Tibial Plateau Fracture — ORIF (Schatzker I)

OrthoNY · Evan D. Boyd MD

Weight-Bearing

NWB/TDWB with brace locked in extension wks 0-6; progressing to PWB with brace locked in extension wks 6-8; WBAT per MD based on X-ray from wk 8

Key Restrictions

No active knee extension Phase I; no resisted closed chain or open chain until 6 wks; hinged brace locked at 0 deg for all mobility and gait until at least 4 wks, full extension and good quad control; ROM 0-90 deg wks 0-4, 0-120 deg wks 4-6; no weight bearing stretching into knee flexion until wk 8; no running, jumping or plyometrics until 4-6 months

Timeline & Phases

4 phases: Phase I Immediate Post-Op (0-6 wks), Phase II Protection (7-12 wks), Phase III Advanced Strengthening (13-16 wks), Phase IV Early Return to Sport (16+ wks); running begins at 4 months; plyometrics and agility drills at 4.5 to 5 months; return to sport 7 to 9 months

Notes

Time based and criterion based. Hinge brace until wk 8, then patellofemoral brace with lateral buttress. Includes a return to running program and an agility and plyometric program. Largely adopted from MGH Sports Medicine Physical Therapy protocols.

Surgeon / Author

Evan D. Boyd MD