Recovery of knee function following fracture of the tibial plateau.

We assessed the functional outcome following fracture of the tibial plateau in 63 consecutive patients. Fifty-one patients were treated by internal fixation, five by combined internal and external fixation and seven non-operatively. Measurements of joint movement and muscle function were made using a muscle dynamometer at three, six and 12 months following injury. Thirteen patients (21%) had a residual flexion contracture at one year. Only nine (14%) patients achieved normal quadriceps muscle strength at 12 months, while 19 (30%) achieved normal hamstring muscle strength. Recovery was significantly slower in patients older than 40 years of age. We conclude that there is significant impairment of movement and muscle function after fracture of the tibial plateau and that the majority of patients have not fully recovered one year after injury.

[1]  M. Stokes,et al.  Effects of Joint Pathology on Muscle , 1987, Clinical orthopaedics and related research.

[2]  A. Natri,et al.  Isokinetic performance of the thigh muscles after tibial plateau fractures , 1997, International Orthopaedics.

[3]  A. Young,et al.  The effect of knee injury on the number of muscle fibres in the human quadriceps femoris. , 1982, Clinical science.

[4]  David H. Perrin,et al.  Isokinetic Exercise and Assessment , 1993 .

[5]  M. Hurley,et al.  The effects of joint damage on muscle function, proprioception and rehabilitation. , 1997, Manual therapy.

[6]  G. Danckwardt-Lillieström,et al.  Postoperative restoration of muscle strength after intramedullary nailing of fractures of the femoral shaft. , 1976, Acta orthopaedica Scandinavica.

[7]  P. Gaston,et al.  Analysis of muscle function in the lower limb after fracture of the diaphysis of the tibia in adults. , 2000, The Journal of bone and joint surgery. British volume.

[8]  P. Kannus.  Normality, variability and predictability of work, power and torque acceleration energy with respect to peak torque in isokinetic muscle testing. , 1992, International journal of sports medicine.

[9]  O. Rutherford,et al.  Long-lasting unilateral muscle wasting and weakness following injury and immobilisation. , 1990, Scandinavian journal of rehabilitation medicine.

[10]  J. Keating,et al.  Minimal internal fixation and calcium-phosphate cement in the treatment of fractures of the tibial plateau. A pilot study. , 2003, The Journal of bone and joint surgery. British volume.

[11]  R J Robertson,et al.  Bilateral lsokinetic Peak Torque, Torque Acceleration Energy, Power, and Work Relationships in Athletes and Nonathletes. , 1987, The Journal of orthopaedic and sports physical therapy.

[12]  E. Will,et al.  Outcome after reconstruction of the anterior cruciate ligament in athletic patients. A comparison of early versus delayed surgery. , 2003, The Journal of bone and joint surgery. British volume.

[13]  R. Greer,et al.  A critical analysis of quadriceps function after femoral shaft fracture in adults. , 1980, The Journal of bone and joint surgery. American volume.

[14]  T. Ingemann-Hansen,et al.  Wasting of the human quadriceps muscle after knee ligament injuries. , 1985, Scandinavian journal of rehabilitation medicine. Supplement.

[15]  H. Mckellop,et al.  Healing and remodeling of articular incongruities in a rabbit fracture model. , 1993, The Journal of bone and joint surgery. American volume.

[16]  S. Lephart,et al.  Reliability and Precision of Isokinetic Strength and Muscular Endurance for the Quadriceps and Hamstrings , 1997, International journal of sports medicine.