Fracture of the Proximal Tibia With immediate Weightbearing after a Fulkerson Osteotomy

The records of 234 people who had anteromedializa tion of the tibial tubercle with oblique osteotomy be tween 1983 and 1994 at two separate institutions were reviewed retrospectively. Six patients (2.6%) had frac tures of the proximal tibia postoperatively, within 13 weeks of the Fulkerson osteotomy. All fractures oc curred after a change in the postoperative physical therapy regimen from partial weightbearing to immedi ate full weightbearing. All fractures healed with accept able alignment of less than 5° of varus-valgus or an teroposterior angulation. Given this increase in fracture incidence, a more conservative postoperative physical therapy regimen is recommended. All patients should be nonweightbearing initially, advanced gradually to partial weightbearing, and allowed full weightbearing only after the osteotomy has radiographic evidence of complete healing.