subside․ Additionally, active assistive range of motion (AAROM) exercises may be introduced once the incision has healed sufficiently, allowing for controlled movement with the aid of a therapist or brace․ Consistency is key to avoiding contractures and ensuring optimal recovery․
2․2 Quad Sets and Ankle Pumps
Quad sets and ankle pumps are foundational exercises in early rehabilitation, focusing on muscle activation and circulation․ Quad sets involve contracting the quadriceps without moving the leg, strengthening the muscles and improving joint stability․ Ankle pumps, performed by flexing and extending the foot, enhance blood flow and reduce swelling․ These exercises are typically started immediately post-surgery, even during the non-weight-bearing phase, to prevent atrophy and promote healing․ Patients are instructed to perform multiple sets throughout the day, often for 10-15 repetitions․ These activities are low-impact, making them ideal for the initial stages of recovery when movement is limited․ Consistency with these exercises aids in maintaining muscle function and prepares the leg for more advanced strengthening as the fracture heals․
Weight-Bearing Progression
Progress from non-weight-bearing (NWB) to partial weight-bearing (PWB) and eventually full weight-bearing (FWB), guided by fracture healing and clinical assessment, using crutches or braces for support initially․
3․1 Non-Weight Bearing (NWB) Phase
The NWB phase typically lasts 6 weeks post-surgery, allowing the fracture to stabilize without additional stress․ Patients use crutches or walkers to avoid placing weight on the affected limb․ A hinged knee brace is often worn, locked in extension, to protect the knee and promote healing․ During this period, focus shifts to maintaining joint mobility through passive and active-assistive range of motion exercises․ Quad sets, ankle pumps, and wall slides are commonly prescribed to prevent muscle atrophy and stiffness․ Cryotherapy is recommended to manage swelling, and patients are advised to keep the incisions dry for the first few days․ Regular follow-ups with the orthopedic team ensure proper progression and address any complications early․
3․2 Transition to Partial Weight Bearing
The transition to partial weight bearing (PWB) typically occurs after 6-8 weeks, following radiographic confirmation of fracture stability․ Patients gradually introduce weight-bearing activities, often starting with 25-50% of their body weight, using crutches or walkers for support․ This phase aims to restore functional mobility while minimizing stress on the healing fracture․ Gait training is emphasized to ensure proper weight distribution and prevent compensatory patterns․ Strengthening exercises, such as mini squats and step-ups, are introduced to improve lower extremity strength․ Pain and swelling management continue with modalities like ice or electrical stimulation․ Regular physical therapy sessions monitor progression and address any limitations․ The goal is to progress to full weight bearing safely, avoiding premature stress on the tibia․
Advanced Strengthening Exercises
Advanced strengthening exercises are introduced once the fracture has achieved sufficient stability and the patient progresses beyond the initial recovery phase․ These exercises focus on restoring muscle strength, power, and endurance around the knee and lower extremities․ Leg presses, mini squats, and step-ups are commonly incorporated to target the quadriceps, hamstrings, and glutes․ Resistance bands or light weights may be added to increase intensity․ Balance and proprioception training, such as single-leg stands or wobble board exercises, are also emphasized to improve functional stability․ Patients are encouraged to perform these exercises 3-4 times weekly, gradually increasing resistance and repetitions․ The goal is to restore pre-injury strength levels and prepare the patient for return to daily activities or sports․ Regular reassessment by a physical therapist ensures proper progression and avoids overloading the healing tibia․
Managing Complications and Setbacks
Complications such as hardware failure, infection, or delayed union may arise, requiring prompt intervention․ Signs of complications, including increased pain, swelling, or wound drainage, should be monitored closely․ Imaging studies and laboratory tests may be necessary to identify issues early․ Treatment adjustments could involve antibiotic therapy, additional surgery, or modifications to the rehabilitation plan․ Weight-bearing status may need to be revised temporarily to offload the fracture site․ Physical therapy plays a crucial role in addressing setbacks by maintaining joint mobility and strength during periods of limited activity․ Open communication between the patient and healthcare team is essential to address concerns and adapt the recovery plan as needed․ Psychological support is also important, as setbacks can impact motivation and overall recovery progress․ Regular follow-ups ensure any deviations from the expected healing trajectory are managed effectively to achieve optimal outcomes․
Role of Physical Therapy
Physical therapy is crucial for restoring function and strength after a tibial plateau fracture․ It helps prevent muscle atrophy and improves joint mobility․ Early interventions include passive range of motion exercises and quad sets to maintain muscle activity․ As healing progresses, therapists introduce weight-bearing exercises and advanced strengthening programs tailored to the patient’s recovery stage․ Balance and proprioception training are incorporated to enhance stability and reduce the risk of further injury․ Physical therapy also addresses complications such as limited mobility or pain, ensuring a safe transition to normal activities․ Regular sessions promote long-term recovery, emphasizing functional movements and patient education for continued independence․ The therapist collaborates with the medical team to adapt the rehabilitation plan, ensuring optimal outcomes and addressing any setbacks promptly․ This structured approach minimizes recovery time and maximizes the return to pre-injury function and mobility․
Long-Term Rehabilitation and Recovery
Long-term rehabilitation focuses on restoring full strength, mobility, and function after a tibial plateau fracture․ This phase emphasizes progressive strengthening, functional activities, and proprioception exercises to improve joint stability․ Patients gradually transition to weight-bearing exercises, balance training, and sport-specific movements if applicable․ The goal is to achieve pre-injury levels of activity, with a focus on preventing future injuries․ Recovery timelines vary, but most patients require 6-12 months for complete rehabilitation․ Regular follow-ups with physical therapists ensure proper progression and address any lingering limitations․ Patient education is key, teaching proper movement patterns and exercises for continued independence․ Complications, such as arthritis or chronic pain, are monitored and managed to optimize long-term outcomes․ Psychological support is also important to help patients overcome the challenges of prolonged recovery and regain confidence in their abilities․