Patient suffers from plafond fracture pre and post surgical rehabilitation and exercise.

A plafond fracture, also known as a tibial pilon fracture, is a serious injury that involves the distal end of the tibia, typically extending into the ankle joint. Rehabilitation and exercise are critical both before (pre-operative) and after (post-operative) surgery to optimize recovery, restore function, and prevent complications.

🏥 Pre-Surgical Rehabilitation Goals:

1. Pain and Swelling Control

• Rest, Ice, Compression, Elevation (RICE)

• Non-weight-bearing (use crutches or walker)

• Pain medications as prescribed

2. Joint Mobility Maintenance

• Gentle range-of-motion (ROM) exercises for:

  • Knee

  • Toes

  • Hip

• Maintain flexibility and circulation without moving the ankle

3. Muscle Activation

• Isometric contractions for:

  • Quadriceps (quad sets)

  • Gluteals (glute squeezes)

  • Hamstrings (hamstring sets)

• Upper body and non-injured leg strengthening for mobility support

🛠️ Post-Surgical Rehabilitation Goals:

🚦 Phases of Recovery

🔹 Phase 1: Early Post-Operative (0–6 weeks)

Goals:

• Protect surgical site

• Control swelling and pain

• Prevent complications (DVT, stiffness)

Interventions:

• Immobilization with splint or cast

• Non-weight-bearing (NWB)

• Gentle toe and knee ROM

• Continue quad/glute/hamstring isometrics

🔹 Phase 2: Intermediate Phase (6–12 weeks)

Goals:

• Begin controlled motion

• Gradual weight-bearing

Interventions:

• Begin ankle ROM as permitted by surgeon

• Initiate partial weight-bearing (PWB) with assistive device

• Stationary cycling without resistance

• Pool therapy if available

🔹 Phase 3: Late Phase (3–6 months)

Goals:

• Improve strength and proprioception

• Restore full ROM

• Transition to full weight-bearing

Interventions:

• Full ROM ankle exercises

• Resistance band exercises for ankle

• Balance training (e.g., wobble board, single leg stand)

• Gait training

🔹 Phase 4: Functional/Return to Activity (6+ months)

Goals:

• Return to work/sport

• Restore agility and endurance

Exercises:

• Sport-specific drills

• Plyometrics (e.g., hops, jumps)

• Treadmill walking → jogging

• Progressive resistance training

⚠️ Precautions Throughout Rehabilitation

• Watch for infection, hardware failure, or non-union

• Monitor for complex regional pain syndrome (CRPS)

• Avoid premature loading