Tibial Plateau Fracture Recovery

I am 4 days post surgery, sitting in my recliner, wondering what exercises I can do to strengthen my foot and ankle. Have a knee imobiliser on and am non weight bearing. Can't sleep much, because I am a side sleeper. Any suggestions, would be greatly appreciated. I hope someone answers your question too Vaper. In the mean time I am raising my leg off the pillow and holding it up for five seconds x 5 reps, and wriggling my toes, and trying to move my foot up and down with my good foot under it for support.. I think if you could get a tie or a pair of tights looped around your foot you could move your foot up and down too. Hope you are having a good day, everyone on here :)

Heather and vapor, there's not to much you can do to strengthen your foot and ankle without really fwb on it. What I noticed is even more important the strengthening the foot and ankle is keeping full rom of your ankle. Constantly keep moving it up and down moving the ankle to keep its range of motion. Once you get fwb you will stretch your ankle a lot more with your PT. it's very easy to lose rom in your ankle too with this injury. I've noticed a little loss when I lift up on my foot. The Achilles has not been used or stretching much so it tightens up when not in use, as is the case for our type of injury. Your foot and ankle take some time getting use to fwb again and there's no way to adjust to it other then getting back on it and using it again. I hope that helped somewhat

Thanks Dgw3369 . That's what I am doing right now.

Hi All,

I'm a new user - just found the this thread yesterday and now have the time to respond.

I'm at week eight and feel I can contribute to this thread.

My story is similar to the others - a dirt bike crash which shattered the TP into 18 pieces. I waited 2 days for surgery and now I have two plates and 13 screws holding everything together.

Here is the general timeline:

Post Surgery = ankle to hip fiberglass cast for 6 weeks.

Week 7 - the cast was cut off and I'm listed as NWB at least until my next appointment - August 9th.

My Experience

WITH CAST: While in the cast I had a typical experience. It was difficult to do anything and I spent most of the 6 weeks going between the bed and the TV armchair. I was out a handful of times but it was so difficult it wasn't really worth it. The swelling in my foot was very bad if I stood up for any amount of time. This will sound cliche but every night was a slight improvement in comfort, pain, etc. The only thing that got worse was the itching. My advice = resist. It only gets worse once you start itching.

WITHOUT CAST: It was mentally scary the first few days because there was no support and, invariably, I would hurt it while sleeping, moving, etc. OUCH. Sharp pain. I figured that this was just a normal part of the process and it was. The swelling was the biggest deterrent for me to crutch around. We solved this with a compression sock. This changed everything and suddenly very little blood would go to my foot. Once again, every single day there was improvement.

My wife is a distance swimmer (laps) and I used to go with her. One week ago I got into the pool (finding a pool that can handle me was difficult - ask me and I'll tell more) and it has been LIFE CHANGING. Swimming was doable right away and each day I make HUGE GAINS. I can't express how great swimming is. JUST DO IT.

I am at about 5 degrees and 85 degrees of flexion with my knee and improving every day.

MOST IMPORTANT POINTS FOR RECOVERY:

1. COMPRESSION SOCK

2. SWIMMING

How can I subscribe to this thread?

D

Hi Aunt Tete. I hope you are improving since your last post. I suffered a tibial plateau fracture in April 2012 after a fall landing on my knee. I was unable to stand and felt severe pain so wen to ED and was x-rayed and diagnosed. in the Ed I was placed in an immobilizer splint and told to follow up with ortho surgeon asap. The injury was late on a friday so I didn't see ortho till Mon or Tue of next week. The ortho sent me for a CT scan and confirmed a non-displaced fracture. Treatment was keep immobilized, elevate, ice and pain killers (vicodin). I had follow up appt every week with x-rays to monitor healing aqnd assure non-displacement. After 4 weeks I was put in a knee brace and ROj set to 30 degrees after a couple weeks the ortho advanced to 75% and eventually to 100% foll ROM. At 11 weeks I was given partially weight bearing - 50% of weight -using a walker. This my first week of partial weight bearing and am told I will go back in 2 weeks and then advance to full weight bearing. Next will be a follow up aapt in 1 month after beginning full weight bearing which should be my last visit. the ortho said after a couple more months the fracture should be completely healed and I will be back to my pre-fracture activities. I was concerned reading your post that you may not be getting the proper instruction and attention to address your pain and injury. Thought my story might help as one poster commented our injury is not as severe and complex as may who have commented. Good Luck and hope you are feeling better.

I have to say from my own experience the compression sock works wonders! If I don't use it my foot looks like I have little sausage links for toes.

Hey I just wanted to see if anyone is still having pain issues after 5 months? I broke my tib and fib back in Feb 2012 (Tibial Plateau Fracture and Spiral). I am still taking pain meds and have no idea when this is going to get better. I stuggle seeing the light at the end of the tunnle after reading other posts and seeing how much quicker other people have recovered. I am mostly walking without a cane but still can not walk for long distances without paying the price the next day, and when I say long I mean like three blocks.
anyway just wanted to see if anyone is still sturggling a lot after 5 months.
Wish everyone a speedy recovery :)
-Christy

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Originally Posted by crobertscroberts

Hey I just wanted to see if anyone is still having pain issues after 5 months? I broke my tib and fib back in Feb 2012 (Tibial Plateau Fracture and Spiral). I am still taking pain meds and have no idea when this is going to get better. I stuggle seeing the light at the end of the tunnle after reading other posts and seeing how much quicker other people have recovered. I am mostly walking without a cane but still can not walk for long distances without paying the price the next day, and when I say long I mean like three blocks.
anyway just wanted to see if anyone is still sturggling a lot after 5 months.
Wish everyone a speedy recovery :)
-Christy

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I am not anywhere near your stage of recovery, but seeing that you have come so far and can now walk without a cane, gives me hope. All I can do at present is hop with my walker from bed to recliner and back with a potty stop in between. I can see my husbands frustration that I cannot go and get something, I wish I could . Everyone has different pain thresholds and require different meds. Are you still taking the strong ones or the not so strong. Thank you for being an inspiration. I too am wishing everyone a safe and speedy recovery.

20 days since my surgery and I am excited to read about others PT adventures. Your stories are giving me something to look forward to other than silly foot pumps.

scjohnson07

I am 14 months out from a Type VI TPF, meniscus and fib break and I still cant walk up stairs normally without pain. it takes time. just count on getting better a little each day.

@vaper
My p/t had me doing range of motion stuff like moving your foot side to side and up and down, circles in each direction and then writing the alphabet with my big toe. The alphabet 1 time and all the others three sets of 20, 3 times a day. My p/t also gave me some of those colored bands, they are like elastics. Different colors give different resistance. Doing the up down side to side exercises holding the band opposite the direction your moving your foot.
Good luck! Hope this helped.

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Originally Posted by vaper

since no one answered my last post, i'm gonna ask again. does anyone know any strengthening exercises for the foot and ankle before fwb? would really appreciate it!

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You can use a light resistance band to strengthen the foot and ankle. Take the band and wrap it around the foot and pull to one side. Then move your foot back and forth. Can also do that to strengthen the calf except move the foot up and down. You will probably be given these type of exercises when you start pwb. Ive heard the transition from pwb to fwb takes about 2-3 weeks.

i'm at 7 weeks now, and my rom is still the same for a couple weeks now, i have almost full flexion, i'm at about 130 degrees and i can also hyper extend without pain. i've been taking calcium and vitamin supplements which i hope will help to heal the bone bc i'm very ready to walk! i'm at touchdown pwb and my next appt is aug 13 and it really sucks to have to wait that long. i'm going to try to do the resistance band to help my ankle as you said, soonerstacy. i just can't wait to be walking!

Maker- wow that's rough I hope it gets better for you! I was told that in 3 weeks I can start taking off my immobilizer brace for a couple hours a day to let my leg just "hang out" ... I do that for a couple weeks then I can start trying to slightly bend it and sit on the steps in the pool while letting it float. Going to be a long recovery and my injury date was may 23rd! Guess I won't be putting any weight on it for another couple of months and then tons of slow therapy before they get me ready for my surgery. Anyone have suggestions on how to comfortably sleep with an immobilizer on? I'm not a back sleeper but I don't have many choices.

Well I know I just updated a couple weeks about about my leg healing well so far. Well now I'm at 6 weeks post op and I started pt this week. Not a whole lot they can do except teach you exercises until ur at least pwb. My pt actually told me he will be putting me in the pool before then bc it's really good for me. I'm just excited to get in water! I feel like I'm missing my summer watching everyone else swim. It's going slow and I've been massaging my many scars with tummy butter (leftover from pregnancy) and he says that's really good for it. Anyway. Enough of boring you all. Gonna get back to rubbin! Lol

I have my first post op appointment on Tuesday they plan on removing the imobiliser and replacing it with one at a 30 degree angle. It seems to me that after not being able to bend my leg for 2 weeks that just doing this will be extremely painful? Do I need to take pain pills before or after the appointment or both? Pleases can someone who has passed this stage advise me, thank you.

HeatherB....You are lucky, it took me 6 wks until they would allow me to start flexing. Anyways to answer your question, for me it wasn't too bad. I would think at 2wks though you might still be having some slight pain with your incision area and knee/leg area. I don't think it will be to the point of needing anything for pain. If anything take some Tylenol if you are concerned.

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Originally Posted by HeatherB

I have my first post op appointment on Tuesday they plan on removing the imobiliser and replacing it with one at a 30 degree angle. It seems to me that after not being able to bend my leg for 2 weeks that just doing this will be extremely painful? Do I need to take pain pills before or after the appointment or both? Pleases can someone who has passed this stage advise me, thank you.

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Update....at 7wks, well a little more than a week to go before I go to see the OS and I am flexing at 90 degrees. With my brace off, I can go a little past this point, but don't want to over do it until he gives me the OK. I don't have any pain during flexion or with the incision area. The numbness in my heal and incision area is subsiding. I can see my kneecap again, Yahoo! I am still have pain in the medial side of my knee with soft tissue and pain on the backside of my knee with swelling. Not sure what the pain on the back side is from?? My muscles feel like they are mush and I wonder if I will get them back.

I am feeling good about the progress I have made so far, only 5 wks left of NWB.

Have a great weekend everyone!

Thanks peaton will take your advice. :)

Peaton- I have pain in the same area but I haven't had surgery. My surgery will be in a few months.

Has anyone had experience using one crutch, and 50% weight bearing? Physical therapist told me it was safe, but I feel like its hard to gauge what 50% wb feels like with only one crutch. After she taught me how, I went back to two crutches. Like I feel too wobbly or that I'm doing more than 50%. Don't wanna mess it up now...

Thanks Peaton for easing some of my worries, glad to hear your recovery is progressing. Got a hinge cast on yesterday, although have to keep knee immobilized for another 1 1/2 week. I was shocked when my old cast was removed, quad and calf muscles have disappeared after only 4 weeks and knee is unrecognisable. Peaton what kind of cast/brace do you have on now. They tell me i'll have this hard cast with knee hinge on for another 6 weeks with rom increased incrementally,do you think this is over cautious?

Gav29....I too have a hinged brace. It is a Don Joy ELS Post-Op Immobilizer. Because of the swelling that I have behind my knee it is easier for me to flex it with the brace off. I have been wearing it the past 6 wks. I had a partial plaster cast on for the first week. I am not familiar with your injury, but I don't believe it to be over cautious.

I too have another 5 wks or so for a total of 12 wks NWB, with this brace. If you get lucky and your bones heal fast, you may get out of it sooner or prescribe a different type of brace.

As far as muscle atrophy, they say after not using it for 10 days it will start to wither away. So you can only imagine what ours will look like when we start therapy. I laugh with my hubby, I have been trying very hard not go gain weight while sitting on the couch with no exercise. I have actually lost a few pounds, I told him it is probably because I am loosing muscle mass.

Glad I could help. I was very glad to find this site. I still have days where I have a melt down, but it quickly goes away when I realize how far I have come and how much better it is feeling.

I felt pretty stupid today though...I was trying to get into the truck the same way I have for the past weeks. Well something happened and I fell on my good knee, on purpose I might add. Anyhow, I really need about 3 stitches probably. I scraped it up and a rock pierced my knee and bled like a stuck pig. So I have changed the bandage 2x then finally got smart and put a pressure bandage on. The cut is right where you flex your knee at and kinda deep, I imagine it will take some time to heel. It is bruised and sore and I feel like a dope, LOL!

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Originally Posted by Gav29

Thanks Peaton for easing some of my worries, glad to hear your recovery is progressing. Got a hinge cast on yesterday, although have to keep knee immobilized for another 1 1/2 week. I was shocked when my old cast was removed, quad and calf muscles have disappeared after only 4 weeks and knee is unrecognisable. Peaton what kind of cast/brace do you have on now. They tell me i'll have this hard cast with knee hinge on for another 6 weeks with rom increased incrementally,do you think this is over cautious?

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Hi All,

I thought I'd chime in also with my tibial platue fracture story.

The fracture itself happened Jan 23rd, 2011,so a while ago. The result of a hit and run accident with a large pile of poop now residing where my platue use to be. I too was told it's one of the worst fractures my ortho has seen, so a BIG Yay for me!!!

Anyways, I was improving dramatically until severe pain set in resulting in a need for a second surgery and now a third this coming week. I'll post an X-ray pic later on once I get on my PC but I'm in so much pain and have so much anger!!!

I use to run, ALOT, and now all I do day in and out is Physio and rehab with the feeling my life has been stripped from me.

Any tips on pushing through the physiological scars as well as the physical would be appreciated.

http://imageshack.us/photo/my-images/194/photoawz.jpg

Cheers,

Andy.