Fracture — Tibial Spine Avulsion Fracture Surgical Fixation

UW Health Sports Medicine · UW Health Sports Rehabilitation & Sports Medicine Physician Group

Weight-Bearing

TDWB wks 1-2; PWB (max 50% BW) wks 3-6; WBAT after 6 weeks

Key Restrictions

Brace locked in extension x 6 wks; ROM graded in 30° increments: 0-30° wks 1-2, 30-60° wks 3-4, 60-90° wks 5-6 (imperative to protect periosteal stitch); meniscal repair: NWB flexion x4 wks; ROOT repair: TDWB locked x6 wks, NWB ROM 0-90°

Timeline & Phases

Phase I (0-6 wks: TDWB to PWB, locked brace, graded ROM) -> Phase II (6+ wks: normalize gait, CKC) -> Phase III (12-14 wks: running/impact; Biodex <25%) -> Phase IV (20-24 wks: multi-planar, Biodex <20%) -> Phase V (26-28 wks: cutting/pivoting, RTS; Biodex <10%)

Notes

5-phase protocol; ROM restriction imperative for periosteal stitch; NMES for quad activation; Type I (non-displaced) managed non-operatively with straight-leg brace x6 wks then rehab; Types II-III require surgical fixation (suture/screw arthroscopic); pediatric patients may stay overnight at American Family Children's Hospital; 6-12 months total PT; UW Health Sports Medicine, Madison WI

Surgeon / Author

UW Health Sports Rehabilitation & Sports Medicine Physician Group