Surgical and Functional Outcome of Early Mobilization in Proximal Tibial Fracture

Background: The major cause of proximal tibial fractures attributes to road traffic accident, dominated by male gender with younger age group from high energy trauma. With advancement in newer surgical techniques, improvement in the quality of implants, better soft tissue handling during surgery, and early mobilization in the form of assisted and supervised physiotherapy; the results of surgical outcome are improving. We aim to study clinical and functional outcome after surgery with introduction of early mobilization in various types of Proximal Tibial fractures in terms of range of motion and its effect on operative construct.

Methods: This is prospective observational study of 68 cases of Proximal Tibia fractures with 53(77.9%) males and 15(22.1%) females using suitable implants and initiating early physiotherapy from day 2. Follow up at 3rd and 6th week was done to assess the outcome.

Results: Early initiation of physiotherapy showed significant association with improvement in range of motion with choice of implant at 3rd week (p value -0.039) and at 6th week (p value-0.000) and type of fracture as well.

Conclusion: The early mobilization after fixation of proximal tibial fractures helps in improving the range of motion of the knee joint, strength of quadriceps and hamstrings. Since Schatzker type V and VI are more severe than Schatzker type I and II the outcome also varied with improved results seen in later than the former.