Thesis (Ph.D.) - Cairo University - Faculty of Physical therapy - Department of Physical Therapy for Orthopaedics

Backgrounds/Significance: There is lack of evidence supporting early weight bearing in physical therapy treatment programs after open reduction and internal fixation of fractures. Up to our knowledge there is no published work performed to investigate the effect of adding early weight bearing to the protocol of treatment after open reduction internal fixation surgeries of tibial plateau fracture. Subjects: Thirty patients diagnosed with tibial plateau fractures Schatzker type I, II, III and IV fixed by locked buttress plates with sub-articular screws were referred from orthopedic surgeons after the operation. Methods and materials: Patient age ranges from 25-45 years. Group A treated with physical therapy program with introducing early weight bearing training. Group B treated with physical therapy program and delayed weight bearing training. Criteria for progression were based on surgeon judgment, pain level, condition of surgical site and strength of the lower extremity. The outcome measures were: Digital X-ray to assess the fracture stability pre-and post-treatment, VAS to assess pain level and fluid-filled inclinometer to measure the ROM during rehabilitation. Results: There was no significant differences in migration mean values of pre-treatment and post-6 wks. while, a significant difference in post-12 wks., between groups 1 and 2. There was significant differences in ROM measurement pretreatment post treatment and there was no significant difference between groups in pain intensity level (VAS) pre and post treatment. There was a significant difference between pre-and post-treatment within group A regarding ROM and group B regarding VAS. There was significant difference regarding fracture stability within group A and within group B regarding fracture stability

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