Rehabilitation following Medial Meniscus tear and Lateral Tibial Plateau fracture managed conservatively: A Case Report

Priya S, Harish S. Krishna, Komal R Gupta
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Abstract

Background and purpose: Dashboard injuries with forced lateral rotation of the leg can cause tibial plateau fractures with medial meniscus and ACL injuries. Tibial plateau fractures are difficult to treat and can have devastating effects such as discomfort, deformity, restricted ROM causing early degenerative changes in the knee joint. The purpose of this case report is to explain the physiotherapy intervention options and to assess their success in the conservative management of such injury. Case description: 33-year-old female presented to physical therapy with severe pain over the right knee while standing, unable to bend or straighten the knee and had a feeling of giving away of knee while walking since the time patient experienced a fall from her motorcycle. The condition was managed with supervised and unsupervised physiotherapy for 8 weeks. Intervention consisted of patient’s education about the condition, immobilization, electrotherapeutic modalities, exercise therapy, posture, gait, balance and proprioception training and counselling for 8 weeks, six days a week, for 45–60 minutes each day. Outcome: The patient gained the knee ROM and strength in the lower extremities while achieving all short-term goals. She began ambulating independently and was mobile and autonomous in most situations. Her Oxford knee score improved by 75%. Discussion: It has been demonstrated that physical therapy interventions are helpful in reducing patients' functional limitations. Due to a lack of supporting data, this case report describes specific procedures that were used to reduce functional restrictions caused by a medial meniscus rupture and a lateral tibial plateau fracture. KEYWORDS: Meniscal cartilage, intra-articular fracture, physical therapy, ambulation, functional status.
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保守治疗内侧半月板撕裂和胫骨外侧平台骨折后的康复治疗:病例报告
背景和目的:腿部被迫侧旋时发生的冲撞伤可导致胫骨平台骨折,并伴有内侧半月板和前十字韧带损伤。胫骨平台骨折很难治疗,会造成破坏性影响,如不适、畸形、活动度受限,导致膝关节早期退行性病变。本病例报告旨在解释物理治疗干预方案,并评估其在此类损伤的保守治疗中的成功率。病例描述33 岁的女性患者因站立时右膝盖剧烈疼痛、膝关节无法弯曲或伸直、行走时膝关节有屈曲感而前来接受物理治疗。患者接受了为期 8 周的有监督和无监督物理治疗。干预措施包括对患者进行病情教育、固定、电疗模式、运动疗法、姿势、步态、平衡和本体感觉训练以及咨询,为期 8 周,每周 6 天,每天 45-60 分钟。结果:患者的膝关节活动度和下肢力量得到恢复,同时实现了所有短期目标。她开始独立行走,在大多数情况下都能自主行动。她的牛津膝关节评分提高了 75%。讨论事实证明,物理治疗干预有助于减少患者的功能限制。由于缺乏支持性数据,本病例报告介绍了用于减少内侧半月板破裂和外侧胫骨平台骨折造成的功能限制的具体方法。关键词:半月板软骨、关节内骨折、物理治疗、行走、功能状态。
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