N. Magida1, C. Carstein1, T. Fakude1, C. Van Niekerk1, P. Makhura1, K. Rampheng1, P. Lennon1
1University of Pretoria, Physiotherapy Department, Pretoria, South Africa

Background: The tibial plateau is a crucial load-bearing articulation of the tibia and when excessive pressure is placed on it, leads to tibial plateau fractures (TPFs). TPFs result from high impact varus or valgus forces joined with axial loading. Due to the pathomechanics of injury, Schatzker classified TPFs according to the severity of the injury. The severity of injury contributes to the choice of management of TPFs.  Management includes conservative or surgical. Physiotherapy management is crucial in the management of TPFs whether conservative or surgical, for maintaining joint, muscular and movement function of the patient. The golden standard of surgical management is open reduction internal fixation (ORIF). Following ORIF management of TPFs a variety of functional limitations exist. The researchers are interested in the experiences of patients managed with ORIF following TPFs within six to 24 months after injury.

Purpose: The purpose of the study is to explore patient experiences following TPFs managed by ORIF within six to 24 months.

Methods: A qualitative exploratory phenomenological study was used. Semi-structured interviews were employed to collect data. Baseline study started by reviewing records at two academic state hospitals, orthopaedic units. Perusal of records collected patients with tibial plateau fractures and managed with ORIF between June 2017 to June 2019. Patients’ X-ray records were reviewed to confirm the type of TPF. Patients were recruited to participate in the study by means of telephone. Once verbal concern was received, patients were requested for semi-structured interviews in their respective hospitals and written concern was signed for interviews and audio-recording prior interviews commenced. Two researchers carried out interviewees and audio recording was used to store the data.  A purposive sampling method was employed and a sample size of seven participants was determined by data saturation. Data were analysed by other researchers using the colaizzi analysis approach.

Results: Impairments experienced by patients were most often pain and decreased range of motion of the knee joint. The impairments lead to activity limitations experienced such as walking, kneeling, bending the knee, climbing (e.g. stairs or a ladder) or standing for long periods. Furthermore, participation restrictions were reported because of impairments and activity limitations.

Conclusion(s): Patients with tibial plateau fractures experienced a number of impairments such as pain and decreased range of motion. Activity limitations resulted from the aforementioned impairments. Similarly, activity limitation resulted in participation restrictions in patients with tibial plateau fractures. Patients reported inability to return back to work at the same level they were prior to the injury. Further research needs to be conducted with a recommended focus on the physiotherapy treatment received by these patents, thus taking everything into account, which could contribute to their experience following their TPF managed by ORIF.

Implications: Patient experiences may help to better the planning of treatment policies to assist the patients in their disability needs.

Funding, acknowledgements: The study was not funded

Keywords: Tibial Plateau Fracture, Impairment, patient experience

Topic: Orthopaedics

Did this work require ethics approval? Yes
Institution: University of Pretoria
Committee: University of Pretoria Ethics Committee
Ethics number: No. 770/2019

All authors, affiliations and abstracts have been published as submitted.

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