Tibia fracture with acl tear

I can't seem to get this to post so I hope it doesn't go twice. I recently (in may) injured my knee during a horseback riding accident. I have a hairline fracture in my tibial plateau along with acl and meniscus tear and mcl sprain. My ortho decided against pinning the tibia due to it being a fx that isn't displaced. He advised me no weight bearing and no movement at all with the knee for 3 months before he assesses the ligament repair surgery. I am a trainer so I need my knee just as good as new. I have terrible atrophy in my leg already along with tingling in the bottom of my foot without a compression sock on. I have been evaluated for DVT and circulation issues in my foot and have checked out ok on both. Has anyone experienced this long of a wait prior to surgery? These symptoms? I also tried bending it slightly (accidentally while changing ace bandage) and the knee is completely locked. Normal? I have pain that comes and goes but for the most part I'm generally painless 80 % of the day. When the pain does come its tolerable (I have an extremely high pain tolerance).

Hi Scjohnson07....

Welcome to the board/thread, unfortunately! I too fx'd my tibia in 4 places with a depression fx and my patella in May 23rd. On the 30th I had surgery. Sounds like surgery isn't needed for yours, you are lucky. I am 5 wks post-surgery and now just able to start flexing my leg per the OS. I am also not allowed to bare any weight on my leg for another 7 wks. I am also still experiencing the numbness/prickles/tingling from the heal to my toes that you speak of. It has gotten better for me since my injury and am told it should eventually clear up, that it just takes time.

With just starting flexing my knee I too have the locking that you speak of. I don't know if I have any tears from my injury as they won't evaluate for this until the top of my tibia is healed. Most of the time they can't fix the tears until this can occur. I suspect that my ACL is torn(MCL was torn in a prior horse related accident) the fact that my cartilage is damaged and scar tissue is starting to form is some of the cause of the locking. Don't try to push past the locking. I just try to work through it, by extending the leg, massage the area and retry flexing again. Usually this will release the lock and allow me to flex.

It will take some time to return to normal or close to. Be patient, do the work, stay positive (this is difficult for most). I too am a horse rider, I own 2. I so miss being on them and riding, especially now, the weather has returned to the 70's here. But do enjoy my time in the barn, grooming, talking, and loving on them. I find it very healing for me and better than watching the brain drain TV.

Good luck and keep us informed. You are not alone.

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Originally Posted by scjohnson07

I can't seem to get this to post so I hope it doesn't go twice. I recently (in may) injured my knee during a horseback riding accident. I have a hairline fracture in my tibial plateau along with acl and meniscus tear and mcl sprain. My ortho decided against pinning the tibia due to it being a fx that isn't displaced. He advised me no weight bearing and no movement at all with the knee for 3 months before he assesses the ligament repair surgery. I am a trainer so I need my knee just as good as new. I have terrible atrophy in my leg already along with tingling in the bottom of my foot without a compression sock on. I have been evaluated for DVT and circulation issues in my foot and have checked out ok on both. Has anyone experienced this long of a wait prior to surgery? These symptoms? I also tried bending it slightly (accidentally while changing ace bandage) and the knee is completely locked. Normal? I have pain that comes and goes but for the most part I'm generally painless 80 % of the day. When the pain does come its tolerable (I have an extremely high pain tolerance).

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Sc...sorry to hear about your situation. There are often numerous ways to approach any medical problem, and one thing patients don't realize is that surgeons are not offended if you have concerns and seek a second opinion. If you have any questions at all, just ask if your surgeon can recommend anyone else who might offer a fresh pair of eyes. One usually tries to avoid completely immobilizing a knee for an extended period of time unless there's just no way around it (for example, a severe knee dislocation with arterial injury requiring repair, where you just have to protect the arterial repair at all cost). If it's a nondisplaced fracture that's still too unstable for knee range of motion, operating to stabilize it so that you can move the knee may be another viable approach (obviously, your surgeon had concrete reasons for your treatment plan and this may not be possible).

Regardless, best of luck...sounds like you've been through a lot.

Thanks to the both of you for your responses! I also have recently (past couple of weeks) noticed that the knee itself is getting larger (not from swelling but actually rock hard). When I get swelling it's soft from fluid but when it goes down the knee doesn't and stays hard and big. Kinda weird to explain but I hope I'm doing an ok job! Yes I terribly miss my horses and had to send clients elsewhere until I recover. It's a good thing I have good support to take care of the ones I have (7!). My orthos reason for not pinning the tibia was because he thought it would heal on its own and he didn't want to have me go through 2 surgeries. Understandable! However at this point if it's best for my leg in the long run then that's fine by me. I still have 5 more weeks of the brace and it being "locked" before he goes about my ligament repair. My last appt he did X-rays and said the bone was healing well. Crutches are killing me! It's good to hear I'm not alone with the tingling feeling (it seems to feel better when I use one of those diabetic compresson stockings).

I forgot to add about the tingling...that it sometimes gets worse before it gets better. Kind of like when you sit wrong and your foot goes to sleep, when you adjust it and it starts to so-to-speak wake up, the tingling gets worse before it is normal again. You will also find that when you are able to unlock your brace and start sitting in chairs normally, the swelling to your whole lower leg/foot returns. So does the tingling, but don't fear it goes away when the swelling subsides. At least this is what I have experienced since getting by brace unlocked. The more I use it, the more it swells, the tingling returns until the swelling goes down.

7 horses, wow....lots of work. My husband would probably make me hire someone to take care of them if I had that many. He is not a horse person, so all the chores required are a bit much for him. He is actually doing a fabulous job and I keep telling him that.

Again, good luck! It takes a while for this to heal, so don't rush things or you may set yourself back. I re-read your post and it does sound like you have surgery in your future for the ligaments/tendons, but of luck.

The following link to a thread on this site has many people writing about their stories, rehab, recovery and questions regarding a TPF's. They are all a little different, but lots of support and information there.

http://www.tetongravity.com/forums/s...cture-Recovery

Paige

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Originally Posted by scjohnson07

Thanks to the both of you for your responses! I also have recently (past couple of weeks) noticed that the knee itself is getting larger (not from swelling but actually rock hard). When I get swelling it's soft from fluid but when it goes down the knee doesn't and stays hard and big. Kinda weird to explain but I hope I'm doing an ok job! Yes I terribly miss my horses and had to send clients elsewhere until I recover. It's a good thing I have good support to take care of the ones I have (7!). My orthos reason for not pinning the tibia was because he thought it would heal on its own and he didn't want to have me go through 2 surgeries. Understandable! However at this point if it's best for my leg in the long run then that's fine by me. I still have 5 more weeks of the brace and it being "locked" before he goes about my ligament repair. My last appt he did X-rays and said the bone was healing well. Crutches are killing me! It's good to hear I'm not alone with the tingling feeling (it seems to feel better when I use one of those diabetic compresson stockings).

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I have noticed that about the tingling and swelling. Sitting in a chair does make it worse even though I have my brace on.
Yes 7 is a lot! Good thing is that 3 of them are mares in foal and the rest are pretty easy going lazy animals! My husband too is a non horse person and I'm lucky to have my mom and a few other horsey people to help out. My husband does try though and does a good job.
I can't help but be concerned about the locked knee and the hard swelling that doesn't go away. Hoping I will get answers next week from ortho! Thanks a bunch!

Follow up is tomorrow I'm hoping for answers! I have a list! :)

My dr did a bunch of scans and decided that he will wait for surgery until after I start using my leg in about another month and a half or so. My leg is extremely atrophied and he doesn't want to do anything to it now. My bone is healing nicely from what he said. His words were pretty much something to the effect of a puzzle that is put together on a table looks good and put together but you go to try and pick it up, bend it and move it and it falls apart. He wants to see what ligaments he needs to repair once my leg is mobile again. Everything he said seemed to make sense I just am impatient and want my life back! His explanation for the tingling and nerve issues was my knee immobilizer brace is pushing on a nerve in the back of my leg (which explains why it comes and goes). I have a long way to go and have had to make some decisions as far as my horses go but I have faith I'll return to riding. He did say my acl isn't that stable but it's still somewhat attached and my meniscus is in bad shape. Any words of advice for sleeping with an immobilizer on? I'm not a back sleeper but it seems as though I have no choice!