Can Rehabilitation Speed Up Recovery from a Severe Tibial Fracture?

Open comminuted fracture of the right tibia?

Hello, Doctor.
I was in a car accident on June 26 and sustained a comminuted fracture of the right tibia.
I underwent surgery that night, during which a steel plate and screws were implanted.
The doctor mentioned that the fracture was severe, and I have been using a four-point walker to assist with walking since the surgery.
After two follow-up visits, the doctor said that I would not have any issues with walking in the future.
During my second follow-up on August 8, the physician advised me to practice putting weight on my right leg gradually, but I do not need physical therapy.
My next follow-up appointment is in two months.

I have researched online and found many cases of comminuted fractures in the same area, and most patients go to the hospital for rehabilitation.
The articles suggest that physical therapy can help speed up the healing process, and some patients who regularly attend therapy can walk without assistance much sooner.
I would like to ask the doctor if pursuing physical therapy would indeed allow me to walk without assistance earlier.
Thank you, Doctor.

Bì xìng Yáng, 10~19 year old female. Ask Date: 2022/08/12

Dr. Shi Guozheng reply Orthopedics

A comminuted fracture of the tibia must heal before one can walk without assistive devices, which typically takes three to six months.
If too much weight is placed on the fracture site before it has healed, there is a risk of displacement or re-fracture.
This is not significantly related to whether rehabilitation is performed.
You must wait for a follow-up appointment and an X-ray to determine if you can discontinue the use of assistive devices.

Reply Date: 2022/08/12

More Info

Rehabilitation plays a crucial role in the recovery process following a severe tibial fracture, particularly in cases involving complex injuries such as yours. After sustaining a comminuted fracture of the tibia, which involves multiple fragments of bone, the healing process can be significantly impacted by various factors, including the severity of the injury, the surgical intervention, and the rehabilitation approach taken post-surgery.

In your case, you underwent surgery to implant a plate and screws, which is a common procedure for stabilizing such fractures. The fact that your doctor has advised you to gradually start bearing weight on your leg is a positive sign, indicating that the initial healing process is progressing well. However, the timeline for recovery can vary widely among individuals based on several factors, including age, overall health, and adherence to rehabilitation protocols.

Engaging in rehabilitation can indeed expedite your recovery. Physical therapy is designed to restore function, improve strength, and enhance mobility. It typically includes exercises that focus on range of motion, strengthening the muscles around the injured area, and gradually increasing weight-bearing activities. While your doctor has indicated that formal rehabilitation may not be necessary at this stage, many patients find that participating in a structured rehabilitation program can lead to improved outcomes.

Research has shown that early mobilization and rehabilitation can promote bone healing and improve functional recovery. For example, studies indicate that patients who engage in physical therapy after a fracture often experience faster recovery times and better functional outcomes compared to those who do not. This is particularly true for weight-bearing exercises, which can stimulate bone remodeling and healing.

If you choose to pursue rehabilitation, it is essential to communicate with your healthcare provider about your intentions. They can help you develop a tailored rehabilitation plan that aligns with your recovery goals and current condition. Your rehabilitation program may include:
1. Range of Motion Exercises: These exercises help maintain flexibility in the knee and ankle joints, which can be affected by immobilization.

2. Strengthening Exercises: Focused on the muscles surrounding the tibia, these exercises will help restore strength and stability to your leg.

3. Weight-Bearing Activities: Gradually increasing the weight you place on your leg can help stimulate healing and improve your ability to walk without assistance.

4. Balance and Coordination Training: As you progress, incorporating balance exercises can help prevent falls and improve your overall stability.

5. Pain Management Techniques: Your rehabilitation team can provide strategies to manage any discomfort you may experience during your recovery.

It is also important to listen to your body during rehabilitation. If you experience significant pain or discomfort while performing exercises, it is crucial to inform your therapist or doctor. They can adjust your program to ensure that you are progressing safely.

In conclusion, while your doctor may not have prescribed formal rehabilitation at this time, pursuing a structured rehabilitation program can potentially accelerate your recovery from a severe tibial fracture. Engaging in physical therapy can enhance your strength, mobility, and overall function, ultimately helping you return to your normal activities more quickly and with greater confidence. Always consult with your healthcare provider before starting any new rehabilitation program to ensure it is appropriate for your specific situation.

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