Tibial Plateau Fracture Recovery

amy...i have almost your exact injury. type VI with TWO spiral fractures. My accident was on 12/10. I had an ex fix in for 2.5 weeks and then 2 plates and 12 screws. Part of my tibia plat. is in 8 pieces. It's been almost 4 weeks since my surgery and I am in a brace, locked at 30. I have x rays this week and hope to get cleared for PT. I am so so so scared about my path to recovery that it easily overwhelms me when I think about it. Your injury so closely resembles mine. could you please share with me your recovery so far. I have so many questions I'd like to ask. If you are the slightest bit interested or have the time, could you email me? ryanrenee513@msn.com thank you so much, Ryan

Amy
I would let the Surgeon tell you what you are capable of physically not the PT or OS. He can order MRI, CT or whatever he needs to determine what direction to go next. The PT guys are usually good but they don't know everything. Some are better than others. I would think you can eventually get extension to the point you can live with it. I have noticed in the 3 months I have been going to my PT that some of the knee replacement patients really struggle with this. So far I think all of them have reached close to 0 extension? Mine was not an issue to begin with so I can't really relate to the pain. Keep your head up this is just a bump in the road again. I know you are as frustrated and ready to get to your new normal life. Shop around for a new doc or PT if necessary before you take their word as gospel. I hope you get where you need to be soon. I am close to switching from one crutch to a cane tomorrow hopefully.
good luck
thanks
jesse

Thanks guys. I appreciate the positive attitude and encouragement that you all share. It's priceless.
I went to see another PT today. I saw him in the very beginning, but because of insurance, I changed to the one that I've been seeing fo the past five months. So I think it was helpful that my "second opinion" was from a PT that saw where I started from. He didn't outright say it, but I thought it obvious that he thinks I should be farther along than I am. He gave me some exercises to do that he can't understand why I haven't already been doing. He said twice that he doesn't want to give me false hope that he can get my leg straight but I'm confident that I'm better off with him. He was so much more hands-on and "tough" on me.
So.....I have a call into my current PT and I'm nervous to "break-up" with him. As silly as that sounds. I've come to really like him, so I feel a little bad about it. Oh well, I'll get over it! :)
Thanks again!!

Jesse....How is the transition to the cane going? I'm sending you good vibes!!

Oh MY!! I hate this for you. And to have a 3 and 6 year old...and full time job...that is enough without this injury! All I can say is since you have all lot of time in a bed (like me) read, write letters...i got back into graphite drawing and have sold some pictures. I have more that I am doing for people who will be buying them as well. Be careful on your "good leg". I have not been able to walk on crutches because the "good leg" had so much pain when I would bear weight on it, that I could not. Then of course, we found out just last week that it was broken in two places on 10/30/12 and had the ACL and meniscus tears as well.

This injury has a very long recovery period and you just have to accept it. Once you do that, and put your anger aside, you will feel better. Try to do something mentally stimulating. I work in the fast paced world of IT for a large financial institution and manage people. large budgets and projects. Luckily for me, I have a desk job and will be able to work from home when my Short Term Disability is over. However, I am going to have surgery on the good knee the second week of Feb, and could also on the bad knee, if I can not get the ROM to 120 degrees. I just think I am going to be able to get it to 120. I have PT tomorrow, so we wil measure it then.

Swelling in my knee has finally started to go down I can actually see my knee cap and I can feel one of the screws...it is strange. I am now able to sit in my wheel chair with my leg bent to about 90 degrees hanging to the floor. I am moving it a lot during the day, and everyone will advise you to start moving it as much as possible. Be careful on your CPM machine to not cheat. I realize now, that I was moving my hip up or tilting my knee and thought I was over 100 degrees and I probably was not. Make sure you sit squarely in in and do not shift your body as you increase your angle. Did you have an external fixator? That is also what has caused me issues as my quad muscle and femur had bolts drving through, which really caused me a lot of pain in my upper thigh. I now spend several times during the day massaging my quad and other thigh muscles to help with my ROM. It is interesting how all of this works together!

At 3.5 weeks out...just try to stay positive but dont hurt your other knee by compensating! Keep in touch and let me know how you are doing!

Thank you....just trying to move forward!

@liamy -

I was in a similar situation as you at around 8 months post op. Still -5 degrees off of straight. Doctor did additional X-rays, and ordered a follow up scope surgery that help get me a few more degrees. Recovery was minimal and then I strapped myself to a board every night which also got me 1 or 2 more degreews. All in all I was able to get to 0 (my other leg is at +5 beyond straight). I have been putting lifts in the shoe of my good leg recently which actively helps your my leg reach for the ground and should give me some more straightening over time.

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Originally Posted by liamy

Thanks guys. I appreciate the positive attitude and encouragement that you all share. It's priceless.
I went to see another PT today. I saw him in the very beginning, but because of insurance, I changed to the one that I've been seeing fo the past five months. So I think it was helpful that my "second opinion" was from a PT that saw where I started from. He didn't outright say it, but I thought it obvious that he thinks I should be farther along than I am. He gave me some exercises to do that he can't understand why I haven't already been doing. He said twice that he doesn't want to give me false hope that he can get my leg straight but I'm confident that I'm better off with him. He was so much more hands-on and "tough" on me.
So.....I have a call into my current PT and I'm nervous to "break-up" with him. As silly as that sounds. I've come to really like him, so I feel a little bad about it. Oh well, I'll get over it! :)
Thanks again!!

Jesse....How is the transition to the cane going? I'm sending you good vibes!!

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Amy
Sounds like you have a plan now. Hopefully this new/old PT can make some things happen. If not seek more help? I had to terminate my in home therapist girl when I moved to outpatient. She really wasn't helping me much anymore but you are right it's like breaking up in high school or doing something terrible to a friend. I guess we see so few people for a few months that you form bonds with these guys. I know therapy was the most exciting thing to do for the first month or so. I did not feel like going out to do anything else and you sort of fit in with all the other damaged souls at the therapy place. If they are no longer making progress they are no longer needed. Take them a pizza or something as a farewell gift. Move on you have to do what is best for AMY.
I had forgotten that my wife battled with the extension at or around 5 degrees also after her knee replacement. She would sit on the floor and push down on her knee with her hand for hours while watching TV. Hours at a time then a pillow under her heel. This was after they put her out and manipulated the knee (she caught pneumonia 2 weeks after the total knee). They had her in the hospital and no therapy for a week so the knee locked up. I guess everyone has a story huh? She has great extension now but she can only get to 110 degrees. They finally quit working on it when the OS,PT and she decided it was good enough. This was in Oct 2008.
I used the cane today. Kind of a weird feeling but it works. Less to deal with than a crutch getting in and out of the car etc. I just need to master the swing of the cane. I look awkward but I am sure it will get better. They are having me try to balance on my bad leg now. 30 seconds three times is about all I can do with both hands deathgrip on the stand they had me at. Not so painful just no stamina. Feels like the leg will just fold up under me at any time. It will get better I am sure.
Spent about 9 hrs yesterday out and about up on the leg as much as possible. Sure was swollen last night but it no longer turns purple and the aching is less intense. I went to see my boss looking for some insight on returning to the land of employment. I have to be free of restrictions before the company doc will let me go back. Not sure what restrictions they might impose? They have some light work for me lined up if I can get a release. Hopefully mid march or a little before. I will know more next wed after I see the OS again. Progress is slow but steady I guess huh.
thanks
jesse

updates from my 4 week post op appointment yesterday. xrays show my bones are healing, which my OS was happy about. he set my brace to 60, from 30 and really got on me about working my ankle which is really stiff and not even at 90 degrees yet. he's holding off on ordering PT for another 3 weeks. i talked to him about the CPM as i've noticed nearly everyone on here seems to be using it. he said no CPM citing that there are many studies that prove it doesn't do a thing in terms of improving ROM. so I am on my own and finding it hard to inflict pain on myself. so for the next 3 weeks I am pulling up on my ankle and moving my knee, which I find harder than I thought.

why do i feel like im going to break something as I push myself with my knee? I can't bear weight so I am using my hands and my leg muscles (which I have none these days) and it feels so weird...like my knees going to pop. any suggestions on working thru this?

Amy..I seem to have nearly the exact same injury as you...type VI fracture and two spiral fractures. I had an ex fix for 2.5 weeks and then 2 plates and 12 screws. please offer some advice on your recovery so far....

oh and i got clearence to return to work part time and to drive...if only I can get my leg to bend to get in the car....

Ryanrene ...Hang in there! I still have to sit in the back bench seat of my wagon with my husband and son in the front! We call it "Driving Miss Daisey!!"

I found out today that my fracture on my "good leg" is actually a TPF but is it not displaced. Can you believe it! I have been having to pivot and transfer on another fractured leg now for 3 months...plus it has an ACL and Miniscus tear....so I go in for surgery for that in two weeks now. My Grade 6 TPF on the other leg, will probably need another surgery as I can only get to 98 degrees, so I will more than likely have surgery on both knees at once. So I will be out again for a while.

Thanks guys for listening!

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Originally Posted by Ryanrene

updates from my 4 week post op appointment yesterday. xrays show my bones are healing, which my OS was happy about. he set my brace to 60, from 30 and really got on me about working my ankle which is really stiff and not even at 90 degrees yet. he's holding off on ordering PT for another 3 weeks. i talked to him about the CPM as i've noticed nearly everyone on here seems to be using it. he said no CPM citing that there are many studies that prove it doesn't do a thing in terms of improving ROM. so I am on my own and finding it hard to inflict pain on myself. so for the next 3 weeks I am pulling up on my ankle and moving my knee, which I find harder than I thought.

why do i feel like im going to break something as I push myself with my knee? I can't bear weight so I am using my hands and my leg muscles (which I have none these days) and it feels so weird...like my knees going to pop. any suggestions on working thru this?

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Ryanrene, I am not a TPF veteran on this forum, but I will offer up some of my experience with pt. I am only 2 weeks ahead of you as I am 6 weeks post op. A little background, I have a plate and nine screws in my left knee from a snowboard accident and I am 26 years old. I just started physio last week.
I found that moving my knee in the first month was also difficult. I didn't focus too much on bending my knee and kept it elevated in a recliner. Every hour, i would let the recliner down, extend my leg and slide my foot with my heel flat on the ground back towards the recliner.
I found what restricted me the most was my calf muscle, which was very stiff and still is a bit. Since day 1 I have moved my ankle around constantly. Rotating it clockwise and then counter-clockwise, front to back. Sometimes using a rubber band or leash to pull my toes toward myself. Also, make sure u move your toes. Squeezing them together like you are picking something up or even just wiggling them gets the muscles moving.
My physio has told me I have a good range of motion for a tpf. I can bend my ankle past 95 degrees and had 110 degrees in my knee upon my first visit. He hasn't been pushing me too much yet. Just stretching excercis and leg lifts with my foot twisted outward to build up my inner quad. He has been my physio for a multiple injuries in the past and I can honestly say it is not in his nature to go easy. He told me to push my stretching until it is tight, (yes, sometimes it feels wierd) but as soon as their is any sharp pain to stop immediately.
Hopefully my experience so far will offer up some help to you. All the best.

Consider yourself lucky if seemingly random pain doesn't wake you up at 2 AM.


-B

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Originally Posted by 97r82

Moonstruck
I thought I had a bad accident. You have been thru too much. I just had the one bad leg to deal with after the bruises healed on my good leg. The boredom is the killer. The pain is manageable. Hang in there. Keep a good attitude and follow the docs orders. Find a good PT. Make sure they do hands on to work out all the knotted up muscles. Some PT never touch their patients. You need both the exercise and hands on. Each day my leg feels slightly better. My accident was Oct 7th 2011. Still on crutches but getting there. Keep us informed and just remember that a broken tibia alone is a very serious event. Seems to heal slower than most bones.
thanks
jesse

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Thanks Jesse! and now i have TPF on both legs. At least the "good one" isn't displaced. But surgery will be needed for the ACL and Meniscus.!

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Originally Posted by karpiel

Consider yourself lucky if seemingly random pain doesn't wake you up at 2 AM.


-B

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I agree...I usually wake up between 2-3 AM every morning and never go back to sleep!

I am approaching 6 months and so far things are good, but I have been getting a lot of pain behind my knee. I told my PT and he says it's my hamstring, specifically where it cross behind the knee. He gave me stretches I can do and he does some massage to work the muscle but I still have daily pain which makes walking "normal" hard to do. I was wondering if anyone has or had this issue and what if anything did you do about it. I thank you for any input or advice.

http://a8.sphotos.ak.fbcdn.net/hphot...53375266_n.jpg
Fractured mine 4-weeks ago to the day riding dirt bikes. Progress seems slow, but I know it's just because I'm anxious to get going again. Luckily no surgery, but that also means the bone is less stable, potentially leading to longer PT times. I have been in a brace, but am finally allowed to take it off to let my knee bend (without resistance), which feels fantastic.

Funny to read the above posts and see the similarities to what I'm experiencing - including waking up at 2-am with random pain. Mine typically feels like my knee it bending laterally, which is super freaky!

You guys are probably already aware, but my Ortho said stay away from Ibuprofin, as it reduces your body's ability to heal the bone. I'll be honest I took some for the first 5 days after the accident, but have been off meds ever since. I won't take any narcotic pain meds... they just make me drool all over myself. It's sometimes tempting to take something, but I just try and push through it.

Whatever you do, don't just sit and rot while healing. Get out for walks (yes, on your crutches), stretch, move the healthy parts of your body - and exercise your brain! Massage and isometric exercises have helped a ton! I also ordered an EMS (electric muscle stimulator) to reduce the atrophy my upper leg is experiencing and it's working great.

My next race is in 11 weeks, and I plan on being there.

This world sucks. I try to stay positive, but enough is enough. I went to the river yesterday cause its Jan 31 the coldest most miserable day of the year usually, to 'celebrate' the clathrate gun--praying I won't get cooked in a few months, and while I'm paddling some kids ignored my muddy prints directly into the river, and came and stole my crutches and my altered baby carriage i use to pull the boat when I walk the two miles to and from the river, and launched it over the side of a bridge into the rushing water. I was helpless. I caught them but it was too late. the scrawny bastards offered to carry me and the boat but I screamed so loudly about their parents inadequacy that some people in a van gave me and the boat a ride home. Replacement costs: three weeks or more of selling blood, and the bill collectors are starting to get mean. I already went back to work against doctors orders and the superbowl is going to make me limp for life. It hurts sometimes being nobody's somebody, but dead friends are better than no friends. Seriously I would have shot those children if I'd had a gun. Look how cool it looks splashing into the river, will it sink was a logical question in their case, they weren't made of steel and one was fat the other boney.

Hello, My name is Cindi I am a 41 yr old Female, My husband and I were in a motorcycle accident on July 9,2011 where i suffered a Tibia Plateau Fracture of the left leg. We were very lucky that my husband knew how to handle the bike or we would have been hurt alot worse. He did not lay the bike down when the SUV hit us at about 25mph. I had an external fixator on for about 4 weeks then went back in to have a plate and screws placed. I also had to have some dead tissue removed as well. I am now in Pt and doing some better. I have not been driving yet i have some nerve damage in my left foot and big toe, My dr thinks that it will go away. It has been a long hard road as most of you know. I hope to be back to some what normal state soon. Glad I found this site, hope i can make some new friends!!

Welcome Cindi
You found a great place to learn more about your recovery. My accident was in early Oct and I am just now walking with a cane. Still going to therapy and lots of home exercise. I think everyone has the nerve damage to begin with. Mine has gotten better since the doc let me put weight on the foot. Felt like bees stinging me most of the time. The mental part is the hardest. Find something you like that you can do to occupy your mind. Hope you do well. Keep us informed on your progress. As you have probably learned this board has a lot of people who have been thru similar stuff like you are enduring now.
thanks
jesse

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Originally Posted by Harleygirl

Hello, My name is Cindi I am a 41 yr old Female, My husband and I were in a motorcycle accident on July 9,2011 where i suffered a Tibia Plateau Fracture of the left leg. We were very lucky that my husband knew how to handle the bike or we would have been hurt alot worse. He did not lay the bike down when the SUV hit us at about 25mph. I had an external fixator on for about 4 weeks then went back in to have a plate and screws placed. I also had to have some dead tissue removed as well. I am now in Pt and doing some better. I have not been driving yet i have some nerve damage in my left foot and big toe, My dr thinks that it will go away. It has been a long hard road as most of you know. I hope to be back to some what normal state soon. Glad I found this site, hope i can make some new friends!!

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Amy
How is the new/old PT working out? Have they helped you gain any ROM?
I saw my OS wed. He says I am doing exceptional. I finally asked him what my injury rated on the scale. It is a 5.5 with 6 being the worst. I can finally walk short distance without a cane but using it most of the time to make me walk correctly (PT and OS both said to keep at it with the cane until I retrain my leg to walk normally). Walking over 2 miles a day around the house and out around the farm. I go back to the OS the end of the month to see about going back to work. Let us know how you are doing.
thanks
jesse

Hi Jesse. I'm so glad to hear how well you're doing. It sounds like great progress!
My PT has been great! On my third session with him, he worked me hard and then measured me at 1/2 degree of HYPERextension!!!! Holy cow!!! That seems to be a bit of a fluke, I've been hovering right around -2. Since I've been stuck at -5 for so long, I think it's working. However, nothing seems to be easy........
The day that I got the hyperextension, I realized that I missed an important change to my health insurance. As of 1/1, the network that he is a part of, is no longer covered!! I spent the whole day in tears....again. He has helped me find another PT that is covered and I go on Wed for a consult. We'll see. What a headache.

Ryanrene: I'm sorry. I skipped right over the post that you wrote asking me for any advice. I think that there is so much wonderful stuff on this site. When I first found this forum, it freaked me out. It took me a long time to realize what a really big deal this is. I'm not sure that I still fully am accepting of it. Just, don't give up. But, you also need to allow yourself time to rest and heal and cry if you need it.
Do your exercises, rest and do them again. Work on extension early!!!! I'm in a tough spot now because it wasn't fixed early enough. Don't let your ankle, foot be ignored. If you're overwhelmed and feel like you need to vent, come here. :)

I just downloaded this forum from iTunes for my iPad, and figured out how to upload pics. Here is my unfixed and fixed leg. Enjoy :)


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Amy
I am sorry to hear you are having issues with your insurance company. Sounds like you were actually getting somewhere. Keep doing the exercises you did to get your ROM he helped you achieve. I guess we need to be talking to a co-worker to keep up with changes at our jobs while away. Seems like you loose touch with them though while concentrating on getting yourself well. Sounds like you are doing better except for the frustrating PT situation. You will be back at work soon wishing you had a day off. PT is the most important part of the healing process in my opinion. They do more than the OS once the surgery does his part.
I am uploading pics of my xray (after) it looks similar to yours. I have 22 screws and 2 plates. Wish I had a before pic. I may ask the OS to show them to me when I go back to see him.
thanks
jesse

Hi, I broke tp 2 weeks ago had plate and screws and was a rare break had to be opened up round the back of my knee and down the side and have a scar of around 13inches . Have started pt and am told to bear as much weight as I can but the more I do the more my knee swells and the more it hurts! Does anybody have any idea how long the major swelling lasts and the pain?