Querry in treatment of post-op Tibia #

[msk101]

Hi There,

It would depend on why the stiffness is there.. is it due to soft tissue contracture due to immobilisation or disuse, or is it swelling/oedematous, or other structural impediments. Have you queried whether surgery would consider a manipulation under anaesthetic if you're really stuck as it has been a long time since cast was removed. If it's just due to short tissues and stiffness that way i would be very aggressive with prolonged stretching and kneeling back onto heels as far as possible to sit for as long as possible (ie. 15 minutes at a time) to cause actual tissue fibre lengthening (rather than a short term stretch response which occurs with short duration stretching and mobilisation). also check that the rotational component of tibia on femur is occurring correctly to enable full flexion and full extension of the knee.

Hope that helps.
msk101

[dinku86]

thanx a lot for ur postings...
What I can draw out is that making him sit in full squat position for 15 min. would be a better option...He can sit in full squat for no more than 5 min. since 20 days..
My Senior physiotherapist told me to use dynamic knee flexion splint and he told that now if u stretch this patient more .... the collagen formation will also increase and there is every chance for stiffness which will be invited by me only....The next option he told was surgery...
SO WHAT U PEOPLE SUGGEST....