4 0 obj 4 0 obj 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]}[ t\Leh1vh y+yx~f|t]eMpAcP?;.`9tFva"cm@ eId_?c2 QUIO83&S|bTn B8.njca4zfA } 0R "pOY8\vpV)gJ9(fYWlB[j,,ibzZT3( <> The amount of weightbearing allowed is based on the quality of the fixation, quality of the bone and the healing status of the fracture. 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 Rehabilitation should create the optimal environment for the natural process of healing to occur. endobj TIBIAL TUBERCLE ORIF PHYSICAL THERAPY Philosophy . 3 0 obj Tibial Fracture: If the joint surface is exactly restored it is unlikely that arthritis will develop. 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 2 0 obj All should go well after the healing period and pt. 3 0 obj endobj Knee PROM/AAROM to 90 flex; Work on quad, ankle, core strengthening; lower extremity stretching; ROM Goals: Knee Flex 90 Ext 0. using a standardized transportal technique and . 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. 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 . Rehabilitation should create the optimal environment for the natural process of healing to occur. Implement sport specific, multidirectional drills; begin plyometrics; continue lower extremity strengthening exs. Early passive joint motion is key. Regain range of motion 4. %PDF-1.7 It is recommended that clinicians collaborate closely with the referring physician regarding the timeframes for progression. 1 0 obj 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 Non-weightbearing status for 4 weeks post-op. The path to regaining range of motion, strength and function can require a sustained and coordinated effort . Protect the fractured clavicle 2. Proximal Humeral Fracture Open Reduction Internal Fixation . AROM for ankle, subtalar, midtarsal joints within pain tolerance 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. %h|s-0!pj"3'!f4D1H*c|*ZET!Ao0c7I^[AD^%(wMecbD3`Z}b0&e)r`D.S <> endobj 53880 Carmichael Drive South Bend, IN 46635 60160 Bodnar Boulevard Mishawaka, IN 46544 Phone: 574.247.9441 Fax: 574.247.9442 www.sbortho.com . If surgery required: ORIF and casting. <> <> Our evidence-based post-procedure rehab guidelines helps facilitate a successful return to activity. 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. Thank. x\[OH~G?JveXm&ayh^:46!_6 nw/=~,}:8]qp6;8^72_|;+o|0swg? #O %]H.X Tibial Plateau Fracture Rehab Protocol Keys to a Successful Outcome Early passive joint motion is key. Initially, there should be a strong emphasis on minimizing swelling . 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 Goal is to achieve full range of motion within first 6 weeks. Conclusion: The present literature review illuminates the controversy that exists in the literature about the physiotherapy following tibia plateau fracture . Tibial Plateau Fracture ORIF Rehabilitation Protocol . New West sports medicine & orthopaedic surgery Phone: 2810 W. 35th Street Kearney, NE 68845 (308) 865-2570 or (800) 408-1689 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 Dr. Murken operates at St. Anthony's Hospital, Golden Ridge Surgery Center and Ortho Colorado Hospital. 2 0 obj The tibia, or shin bone, is the larger bone in your lower leg. Goal is to achieve full range of motion within first 6 weeks. ''z/'9KV_"O2OG~=Uz$/fHo|z|W/KkKib_`ZrU!g2tZfEp:SB_',yGp7g"jC>cYyd 9D@/8lNDQ-2^R;7T-50/T UH| <> It is recommended that clinicians collaborate closely with the referring physician regarding the timeframes for progression. 4 0 obj Foot placed in CAM boot for stabilization and wound protect ion 2. vw>nvwDBW&4UX0lew2N,e;Pks#v |!5G`_OY';O@ WuZI2H&{-x ZE!&.6n,,0vM7d=!'we, |r _\KKJ|E ^!b YWDJ/Z0!oW-D}TEB|In5t]bve=C3E/S#x.4OsAf8]dlXAQaBH]d= )@WMt,n4LUu.L8gByJ2>$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. 1 0 obj 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. . It is not intended to be a substitute for clinical decision making regarding the progression of a patient's Physical Therapy Protocol Prescription . Ankle Fracture ORIF Advanced Rehab Protocol . 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. High Tibial Osteotomy Protocol; Iliotibial Band Syndrome; Knee Joint Resurfacing; MCL Injury; Medial Patellofemoral Ligament (MPFL) Reconstruction . Associate Professor of Orthopaedics Chief, Division of Sports Medicine Tel: (646) 501-7223 Rehabilitation Protocol: Tibial Spine Open Reduction Internal Fixation Rehabilitation after Clavicle Fracture Phase One: 0 to 6 weeks after surgery Goals: 1. % twitter.com/i/web/status/1, Internal rotation following reverse total shoulder arthroplasty continues to be a complex challenge. endobj Your tibial plateau supports most of your body weight. Your Easy & Proven Tibial Plateau Fracture Rehab Protocol. 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- Initially, there should be a strong emphasis on minimizing swelling . Ortho.Boston is a private Orthopedic Surgery practice located in Needham Heights, MA. At 2-4 weeks s/p, initiate weight-bearing as tolerated with crutches 2. Az]Q0PBE OL Dr. Ahmad M Hadied and another doctor agree. If surgery is not required: closed reduction then casting. Static quadriceps exercises with passive range of motion is encouraged. 617-643-9999; Sports PT Staff; Sports Medicine Center; Like us on Facebook . Patients will be in a hinged brace for support and to serve as a reminder not to weight-bear. Phase / Goals . <>/Metadata 257 0 R/ViewerPreferences 258 0 R>> Static quadriceps exercises with passive range of motion is encouraged. General Notes: The type of fracture and required fixation may dictate alterations to the general protocol below. Sling Use your sling most of the time for the first 2 weeks. 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. endobj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> endobj Control pain and swelling Activities: 1. Static quad strengthening; transfer training. 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. 1 0 obj % <>>> This should be filled and ready for use when you return home from the surgery center/hospital. ORIF TIBIAL TUBERCLE PROTOCOL I. 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. Initially, there should be a strong emphasis on minimizing swelling . Before reaching the point of walking we have to ensure that all the component of walking is intact. Work on Knee Flex AROM; Gait training*; progressive lower extremity strengthening including quads, hams and hips. You should not drive, operate heavy machinery or participate in activities that Phone: 763-717-4120 | Website: . If you have any questions regarding this protocol, please contact the UGH Orthopedics and Sports Medicine Department at . The mechanical stimulus of the joint moving allows for improved joint surface remodeling/healing. Procedure: Tibia ORIF/Intramedullary nail Pain Medication: You will be given a prescription for pain medication to be taken after surgery. <> %PDF-1.5 Regular manual treatment should be conducted to the patella and all incisions--with particular attention to the anterior medial portal--to decrease the . endobj If you have any questions regarding this protocol, please contact the UGH Orthopedics and Sports Medicine Department at (706 . ROM goals: FAROM of knee. Open reduction and internal fixation (ORIF) is a type of surgery used to stabilize and heal a broken bone. stream Some patients may not progress as quickly as the protocol allows. It's heavily built and designed to withstand a lot of heavy lifting, so tibial plateau fractures are rare - but they can happen. *Gaittraining may begin if cleared by MD at week 8. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> You might need this procedure to treat your broken shin bone (tibia) or your fibula. The goal of treatment is to maximize the long term function of the ankle by restoring and maintaining alignment. What is a Pediatric Sports Medicine Specialist? &8= Beside it, more toward the outside of the leg, is the fibula. Ohio State physicians and physical therapists work collaboratively to develop best clinical practices for post-surgical rehabilitation. Prevent shoulder stiffness 3. race: 8 weeks total Weeks 0-2: Toe-Touch Weight Bearing (Full Extension) Weeks 3-4: Partial Weight Bearing (Full . 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. 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. TJ Ridley, MD . stream <>/Metadata 469 0 R/ViewerPreferences 470 0 R>> Seek full hyperextension equal to opposite side. 6.3k views Reviewed >2 years ago. TJRidleyMD.com | Instagram: @dr._ridley . 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. {v3.g _e)K+nvwv?9c_@Vor@iD(&T,aKpCAslk;oc#uL._/);Z?LGrY,Ky3)M) ,f3TRjr%4z5ttQ^#=h]Ej6D2D\1m,{aX=JD9HiOZV{ % Tibia plateau fractures can have significant impact on the patients' lives, so ongoing rehabilitation with focus on quadriceps strengthening and proprioception exercises is recommended. The doctor will give you additional 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). The most common mechanism of injury is motor vehicle accident, PHASE I: Goals: Wound healing and edema control Day 1: 1. endobj 2 0 obj <>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Progress strengthening and balance exs; Begin treadmill walking, progress to pool running, followed by treadmill running. Orthopedic Surgery 51 years experience. TIBIAL PLATEAU ORIF PHYSICAL THERAPY Philosophy . Rehabilitation should create the optimal environment for the natural process of healing to occur. If you have any questions regarding this protocol, please contact the UGH Orthopedics and Sports Medicine Department at (706 . %PDF-1.5 endobj The mechanical stimulus of the joint moving allows for improved joint surface remodeling/healing. 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. An effective treatment regimen and healthy lifestyle choices can get patients back on their feet. 3 0 obj *V~s*?d|gblDcHiJGN2\z8uYoYzO,I|j4>A}u7,Ke0U$e9?2g0C2'IcwhaGD 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 Find PDFs of our most common rehabilitation protocols. 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