Abstract. This retrospective study assessed 5 male and 5 female patients, age 35.116 years, height 171.812cm, and weight 75.518kg (meanSD) who were more than 1year post isolated tibial fracture (186 months) and had been treated with an intramedullary tibial nail. Subjects completed a 12-question visual analog scale, a physical symptom and activity of daily living survey, and were also tested for bilateral isokinetic (60/s) quadriceps femoris and hamstring strength. Knee pain during activity, stiffness, swelling, and buckling were the primary symptomatic complaints. Perceived functional task deficits were greatest for climbing or descending stairs, pivoting, squatting, and walking on uneven surfaces. Involved lower extremity knee extensor and flexor torque production deficits were 25% and 17%, respectively. Early rehabilitation focuses on maintaining adequate operative site bony fixation while providing controlled, progressive, and regular biomechanical loading to restore functionally competent tissue. Following adequate fracture healing, greater emphasis should be placed on lower extremity functional recovery including commonly performed activities of daily living and other functional tasks that are relevant to the patient's disability level. A cyclic rehabilitation program that progresses the weight-bearing environment to facilitate bone and soft tissue healing and neuromuscular re-education is proposed.
Rsum. tude rtrospective de 10 patients (5 hommes et 5 femmes) qui ont prsent une fracture isole du tibia et qui ont t traits par un clou intra-mdullaire. Les caractristiques de ce groupe (moyennedviation standard) sont : dlai depuis la fracture=18+6 mois, age=35.1+16 ans, taille=171.8+12cm, et poids=75.5+18kg. Les sujets ont rempli un questionnaire comprenant douze questions portant sur la description de l'amlioration de leurs symptmes et sur leurs vies quotidiennes. Des tudes ont galement t entreprises afin de tester un isokintisme bilatral (60/s) du quadriceps. Les principaux symptmes rapports par les patients comprennent des douleurs du genou durant l'effort, ainsi qu une raideur, un gonflement et des phnomnes de ressaut. L'action de monter et de descendre un escalier, de pivoter, de s'accroupir et de marcher sur un terrain irrgulier s'avre comme les taches les plus difficiles raliser. Le dficit du moment de rotation en flexion et extension de l'extrmit basse du genou sont respectivement de 25% et 17%. Dans le futur, les preuves radiologiques et cliniques d'une cicatrisation adquate de la fracture devront tenir compte de l'valuation de la rcupration fonctionnelle du membre infrieur. Un programme cyclique de rducation est propos.