Immediate Knee Joint Range of Motion after Stable Fixation of Tibial Plateau Fractures

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The purpose of this study was to evaluate factors that affect initiation of early postoperative range of motion (ROM) rehabilitation and to investigate whether the postoperative ROM and clinical outcomes were affected by initiation of early ROM, immobilization and other factors. We conducted a retrospective analysis of tibial plateau fractures treated using stable internal fixation between December 2003 and June 2007. The resulting degree of flexion and Rasmussen Clinical and Radiographic Scores were evaluated. Thirty-nine patients were included, and 23 patients underwent a lateral submeniscal arthrotomy for evaluation of joint surface reduction, with 6 lateral meniscus lesions identified via arthrotomy. Three lateral collateral ligament lesions, 3 medial collateral ligament lesions and 1 anterior cruciate ligament lesion were found. Meniscus and ligament lesions significantly and negatively affected the initiation of knee joint ROM. Early ROM was achieved in 26 cases and 13 patients underwent immobilization for 4 weeks. At the final evaluation, the early ROM group had 130.42° ± 5.50° of flexion, compared with 122.92° ± 5.28° in the immobilization group. Moreover, the final Rasmussen score was 25.69 ± 2.92 in the early motion group, compared with 22.61 ± 3.5 in the immobilization group. There was no difference between radiographic scores of the groups. Although the initiation of early ROM improved the clinical results, soft tissue lesions influenced initiation of early knee joint motion. Therefore, meniscus and ligament injuries should be considered as prognostic factors in similar cases.