6.3k views Reviewed >2 years ago. Beside it, more toward the outside of the leg, is the fibula. 3 0 obj <> endobj Orthopedic Surgery 51 years experience. Ankle Fracture ORIF Advanced Rehab Protocol . The tibia, or shin bone, is the larger bone in your lower leg. The goal of treatment is to maximize the long term function of the ankle by restoring and maintaining alignment. %PDF-1.5 <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> endobj TJRidleyMD.com | Instagram: @dr._ridley . tibial fractures6,7,20,21,42,47 because patients reach a higher degree of activity and confidence sooner with a "vulnerable tibia" in the postoperative rehabilitation stage.20,21,24,42 While accelerated rehabilitation protocols have been implemented in TTO surgeries throughout the years,5,24,27,43 little to no research has been completed look- Foot placed in CAM boot for stabilization and wound protect ion 2. Tibial Plateau ORIF Rehabilitation Protocol, Malalignment (Bow-legged and knock knees), Articular Cartilage Repair and Restoration, Medial Patellofemoral Ligament (MPFL) Reconstruction, Patellofemoral Chondral Injury Reconstruction, Cartilage Injury in Children, Youth and Teens, Meniscal Injury in Children and Adolescents, Patella Instability in Children and Adolescents, Shoulder Instability in Children, Youth and Teens, ACL Reconstruction Open Growth Plate Pediatric, Articular Cartilage Injury in Children and Adolescents, Meniscus Repair or Transplantation in Pediatric Patients, Osteochondritis Dissecans in Children and Adolescents, Meniscus Repair Part 2: Technical Aspects, Biologic Augmentation, Rehabilitation, and Outcomes, Meniscus Repair Part 1: Biology, Function, Tear Morphology, and Special Considerations, Minimum 2-Year Clinical Outcomes-Meniscus Root Tears, Knotted Transosseous-Equivalent Technique for Rotator Cuff Repair, Brace 0-90 (unlocked) for 6 weeks (unless otherwise specified), Quad strengthening to gain full extension, SLR in brace at 0 until quad can maintain knee locked, Toe touch weight bearing with crutches weeks 6-8, Advance 25% weekly weight bearing and progress to full weight bearing, Progress open/closed chain exercises as tolerated, Strength 80% of uninvolved leg by week 16, Pool exercises for strengthening (pool running at week 16), Implement sport specific, multidirectional drills, Being bilateral plyometrics, progress to unilateral, Continue with aggressive lower extremity strength progression, Clearance from physician prior to return to sport. Initially, there should be a strong emphasis on minimizing swelling . Phase 1 (Weeks 1-6) Appointments Dr. Cien follow up visit at 2 weeks post op Begin physical therapy for knee ROM at 2 weeks post op Rehabilitation MaintainGoals kneeEXT toallow incisions heal and prevent Our evidence-based post-procedure rehab guidelines helps facilitate a successful return to activity. 4 0 obj The mechanical stimulus of the joint moving allows for improved joint surface remodeling/healing. For the Clinician: The intent of this protocol is to provide the clinician with a guideline of the post-operative rehabilitation for the patients who undergo surgery for an ankle fracture. Rehabilitation should create the optimal environment for the natural process of healing to occur. Regain range of motion 4. Dr. Ahmad M Hadied and another doctor agree. % Rehabilitation after Clavicle Fracture Phase One: 0 to 6 weeks after surgery Goals: 1. Phone: 763-717-4120 | Website: . 3 0 obj Procedure: Tibia ORIF/Intramedullary nail Pain Medication: You will be given a prescription for pain medication to be taken after surgery. Progress strengthening and balance exs; Begin treadmill walking, progress to pool running, followed by treadmill running. stream t\Leh1vh y+yx~f|t]eMpAcP?;.`9tFva"cm@ eId_?c2 QUIO83&S|bTn B8.njca4zfA } 0R "pOY8\vpV)gJ9(fYWlB[j,,ibzZT3( If you have any questions regarding this protocol, please contact the UGH Orthopedics and Sports Medicine Department at . If you have any questions regarding this protocol, please contact the UGH Orthopedics and Sports Medicine Department at (706 . <> Your tibial plateau supports most of your body weight. The amount of weightbearing allowed is based on the quality of the fixation, quality of the bone and the healing status of the fracture. race: 8 weeks total Weeks 0-2: Toe-Touch Weight Bearing (Full Extension) Weeks 3-4: Partial Weight Bearing (Full . ''z/'9KV_"O2OG~=Uz$/fHo|z|W/KkKib_`ZrU!g2tZfEp:SB_',yGp7g"jC>cYyd 9D@/8lNDQ-2^R;7T-50/T UH| 4 0 obj Tibial Plateau Fracture Post-Operative Protocol Phase I - Maximum Protection (0 to 1 weeks): 0 to 1 week: Ice and modalities to reduce pain and inflammation Use crutches non-weight bearing for 6 weeks Brace for 6 weeks in full extension (may begin light knee range of motion exercises once incision is healed and cleared by Dr . Tibial Plateau Fracture ORIF Rehabilitation Protocol . Regular manual treatment should be conducted to the patella and all incisions--with particular attention to the anterior medial portal--to decrease the . <>/Metadata 469 0 R/ViewerPreferences 470 0 R>> Rehabilitation should create the optimal environment for the natural process of healing to occur. Tibia fracture physiotherapy rehab protocol The goal of the surgical and rehabilitative team focuses on the return of a patient to their previous level of function often in the setting of competing for short-term goals 2. Conclusion: The present literature review illuminates the controversy that exists in the literature about the physiotherapy following tibia plateau fracture . SH!7V#h4OTe%QDMnT|&->2)RV|VSot/^ iDc|kn_ X{EPz:]U6Fk {*5x{iL]\Pc" B~ b0K9r.G?Y3s[}#n8-zW6,~(GEOj >4fK0mvexSA=_hw.%]T ON+iLXxhD=bt-ki(h~>e;.nVFS`n73[q_IN%\Jm&hCk|DG)Rgmdf}LqL&Rr#NUVu4 b6<46dVuqJ7 t jq3TP 6i379LTM]obHHx&)ln5"lUsB. <> x\[s~WZ:8vnd6eb{: PRbIV"H |a?_g_'juO! Dr. Murken operates at St. Anthony's Hospital, Golden Ridge Surgery Center and Ortho Colorado Hospital. This should be filled and ready for use when you return home from the surgery center/hospital. What is a Pediatric Sports Medicine Specialist? AROM for ankle, subtalar, midtarsal joints within pain tolerance using a standardized transportal technique and . It's heavily built and designed to withstand a lot of heavy lifting, so tibial plateau fractures are rare - but they can happen. You might need this procedure to treat your broken shin bone (tibia) or your fibula. endobj <> Protect the fractured clavicle 2. Physical Therapy Protocol Prescription . Patients will be in a hinged brace for support and to serve as a reminder not to weight-bear. 1 0 obj The mechanical stimulus of the joint moving allows for improved joint surface remodeling/healing. % % Control pain and swelling Activities: 1. Download Patella ORIF Rehab Protocol Patella ORIF Rehabilitation Protocol Initial Restrictions: ROM: 0-90 x 4 weeks, 0-120 weeks 4-6, then progress as tolerated after 6 week clinic visit and cleared by physician Brace: Locked in extension x 6 weeks Weight Bearing Status: WBAT with crutches &8= *Gaittraining may begin if cleared by MD at week 8. Some patients may not progress as quickly as the protocol allows. 2 0 obj stream If either increase, modify rehab PRICE Ankle Pumps E-stim if Needed Phase I (up to 6 weeks s/p ORIF): Goals: PWB involved LE with or without one crutch DF to neutral Control edema 1. Surgery Date: Diagnosis: Tibial Spine Avulsion Fracture Frequency: 2-3 visits/week Duration: 4 months OVERVIEW: Focus on the protection of fixation in Phase I (0-6 weeks postop). Rehabilitation Protocol: ORIF Tibial Plateau Fracture W e i g h t Be a r i n g RO M Br a c e Us e T h e r a p e u ti c E l e me n ts PHASE I 0 - 4 weeks 4 - 6 weeks T o u ch -d o wn we i g h t b e a ri n g (T DW B ) wi t h cru t ch e s. T DW B wi t h cru t ch e s. O b t a i n f u l l e xt e n si o n n o w. Thank. If you have any questions regarding this protocol, please contact the UGH Orthopedics and Sports Medicine Department at (706 . <>/Metadata 257 0 R/ViewerPreferences 258 0 R>> vw>nvwDBW&4UX0lew2N,e;Pks#v |!5G`_OY';O@ WuZI2H&{-x ZE!&.6n,,0vM7d=!'we, |r _\KKJ|E ^!b YWDJ/Z0!oW-D}TEB|In5t]bve=C3E/S#x.4OsAf8]dlXAQaBH]d= )@WMt,n4LUu.L8gByJ2>$Ra {dQ=]mHf&ICwP@pXO&A:9?o?!zqs/ZI Ytdo%?2TQk b&=6PotircWS7x[(t(_y>`2MNrQbR.fxBU_:@"7iMEhyZT*rlIH][h-` ;vagLpOP2}EyCISOAipiJJ_6oSq /%Fdo%M)9,yb8Lw!.HeQgED-2c`o9F E`=G. 3 0 obj TIBIAL TUBERCLE ORIF PHYSICAL THERAPY Philosophy . Your Easy & Proven Tibial Plateau Fracture Rehab Protocol. It is recommended that clinicians collaborate closely with the referring physician regarding the timeframes for progression. General Notes: The type of fracture and required fixation may dictate alterations to the general protocol below. Initially, there should be a strong emphasis on minimizing swelling . <> To determine whether supplementary tibial graft fixation with a staple is routinely necessary for anterior cruciate ligament (ACL) reconstructions.We retrospectively reviewed a series of consecutive patients who underwent ACL reconstruction at our institution from April 2012 to July 2013. . Ortho.Boston is a private Orthopedic Surgery practice located in Needham Heights, MA. Immediate Postoperative/Max Protection Phase (Weeks 1-4) Goals: Restore full passive knee extension Diminish pain and joint swelling Restore patellar mobility *Control forces on repair site Postoperative Weeks 1-4 Brace: brace locked at 0 deg extension with compression wrap except for PT 1 0 obj TJ Ridley, MD . Department of Rehabilitation Services Physical Therapy Standard of Care: Tibial Plateau Fracture Case Type / Diagnosis: ICD-9: 823.00 - fracture of proximal tibia Tibial plateau fractures can occur as a result of high-energy trauma or in low-energy trauma when bone quality is poor. 617-643-9999; Sports PT Staff; Sports Medicine Center; Like us on Facebook . Work on Knee Flex AROM; Gait training*; progressive lower extremity strengthening including quads, hams and hips. Phase / Goals . Knee PROM/AAROM to 90 flex; Work on quad, ankle, core strengthening; lower extremity stretching; ROM Goals: Knee Flex 90 Ext 0. endobj PHASE I: Goals: Wound healing and edema control Day 1: 1. The path to regaining range of motion, strength and function can require a sustained and coordinated effort . If surgery required: ORIF and casting. ORIF (OPEN REDUCTION INTERNAL FIXATION) TIBIAL SHAFT FRACTURE POST-OPERATIVE GUIDELINES Scheduling Your Surgery A surgery scheduler will be contacting you within the next week to work on getting a date set for your surgery. The doctor will give you additional Tibia plateau fractures can have significant impact on the patients' lives, so ongoing rehabilitation with focus on quadriceps strengthening and proprioception exercises is recommended. %PDF-1.5 You should not drive, operate heavy machinery or participate in activities that Prevent shoulder stiffness 3. 53880 Carmichael Drive South Bend, IN 46635 60160 Bodnar Boulevard Mishawaka, IN 46544 Phone: 574.247.9441 Fax: 574.247.9442 www.sbortho.com . A great articl twitter.com/i/web/status/1. Early passive joint motion is key. twitter.com/i/web/status/1, Internal rotation following reverse total shoulder arthroplasty continues to be a complex challenge. The most common mechanism of injury is motor vehicle accident, Ohio State physicians and physical therapists work collaboratively to develop best clinical practices for post-surgical rehabilitation. It is recommended that clinicians collaborate closely with the referring physician regarding the timeframes for progression. An effective treatment regimen and healthy lifestyle choices can get patients back on their feet. Implement sport specific, multidirectional drills; begin plyometrics; continue lower extremity strengthening exs. endobj <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Rehabilitation should create the optimal environment for the natural process of healing to occur. *V~s*?d|gblDcHiJGN2\z8uYoYzO,I|j4>A}u7,Ke0U$e9?2g0C2'IcwhaGD <> Before reaching the point of walking we have to ensure that all the component of walking is intact. Considerations for the Post-operative Ankle ORIF Many different factors influence the post-operative ankle ORIF rehabilitation outcomes, including rate of healing, complexity of the fracture and/or need for hardware removal. Sling Use your sling most of the time for the first 2 weeks. #O %]H.X Open reduction and internal fixation (ORIF) is a type of surgery used to stabilize and heal a broken bone. 1 0 obj Proximal Humeral Fracture Open Reduction Internal Fixation . High Tibial Osteotomy Protocol; Iliotibial Band Syndrome; Knee Joint Resurfacing; MCL Injury; Medial Patellofemoral Ligament (MPFL) Reconstruction . Tibial Plateau ORIF Protocol 0-6 Weeks Post Op Non weight bearing x 6 weeks Brace 0-90 (unlocked) for 6 weeks (unless otherwise specified) Pain/edema control, modalities as needed Knee PROM and AAROM to 90 degrees Quad strengthening to gain full extension SLR in brace at 0 until quad can maintain knee locked Heel slides in brace Initially, there should be a strong emphasis on minimizing swelling . 2Km;S&?Mhe&=\'Pwo4OY./S3}?%J( 5:T~t$6oTa@mtvf}3Tx~_ &*t6VrSRGcurI,O &9>|y)KfpQ:1 bW22Dg^O@zO0 ;i!8mvrP4O]sh.]95z@~ e`V/o#M8u. %PDF-1.7 <>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> x\[OH~G?JveXm&ayh^:46!_6 nw/=~,}:8]qp6;8^72_|;+o|0swg? Considerations for the Post-operative Ankle ORIF Many different factors influence the post-operative ankle ORIF rehabilitation outcomes, including rate of healing, complexity of the fracture and/or need for hardware removal. endobj Tibial Tubercle Fracture Download Protocol as a PDF Phase I (Weeks 0 - 4) TDWB with crutches and immobilizer/brace locked in extension NO RANGE OF MOTION FOR FIRST 4 WEEKS Strengthening: Sub maximal quadricep sets, glut sets, HS sets Ankle pumps Patellar mobilizations Phase II (weeks 4-6) WBAT with crutches and T-Scope locking in extension 4 0 obj TIBIAL PLATEAU ORIF PHYSICAL THERAPY Philosophy . New West sports medicine & orthopaedic surgery Phone: 2810 W. 35th Street Kearney, NE 68845 (308) 865-2570 or (800) 408-1689 ROM goals: FAROM of knee. All should go well after the healing period and pt. ORIF TIBIAL TUBERCLE PROTOCOL I. Static quadriceps exercises with passive range of motion is encouraged. Tibial Fracture: If the joint surface is exactly restored it is unlikely that arthritis will develop. endobj REHABILITATION GUIDELINES FOR TIBIAL PLATEAU FRACTURE PHASE I (WEEKS 1-6) DATES: Appointments MD follow up visit at 2 weeks post op Begin physical therapy for knee ROM at 2 weeks post op Rehabilitation Goals Maintain knee EXT to allow incisions to heal and prevent knee flexion contracture It is not intended to be a substitute for clinical decision making regarding the progression of a patient's Goal is to achieve full range of motion within first 6 weeks. 2 0 obj At 2-4 weeks s/p, initiate weight-bearing as tolerated with crutches 2. Seek full hyperextension equal to opposite side. TIBIAL PLATEAU ORIF PHYSICAL THERAPY Philosophy . <>>> Static quadriceps exercises with passive range of motion is encouraged. {v3.g _e)K+nvwv?9c_@Vor@iD(&T,aKpCAslk;oc#uL._/);Z?LGrY,Ky3)M) ,f3TRjr%4z5ttQ^#=h]Ej6D2D\1m,{aX=JD9HiOZV{ x]mo6n,/zb'N H!DRWkECRwbS>|oK/2/og\=qz8|X-OnJjU$g/ 2HHbdlOdAOGT8XGI*!9_~+ h#!3;9F\oGDf"FabQ;xz9?aY:A']Hd\QL&H$"a L7>}NTI$". 9ZK_M\X|iCvTic)ebMh>SSqEvCDP) e6do[[0]}c;!N,Af(KW(j&.>U\-YeI@sV}UzD?/$IO&x?_4)\'K_[lk(k'4V_M6x i5Y$[Sng|R*9S%r-sT%eG8%r$Eq.)$*W}%I [ '{'TR Q<35`0[/6/MK(F-F 3hW pVvu6vTV~CJDp"}_SNElPXq'((GF$i:4jR!( t>!"v 4zM+^1QN%Td]}[ Az]Q0PBE OL endobj Associate Professor of Orthopaedics Chief, Division of Sports Medicine Tel: (646) 501-7223 Rehabilitation Protocol: Tibial Spine Open Reduction Internal Fixation 2 0 obj Goal is to achieve full range of motion within first 6 weeks. Static quad strengthening; transfer training. stream endobj %h|s-0!pj"3'!f4D1H*c|*ZET!Ao0c7I^[AD^%(wMecbD3`Z}b0&e)r`D.S If surgery is not required: closed reduction then casting. Find PDFs of our most common rehabilitation protocols. Tibial Plateau Fracture Rehab Protocol Keys to a Successful Outcome Early passive joint motion is key. 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