Richard Haynes PTA/CPT - 2/5/2009

Question
My TPF occurred on 11/18/08. I had an external fixator for 1 month, surgery to repair followed. I have a plate in my knee, 7 inch rod & 14 screws. I shattered my tibia. I have been on crutches since early December. I am in PT, can only bend my knee to 80 degrees. I'm told Manipulation under sedation is the only way my knee is going to bend beyond this degree, which I believe. What are your thoughts on Manipulation under sedation for my injury?  I am striving to reach 120+ degree of movement, I need to walk normally again. I am still non weight baring. I am active and desire to have my life return to normal, will this happen?

Answer
Hi Jennifer,

Well that may be the case that manipulation may be needed. Who told you that the PT or surgeon?

Unless the surgeon highly recommends manipulation I would wait until I am full weight bearing ton that leg before I get it done. Thats my opinion though and with your case your medical professionals may feel different and advise you get it sooner.

Once you are full weight bearing you can push the knee and leg harder.to keep the range and build more strength.

I suspect PT as you working on range of motion exercises right now which is good.

If adhesions or scar tiisue has been laid down in the knee for instance it will block any further movement.

Too early to tell how the knee will bend ultimately but until are full weight bearing there will be a tendency to aviod getting the full movement you need.

Manipulation itself takes only a few minutes done by the surgeon. I have had good results from it working with my otal knee replacement patients.

If manipulated you have to stay aggressive with the knee flexion exercises before you lose your new found movement again.

You should be fine however in time. You have suffered a serious injury. Anytime yoiu have a lower leg injury like you had they can be complex and takes time to rehab and come back from, but you should do fine.

Richard Haynes
Punta Gorda, Florida.