Comparison of Functional Outcome between Early and Usual CPM Physiotherapy in Healing Tibia Plateau Fracture

Objective: In order to determine the functional outcome of surgically treated tibia plateau fractures using routine and early CPM physiotherapy following operative treatment a descriptive prospective study was carried out. Methods: 120 patients with tibia plateau fractures were initially included in this study. 18 patients were excluded from the study according to the exclusion criteria and the remaining 102 patients were followed for 1 year. There were 76 men and 26 women in this investigation. The mean age was 39 years old. Fractures were classified according to Schatzker classification algorithm. A 1-year follow-up was done on these 102 patients. Functional outcome of the patients was graded with HSS and SF-36 functional scores. Statistical analysis was performed by means of SPSS analysis software version 22. Results: The average time to union was 13 weeks. A mean ROM of 125 degrees for routine physiotherapy and 140 degrees for early CPM physiotherapy treated patients one year after injury. Functional results showed a mean HSS score of 80 points (Range: 19-100). Schatzker type I, II, III and IV fractures showed statistically significant better results compared to Schatzker type V and VI fractures. With regard to SF-36 score, 1 year after injury of eight SF-36 subscales, the results were better in the patients in 6 subscales in early CPM physiotherapy treated patients compared with routine physiotherapy group. The majority of the patients were able to perform most of the pre-injury daily activities after 1 year. The most important independent factors influencing functional results in this study were doing early rehabilitation procedures, age of the patients and fracture type. Conclusion: Functional results after open reduction and internal fixation of tibia plateau fractures seem to be excellent according to HSS score. However, the overall patient function is more satisfactory in early CPM physiotherapy treated patients’ in comparison with routine physiotherapy group.