Tibial Tubercle Fracture

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Phase I (Weeks 0 – 4)

  • TDWB with crutches and immobilizer/brace locked in extension
  • Strengthening:
    • Sub maximal quadricep sets, glut sets, HS sets
    • Ankle pumps
    • Patellar mobilizations

Phase II (weeks 4-6)

  • WBAT with crutches and T-Scope locking in extension
  • Progress PROM/AAROM 
    • WEEK 4- Start 0-30, progress to 0-60 over next 2 weeks as tolerated
  • Strengthening:    
    • Continue Quadricep sets
    • SLR’s in abduction and extension and add light resistance
    • Begin SLR’s in flexion in immobilizer 
  • Begin gentle stretches (hamstrings, gastrocnemius, ITB, etc.)

Phase III (weeks 6-8)

  • WBAT with T-scope unlocked when patient demonstrates a good quad set and SLR flexion without a lag
  • Progress PROM to 90 degrees
  • Strengthening:
    • Continue SLR in all planes
    • Begin light closed chain strengthening
  • Begin balance/proprioception program

Phase IV (weeks 8-12)

  • Wean from brace
  • Progress PROM/AROM to tolerance
  • Begin stationary cycling when 110 degrees of knee flexion
  • Strengthening:
    • Continue closed kinetic chain strengthening
    • Begin light open chain isotonic exercises
    • Continue and advance balance/proprioception program

Phase V (weeks 12- 16)

  • Progress above ROM, flexibility, proprioception and strengthening program
  • Isokinetic test (full ROM/high speeds)
  • Begin straight-line jogging program

Phase VI (Weeks 16 – 24)

  • Begin sport specific agility program
  • Return to play when client meets discharge criteria

Discharge Criteria:

  • Full ROM
  • No effusion
  • No tenderness over patellar tendon or pain with exercise
  • Satisfactory strength test (80% of opposite leg)
  • Satisfactory completion of straight jogging and sport specific agility program
  • Physician approval

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