Tibial Plateau Fracture Recovery

Hi All. I am 18 weeks post op from left lateral Type II depressed TPF. 1 plate and 4 screws. Been FWB for 5 weeks. Currently walking on my own and able to take full steps up and down stairs. Don't need cane anymore. ROM is 135 and extension is about 2 so just a little more to go. Quad is still really weak and sometimes its hard for me to tell whether my knee hurts or my leg is just weak! Continuing PT 3x per week and definitely see the improvement there. I have taken a couple long walks and leg/knee gets sore but not unbearable. All in all, my recovery seems to have taken a little longer than the Dr and PT told me originally, but it slowly contiunes to feel better. Best of luck in your recovery!

looks like we are in the same boat kmrrdbb. It's good to see someone in a similar situation that is having a positive outcome, (though not as quickly as you would have liked)sounds like you have and are continuing to achieve some semblance of normalcy. That's very encouraging as i'm only 5 weeks into my journey, 2weeks post-op. how long post-op til you actually started any pt? did you do any of your own stretching as tolerable for the sutures? how long til the sutures were healed? keep pushing yourself at pt for that rom, sounds like your on the home stretch and your hard work is paying off. i'll keep you and everyone here in my prayers for your continued success and thank you for your input:)

Our entire lives have been spent evading the very thing that is the key to our success in recovery...Pain. and our ability to understand and so use it like a beacon to navigate and negotiate through the tretcherous waters, that are the sensitive areas of our weaknesses. More pain now, less pain later, assuming you know where your pain is coming from, you don't wanna be adding to your trauma, but it seems like a battle of how far you can push yourself to pain without damaging the hardware....definately not for the timid:o best of luck to all of you in your fight through the Pain.

Well, I was thinking FWB was going to be ok but not so. My knee isn't giving me any trouble but I have bad pain from my heel to ankle, so much so that I am still using my crutches and only putting 1/2 to 3/4 of my weight on it. Oh well, i'll keep at it and talk to my OS and Physio.

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Originally Posted by Markxz

Well, I was thinking FWB was going to be ok but not so. My knee isn't giving me any trouble but I have bad pain from my heel to ankle, so much so that I am still using my crutches and only putting 1/2 to 3/4 of my weight on it. Oh well, i'll keep at it and talk to my OS and Physio.

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It's been a good 4-5 weeks since I've been FWB. I'm still getting slight pain in my heel and ankle, although it's getting better. It's just something that I'm sure will go away after a period of time. I've had a lot of issues with drop foot and the nerve sensation on my foot since the operation - hardly any pain near my break. The only time I notice the break is when I'm driving (independence for the last 3 weeks :)). I have the TPF in my left leg, the car is manual and I live in Australia (so clutch foot).

TheDude1, I started PT 3 weeks post op. PT was mostly just range of motion and extension until I was 25lbs partial weight bearing, which was about 6 weeks. It seemed to take longer than I expected for the incision to heal and once it did I was in a pool doing exercises every other day. I have a pool in my backyard and live in a somewhat tropical location. The cold pool water felt great and was also good for the inflammation. In this whole process, especially first 8 weeks, there were many times when I wondered if I would ever feel normal. It does get better every week and sometimes the pain from PT hides that. Even 18 weeks out, my walking gets a little better every week and less and less pain. A friend of mine going thru cancer told me, "When going through hell, just keep going!" and although this no comparison to cancer, that seemed to help at the time. This injury sucks and definitley slows you down but just keep going and before you know it, it will be over.

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Originally Posted by Markxz

Well, I was thinking FWB was going to be ok but not so. My knee isn't giving me any trouble but I have bad pain from my heel to ankle, so much so that I am still using my crutches and only putting 1/2 to 3/4 of my weight on it. Oh well, i'll keep at it and talk to my OS and Physio.

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Hey - congrats on FWB -- I see the OS today and anticipate only partial weight bearing -- OS has said all along no FWB until 12 weeks out. Glad to hear the knee is feeling ok. Hopefully the heel to ankle will continue to improve as it gets used to the status. About 3 hours until my appointment --- hope it goes well.

This is my first post, just found the site. My surgery was 10-12-12, have been partial to full weight bearing for about 6 weeks, using crutches consistently, straightening is good but only about 70% bending...working every day to improve on all fronts. The image, http://www.flickr.com/photos/2947850...in/photostream, shows details of my injury and hardware. Does anyone have the piece that runs horizontally through the knee that is shown here? If so, does it seem to prevent the knee from bending or does it gouge your inner knee?
I'm having the same pain in heel, arch, ankle described above to the point that it's keeping me from putting much weight through the leg when I walk, and the swelling and stiffness just seems to freeze me from making much progress. Unbelievable how long this takes.

Just home from 8 week checkup with the OS -- very excited to be partial weight bearing. OS says up to 35 - 40 pounds of weight on the recovering leg - and of course more PT. PT will focus on strengthening and additional range of motion and partial weight bearing. Interested in those who have used a pool - how much difference did it make and is it worth the investment to find a place. Thanks

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Originally Posted by woomaj

This is my first post, just found the site. My surgery was 10-12-12, have been partial to full weight bearing for about 6 weeks, using crutches consistently, straightening is good but only about 70% bending...working every day to improve on all fronts. The image, http://www.flickr.com/photos/2947850...in/photostream, shows details of my injury and hardware. Does anyone have the piece that runs horizontally through the knee that is shown here? If so, does it seem to prevent the knee from bending or does it gouge your inner knee?
I'm having the same pain in heel, arch, ankle described above to the point that it's keeping me from putting much weight through the leg when I walk, and the swelling and stiffness just seems to freeze me from making much progress. Unbelievable how long this takes.

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I've got a screw (bolt looking thing) that runs horizontally with kwire for good measure. My physio has mentioned in the past that this will hinder the bending of my knee. He estimated that I would only get to 120 on my bend - however before Christmas when we measured I was on 128 and I think it's better than that now. Back to the hospital next Wednesday for (hopefully) sign off, so I will be measured for the report this Thursday when I see my Physio next.

I know that it's hard and feels like an eternity, but from my experience you just need to push through the pain (within reason)...the stiffness and swelling is just a sign that you're progressing. Don't look at day to day or reflect back on what you could do - think of what you've done week to week. Believe me, I have my moments that I want to cry or scream at the frustration of the situation.

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Originally Posted by justathought

Just home from 8 week checkup with the OS -- very excited to be partial weight bearing. OS says up to 35 - 40 pounds of weight on the recovering leg - and of course more PT. PT will focus on strengthening and additional range of motion and partial weight bearing. Interested in those who have used a pool - how much difference did it make and is it worth the investment to find a place. Thanks

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The pool is awesome!!! Just walking with water up to the chest is encouraging to begin with. I progressed with walking by using the built-in ramp. I would walk up until I couldn't physical walk without assistance (or rail) and back again...doing this up to 10 times. The mind also plays a big part in the recovery. I found last week that I was walking without a limp...

Just being able to strengthen the leg/hip/knee is fantastic too!!! I had a noodle (floating device), tucked it under my foot and pushed up and down on it...great way to strengthen the muscles above the knee.

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Just home from 8 week checkup with the OS -- very excited to be partial weight bearing. OS says up to 35 - 40 pounds of weight on the recovering leg - and of course more PT. PT will focus on strengthening and additional range of motion and partial weight bearing. Interested in those who have used a pool - how much difference did it make and is it worth the investment to find a place. Thanks

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Still neck a neck we are.
Fantastic to hear you can start WB.
I spoke to a Doctor yesterday and he told me to take paracetamol and not expect to bear full weight, take it slowly. The OS gave me the impression it would be easier. oh well, keep going.

Hi, crystalteras good to meet you. Beat you by 14 days (May 12th 2012) and 2 screws. I don't know if you have been riding a cycling stationary trainer but that is a good way to rebuild you quads. It also helps with the patella and with smoothing out the uneven surfaces on your tibia. Plus since it cycling is considered non-weight bearing you can do a lot. For anyone else reading this I would not cycle during non-weight bearing unless cleared by medical types.

Good luck.

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Originally Posted by crystalteras

Hi. I haven't posted in a LONG time but here I go...
TPF type VI w/ depression on 5/26/12
Surgery w/ 13 screws and 2 plates on 6/1/12
Didn't start FWB til around end aug/beg sept.
so a few weeks ago, I had a test done at PT to test my quad muscles. My good side was at 53 (scale 1-100) and bad side was at 17...that's not good but I do know it's really hard to rebuild quads. Especially when you have so much pain. My patella has been my biggest problem from day 1 of walking. I don't know if it also has to do with the fact that the os tore right thru it durin surgery but I have horrible pain with it. ALSO, since it's been cold my knee KILLS me!!! I could never handle the cold ice packs bc of the metal but really, this is bad. I have y next appt with my os in about 3 weeks and then we schedule a date to take out all my hardware. I have been having quite a bit of pain due to the hardware as well. Then ill be down another 6 weeks while the holes where stuff was taken out, heals....this whole process just sucks. Bad! :( good luck to everyone else!

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Hi, here is a link of interest. It is a supplement developed by my doctor (Dr. Haidukewych) and some other researchers at UCF (University of Florida). Dr. Haidukewych is one of the best in this field and I have dealt with UCF and they do good research, so this might be good. I'm not recommending it, but I'm going to give it a shot. Due to my long non-weight bearing x-rays are showing osteoporosis of my ankle and foot. My doctor here in Boston tells me 3-4 month to fix it naturally, so I'm going to try and speed this up. Anyway here is the link for anyone interested.

http://www.bonehealthnow.com

Jim

Yes I have that hardware and a lot more. I was told that it could restrict range of motion. I had my surgery in late May 2012 and my range of motion is only 125, which is livable but not ideal. You have gotten to FWB very quickly. You must be a fast healer. I took me 4 months until PWB and 2 more months to FWB. Of course my tibia was in a lot more pieces. It kinda exploded. As anyone here will tell you patience is the key. All of your other pains arch, ankle etc. are fairly typical and will go away. They are from NWB.

Keep your spirits up and keep moving forward.

Jim

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Originally Posted by woomaj

This is my first post, just found the site. My surgery was 10-12-12, have been partial to full weight bearing for about 6 weeks, using crutches consistently, straightening is good but only about 70% bending...working every day to improve on all fronts. The image, http://www.flickr.com/photos/2947850...in/photostream, shows details of my injury and hardware. Does anyone have the piece that runs horizontally through the knee that is shown here? If so, does it seem to prevent the knee from bending or does it gouge your inner knee?
I'm having the same pain in heel, arch, ankle described above to the point that it's keeping me from putting much weight through the leg when I walk, and the swelling and stiffness just seems to freeze me from making much progress. Unbelievable how long this takes.

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Pools especially with a good aqua therapist are way better than land in my opinion. I have been using a hot water pool (96 degrees) lately and I have an excellent therapist and it is really helping with my TPF and with my shoulder which was also operated on (A/C joint separation). I tried a regular pool but many of them are kept cool so swimmers can get rid of excess heat and you can just tense up and get cold in them just walking. I use the pool at New England Rehab Hospital. Some YMCAs in the Boston area have warm water pools (about 85-89 degrees) that are good for walking.

Good luck,

Jim

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Originally Posted by justathought

Just home from 8 week checkup with the OS -- very excited to be partial weight bearing. OS says up to 35 - 40 pounds of weight on the recovering leg - and of course more PT. PT will focus on strengthening and additional range of motion and partial weight bearing. Interested in those who have used a pool - how much difference did it make and is it worth the investment to find a place. Thanks

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I would follow your doctors advice. He can tell from x-rays how the healing is going. If you peruse these pages you will see plenty of people who have had real setbacks, some due to rushing things and quite frankly you sound like a mess. My doctor in Boston (who didn't do the surgery) and is a friend of mine told me this. "If you screw this up, you might as well cut the leg off". This is not an injury to mess with. When your doctor sees the healing he is looking for he will tell you and you can have at it.

Good Luck,

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Originally Posted by Decoy DeVille

I just broke both of my legs 5.5 weeks ago at Keystone. I broke my right femur at mid point in two at a 45° angle of trauma. It was repaired with 1 Titanium rod, 2 screws in the hip, and 3 screws in the knee. I broke my left patella in two, my left tibia at midpoint, and my tibial plateau. It was repaired with 3 screws to the tibial plateau, 2 screws to the patella, 1 Titanium rod, 2 screws in the head of the tibia and 2 screws in my left ankle.

I'm still nwb on my left leg (tibia/patella/plateau) for 3.5 more weeks, but I'm curious if there is anything I can do at home to start strengthening my right quad (where I broke my femur) and my right hip. I'm already fwb on my right leg but after about 20-30 minutes of crutching around I have this excruciating pain in my right hip. Doc said today no fracture or strain in the hip socket. So that leads to muscles and tendons. Any exercises??

Doc doesn't want me starting PT until I can start weight bearing on my left leg too. I disagree due to the massive amount of atrophy occurring, but am following his orders.

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Originally Posted by smilybeck

I've got a screw (bolt looking thing) that runs horizontally with kwire for good measure. My physio has mentioned in the past that this will hinder the bending of my knee. He estimated that I would only get to 120 on my bend - however before Christmas when we measured I was on 128 and I think it's better than that now. Back to the hospital next Wednesday for (hopefully) sign off, so I will be measured for the report this Thursday when I see my Physio next.

I know that it's hard and feels like an eternity, but from my experience you just need to push through the pain (within reason)...the stiffness and swelling is just a sign that you're progressing. Don't look at day to day or reflect back on what you could do - think of what you've done week to week. Believe me, I have my moments that I want to cry or scream at the frustration of the situation.

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Thanks for the reply. Two more questions; did you ever feel a gouging type pain at the 'free' end of the horizontal piece? and, how many weeks did it take to achieve at least a 90 degree bend?
...and just because I can't figure it out through the site, what is the difference between 'minion' and 'registered user' status in this forum? I registered, but seem to remain a lowly minion.

Just had the first post partial weight bearing physical therapy session -- what did I learn? 35 pounds is NOT a lot of weight -- its more than a toe touch and a lot less than carrying real weight BUT it is a HUGE difference in mobility. I walked about 400 feet in my first venture using a walker. My ankle is stiff, I have to be sure not to push off too much with my injured leg (pushing off does hurt), and I must ice afterward but pain was minimal and YAY I am "walking" not hopping and its a huge improvement!

30 minutes after ice, my knee feels stiffer than it has -- not painful but stiff My calf muscle is sore but overall not too bad.

@dnabike -- which New England Rehab do you go to? Interested in the pool and wondering how close it is to me.
Thanks

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Originally Posted by dnabike

Yes I have that hardware and a lot more. I was told that it could restrict range of motion. I had my surgery in late May 2012 and my range of motion is only 125, which is livable but not ideal. You have gotten to FWB very quickly. You must be a fast healer. I took me 4 months until PWB and 2 more months to FWB. Of course my tibia was in a lot more pieces. It kinda exploded. As anyone here will tell you patience is the key. All of your other pains arch, ankle etc. are fairly typical and will go away. They are from NWB.

Keep your spirits up and keep moving forward.

Jim

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Thanks for your reply. I have to ask you about the gouging pain, did you feel anything like that at the 'free' end of the horizontal piece? And, I miscounted the WB weeks, it's been 4 weeks since clearance for P-FWB, but I have to admit I've managed more P than F. But patience and perseverence are for sure the best prescription. I see my doc tomorrow and hope to get OK's for outpatient PT and pool, and driving. Looking forward to the freedom of getting out of the house and being around people!

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Originally Posted by woomaj

Thanks for the reply. Two more questions; did you ever feel a gouging type pain at the 'free' end of the horizontal piece? and, how many weeks did it take to achieve at least a 90 degree bend?
...and just because I can't figure it out through the site, what is the difference between 'minion' and 'registered user' status in this forum? I registered, but seem to remain a lowly minion.

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Actually if I think about it until my second outpatient appointment (about 2-3 months ago) I thought I could feel that, but the OS told me I shouldn't (after checking the xrays). Once I stopped thinking about it as much, I haven't noticed it. My thing at the moment is that it's tight (but I'm also now down to physio appointments every week and a half) cause I've been trying to do lots of walking, cycling and swimming. Also, it sometimes feel weak around that area, like if I bend too far it will break again - but I think that's more a confidence thing.

While I was NWB I had a ROM brace which was set to 90 degrees. The physios in hospital gave me a few exercises (like lifting my leg and bending my knee) which I did religiously. Once I was cleared for PWB and my physio got a hold of me I was on 88 degrees. I think it only took me 2 appointments (one week) to get past 90 degrees. However, he's really into manual therapy and likes to hurt me a lot i.e. liked to bend my knee, sit on my foot so I couldn't move and manuipulate the bejesus out of my knee / break, "just to loosen it up". Now to get further, he dry needles above me knee and we can usually get another 5 degrees out afterwards. Dry needling is similar to acupunture, but is the western treatment and focused on the muscle.

Also, the difference between minion and registered user is the number of posts :)

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Originally Posted by smilybeck

Actually if I think about it until my second outpatient appointment (about 2-3 months ago) I thought I could feel that, but the OS told me I shouldn't (after checking the xrays). Once I stopped thinking about it as much, I haven't noticed it. My thing at the moment is that it's tight (but I'm also now down to physio appointments every week and a half) cause I've been trying to do lots of walking, cycling and swimming. Also, it sometimes feel weak around that area, like if I bend too far it will break again - but I think that's more a confidence thing.

While I was NWB I had a ROM brace which was set to 90 degrees. The physios in hospital gave me a few exercises (like lifting my leg and bending my knee) which I did religiously. Once I was cleared for PWB and my physio got a hold of me I was on 88 degrees. I think it only took me 2 appointments (one week) to get past 90 degrees. However, he's really into manual therapy and likes to hurt me a lot i.e. liked to bend my knee, sit on my foot so I couldn't move and manuipulate the bejesus out of my knee / break, "just to loosen it up". Now to get further, he dry needles above me knee and we can usually get another 5 degrees out afterwards. Dry needling is similar to acupunture, but is the western treatment and focused on the muscle.

Also, the difference between minion and registered user is the number of posts :)

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Yow! This experience just keeps entering more and more rings of hell, sounds like. Thanks for the reply, will check in from time to time.

Just wanted to know if anyone still has issues with there foot (tingling, loss of partial feeling, cant move baby toe) from nerve damage at one year since the TPF?

i have noticed the tendons on my foot recently beginning to get sore. probly just atrophy from under use/weakness.. felt better after stretching today. do u go to PT?

Had my last home physical therapy today - discharged to outpatient physical therapy which starts with an evaluation tomorrow. I suspect the hard work has just begun. Today I got to 0 to 100 ROM, up from 90 a week ago. And I "walked" about 200 feet partial weight bearing (35 pounds max although I think its more like touch down)... My knee feels like a sore Nerf ball after every walk -- mushy but sore and I am finally figuring out how long to ice and elevate to prevent the swelling from getting really bad. I figure the hardest work is yet to come ----