Tibia Fracture Recovery

Full recovery from a tibia fracture can take a year or more. Things can get complicated if the fracture affects other parts of the leg, like the ankle or knee.

In some cases, patients can be left with permanent disability if the post-operative or post healing phase of rehabilitation is not appropriate. Early physiotherapy is absolutely essential in all treatments to prevent muscle wastage and reduce loss of power and function in the knee and ankle.

Early rehabilitation

Early active muscle re-education from day one aims to minimise loss, encourage tone, increase blood flow and reduce swelling and stiffness. Early weight bearing, as pain allows encourages bone growth (callus formation) and speeds the fracture healing rate.

Rehabilitation encourages movement. Sitting in the early phase is unavoidable due to the restrictions of movement but it creates deconditioning of the musculoskeletal system. Early regular movement of any kind is encouraged. Long term outcomes are improved with appropriate early rehabilitation and guidance.

How will recovery work?

In the early stages progress is made with walking, and lower leg muscle and joint exercises. All these fractures will take a full year before return to full activity and the more complex types will never return to contact sports.

Skiing will be delayed for 18 months for all injuries but patients can walk, cycle, swim and be instructed in the gym with appropriate and specific programs.

The key for a good outcome is to start rehabilitation as early as possible, but have expert advice to guide you through the stages of rehabilitation; with these fractures rehabilitation plays at least 50% part of the recovery process. Below is a rehabilitation framework that will give patients a rough guide.

Tibia fracture rehabilitation program

The following is an example of a tibia fracture rehab program and is a guide only. Always check with your doctor or physiotherapist before attempting any rehabilitation.

Stage 1 - 0 to 2 weeks

  • Non-weight bearing and walking with crutches.
  • Early quads and hip exercises.

Stage 2 - 2 to 4 weeks

  • Non-weight bearing and walking with crutches.

Stage 3 - 4 to 6 weeks

  • Change of full leg cast often to below knee cast.
  • Knee bending activity getting the quadriceps restored.
  • Gait re-education.
  • Slowly increase weight bearing as pain allows. General upper body and overall fitness.

Stage 4 - 6 to 12 weeks

  • 8 week check often more X-rays and a further cast or review of metalwork.
  • Aim for full weight bearing 10-12 weeks.
  • Encourage active rehab from 8 weeks +.
  • Work on knee and ankle mobility.
  • Balance and muscle tone are areas that affect longer term disability.

Contributed by Jason Howard, head physiotherapist at The White House physiotherapist clinic based in Sheffield, UK

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