Return to sport following tibial plateau fractures: A systematic review

Robertson, Greg; Wong, Siu-Ching; Wood, Alexander

doi:10.5312/wjo.v8.i7.574

Cited by 22 publications

(22 citation statements)

References 38 publications

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“… 47 Return to sport is typically at 7–12 months after operative fixation of a tibial plateau fracture. 48 No data have been published on return to sport for nonoperatively treated tibial plateau fractures, though standard guidelines of radiographic union, full motion, normal strength, and proprioceptive control will direct sport resumption.…”

Section: Lower Extremitymentioning

confidence: 99%

Management of injuries in snowboarders: rehabilitation and return to activity

Helmig¹,

Treme²,

Richter³

2018

OAJSM

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Snowboarding has seen a continuous increase in popularity, leading to an increase in the number of snowboarding injuries seen in orthopedic practice. Upper-extremity injuries are more common than lower-extremity, spine, and pelvis injuries. In this review, we focus on the most common snowboarding injuries of the extremities, spine, and pelvis and provide an overview of their respective rehabilitation and return-to-sport protocols. Despite many of the injuries seen in snowboarding also occurring in other sports, objective data about rehabilitation and return to sport are lacking for many injuries. This provides an opportunity for research in the area with regard to many sports and many different injuries.

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Section: Lower Extremitymentioning

confidence: 99%

Management of injuries in snowboarders: rehabilitation and return to activity

Helmig¹,

Treme²,

Richter³

2018

OAJSM

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“…In this review, the methodological quality of studies was lower than that of previous similar systematic reviews looking at return to sports following various fracture types, with a mean CMS of 59.5[16-20]. Thus, despite the inclusion of two randomised controlled trials in this study[9,10], this demonstrates a need for further high-quality research in this area including level one studies.…”

Section: Discussionmentioning

confidence: 70%

“…The modified Coleman methodology score (CMS) was employed to determine the quality of the included studies[14]: This has been used in a number of similar reviews[15-20]. The studies were scored by all three authors: the inter-observer reliability of the scoring process was 0.92 (95% confidence interval (CI): 0.90–0.94).…”

Section: Methodsmentioning

confidence: 99%

Return to sport following scaphoid fractures: A systematic review and meta-analysis

Goffin¹,

Liao²,

Robertson³

2019

WJO

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BACKGROUNDScaphoid fracture is the most commonly fractured carpal bone in the athletic patient, accounting for over 85% of all sport-related carpal bone fractures, and is particularly common in sports involving high impact injuries to the wrist. The management of such injuries comprises both conservative and surgical techniques, as guided by fracture location and type. Athletes demonstrate a unique challenge with regards to the management of scaphoid fractures due to their requirement to return to sport, as soon as able.AIMTo review systemically all studies recording return to sport following scaphoid fractures, to collate information on return rates to sport (RRS) and mean return times (RTS) to sport and to determine differences in sporting outcome for the various treatment methods.METHODSA systematic search of MEDLINE, EMBASE, CINAHAL, Cochrane, Google Scholar, Physiotherapy Evidence Database, SPORTDiscus, Web of Science and Scopus was performed in August 2018 using the keywords “scaphoid”, “fracture”, “acute”, “carpal”, “athletes”, “sports”, “non-operative”, “conservative”, “operative” and “return to sport”. All studies that recorded RRS and RTS following scaphoid fractures were included. RTS was recorded as the length of time from commencement of either primary conservative management or primary surgical procedure to return to sport.RESULTSEleven studies were included: Two randomised controlled trials, six retrospective cohort studies and three case series. Seven studies reported on conservative management (n = 77), and eight studies reported on surgical management (n = 83). For conservative management, RRS was 90% (69/77), and the mean RTS was 9.6 wk. Three studies allowed to return to sport in cast [RRS 89% (25/28); RTS 1.9 wk], and four studies required completion of cast treatment prior to returning to sport [RRS 90% (44/49); RTS 13.9 wk]. Four studies recorded fracture union data: Union rate 85% (47/55); mean time to union 14.0 wk. For surgical management, RRS was 98% (81/83), and RTS was 7.3 wk. Three studies reported on Percutaneous Screw Fixation [RRS 97% (32/33); RTS 6.5 wk], and five studies reported on Open Reduction Internal Fixation [RRS 98% (49/50); RTS 7.9 wk]. Six studies recorded fracture union data: Union rate 97% (69/71); mean time to union 9.8 wk. On meta-analysis, RRS (RR = 1.09; 95% confidence interval (CI): 1.00-1.18; P < 0.045), RTS (MD 2.3 wk; 95%CI: 0.79-3.87; P < 0.002), union rates (RR = 1.14; 95%CI: 1.01-1.28; P < 0.030) and mean times to union (MD 4.2 wk; 95%CI: 3.94-4.36; P < 0.001) were all significantly better for the surgical cohort compared to the conservative cohort.CONCLUSIONSurgical management of scaphoid fractures can provide significantly improved RRS and RTS to sport compared to conservative management. Both treatments, however, remain acceptable options, and athletes should be fully informed of the benefits and risks of both prior to deciding treatment plans. Immediate return to sport in a cast should be avoided due to the significant risk of non-union.

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“…Fractures of the tibia plateau had a significant impact on the patients’ lives, decreasing their quality of life and reducing the involvement with sporting activities. Robertson et al 38 in their review study report that patients sustaining a tibia plateau fracture have lower return to sport rates compared to other injury types. Kraus et al 39 found significant decline of these patients’ sporting activity levels 2 years post treatment.…”

Section: Discussionmentioning

confidence: 99%

Physiotherapy after tibial plateau fracture fixation: A systematic review of the literature

Iliopoulos¹,

Galanis

2020

SAGE Open Medicine

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Background: Tibial plateau fractures are frequent injuries that orthopaedic surgeons face. It has been reported that they have a significant negative impact on the patients’ lives, decreasing their quality of live, keeping them of work for long periods of time and reducing their activity levels. Aim: Interestingly, there is not enough focus in the literature about the post-operative rehabilitation of these patients. The aim of the present review is to investigate this field of the literature and try to give answers in four main questions: the range of motion exercises post-surgery, the immobilisation, the weight-bearing status and the ongoing rehabilitation. Materials and Methods: A literature search was conducted using the PubMed and the Google Scholar search engines. A total of 39 articles met the criteria to be included in the study. Results: The literature about this subject is scarce and controversial. Early range of motion exercises should be encouraged as soon as possible after the procedure. The immobilisation after plate fixation does not seem to be correlated with any benefits to the patients. The weight-bearing status of the patients was the most controversial in the literature with the early weight-bearing gaining ground at the most recent studies. Tibia plateau fractures can have significant impact on the patients’ lives, so ongoing rehabilitation with focus on quadriceps strengthening and proprioception exercises is recommended. Conclusion: The present literature review illuminates the controversy that exists in the literature about the physiotherapy following tibia plateau fracture fixation. Early range of motion exercises and early weight bearing should be encouraged. Immobilisation does not seem to provide any benefit. Ongoing rehabilitation should be considered with the view of better clinical outcomes.

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Return to sport following tibial plateau fractures: A systematic review

Cited by 22 publications

References 38 publications

Management of injuries in snowboarders: rehabilitation and return to activity

Management of injuries in snowboarders: rehabilitation and return to activity

Return to sport following scaphoid fractures: A systematic review and meta-analysis

Physiotherapy after tibial plateau fracture fixation: A systematic review of the literature

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