Tibial Plateau Fracture Recovery

Im 37 I have a lvl 6 Plateau Fracture on right leg. happend on May 28. It was fractured in 7 places and a torn ACL. I was in a Ex Fix for a week and im 6 1/2 weeks after surgery. I have 3 plates and 8 screws I was on crutches untill last Whens. im now useing one crutch and can bear 60lbs weight and im at 0% straight and 137% bent. Doc says I can drive in 2 more weeks but I have had handicap controls installed in my car so I have been driving. Here are some pics

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I just read this entire thread. I'm very grateful to everyone for posting their experiences.

I'm 47 years old and sustained my TPF on May 7th, 2011 after falling from a ladder and attempting (successfully) to land on my feet. I went into surgery the following day (Mother's day). The plate, 15 screws and 42 staples really took an emotional toll on me. Having to depend on others for the simple things we take for granted has moved me to tears a couple of times. I'm just wondering if anyone else has been griped by depression as a result of their injury?

Being independent I was thrilled when, four weeks ago, my ortho told me to start bearing weight and work myself onto one crutch by today's follow-up. Despite my best efforts, I wasn't able to take more than one or two single-crutch steps which came at a cost of considerable pain. Pain and muscle weakness were my barriers to success. Today's x-rays indicated that the fractures aren't healing or "filling in" to the doctor's satisfaction. He told me to stick with both crutches with minimal weigh bearing and come back in three weeks. I was also looking forward to starting a PT regimen, which up until now had merely consisted of CPM for three weeks post-op. He (reluctantly) prescribed PT two days a week with no weight bearing. He understandably wants to see bone healing before physical therapy.

This is not the news I wanted to hear after eleven weeks of being on crutches. I'm not sure how effective two days a week of therapy will be. My ROM is about 100 degrees with just a slight bend fully extended.

Hi, Just found this. I shattered my left tibial plateau last August. I am getting ready to have the hardware taken out; two plates and 10 screws. I was wondering if anyone had this done yet? I have had a difficult time finding many people who have had this done but the ones that have are very positive about it.

Luckily I only had 3 screws but I got them out about a year after surgury. No issues for me. As I understand it, if you leave that HW in there, there will always be a chance for infection/staph. On ecase I read, the bone rotted out near teh HW which happened years later for no apparent reason. so I'd say go for it. Plus after the first surgury you'll think this one is nothing.

Thanks for the reply. I have an appt. on Monday and I'm going to schedule it. That first surgery was rough! Plus I had a 9 month old that just started walking the week I broke my leg and had an older 4 year old. Really looking foward to all of this comming out of my leg, I am sure you are right too... nothing compared to the first surgery:)

back from the doc today (12 weeks out; surgery back in May). he is planning to take my 11 screws and 1.5 plate out in Sept/Oct for those that were curious about removing hardware. that would would 5 months post-op.

Two plates and 10 screws to come out on the 11th. Then to figure out what is wrong with my ACL and possibly another surgery:) It has been 12 months since my original surgery. I'll let everyone know how it goes next week.

^^I am in the same boat. Need to see if my acl is ok after taking out the harware. Doc says my knee is quite stable but that could just be from the swelling and scar tissue....so I could be in for acl surgery as well.

My tibia plateau fracture happened 3 1/2 weeks ago. My surgery was 3 weeks ago today. My Dr told me he didn't put a plate in because he thought I would be very careful and it would help lesson the possible arthritis. Mine broke off in one piece, but they had to put bone graphing in along with two screws. I was told no work for the first two weeks and am now back to doing desk work only 1/2 days for two weeks at least. I was told absolutely no weight on that foot for at least the first 4 weeks. I go back to the Dr on Monday to see where we go from here. I have been given exercises to do and started them in the recovery room. I have been allowed to go in the pool and walk on my toes, but have steps to get to the pool so I can only go in there when my husband is here to help. I'm hoping to start PT next week! I am encouraged and scared when I read all of your posts, but it is helpful to know I am not the only one looking at this long recovery time. I thought my doctor had lost it when he told me average of 4 months before I can have 100% weight bearing. My work doesn't believe it either, but that is another story. Thank God for FMLA!
I wish you all a quick and complete recovery!

I am so glad to find this.

Tuesday January 25th, I spent an hour practicing vinyasa yoga, and an hour training intermediate level Muay Thai kickboxing.

Wednesday January 26th around 5 pm, I was on a crosswalk with a walk signal 2 blocks from work when some jackass turned right without looking and sent me airborne. I think that's the first time I've ever screamed in my life. Luckily I went into shock really quickly so I didn't feel much.

Got to the hospital, found out I had a tibial plateau fracture (right leg), and was put on blood thinner injections until surgery. Didn't get surgery until 9 days later, and luckily I went to a different medical group because the hospital orthopaedic surgeon was going to keep me on those blood thinners until the day of surgery- hooray for the possibility of bleeding to death on the OR table. Anyway, a 2 hour surgery turned into 3 because my MCL was completely ripped off the tibia, the meniscus was torn, and I needed bone grafts and two screws along with all the pulverized bone bits being taken out.

The pain was awful the first night after surgery- make sure that the night nurses don't try to cut your pain meds in half in the first 24 hours. And if you have a friend/family member who is willing to stay over night, trust me, you'll need the distraction.

I think I was non-weight bearing for 3 months, seems fairly standard for this type of break from what I've been reading here and on medical sites. But, and this is something I would have really liked to know much earlier, traumatic injuries (like being hit by a car) can cause an excess of scar tissue to build up. I was stuck at 65 degrees until early June when I had to be put under anesthesia for a manipulation. From reading the surgery notes, it sounds like he couldn't even see with a scope inside my knee, there was so much scar tissue. My kneecap wasn't even moving and I could only bend to 65 degrees- it was like hitting a wall. By some miracle, he managed to get me to 135 degrees under anesthesia (my other leg bends to 145 and hyperextends) and 0 (which wasn't as difficult for me). If you need a manipulation after this injury, make damn sure you get someone who will do arthroscopic muscle debridement- they basically shave the scar tissue off your muscles- gross but effective. Otherwise they're just breaking up the scar tissue and it hangs out in there waiting to re-attach. Also get a nerve block- and dope yourself up seriously on pain meds for your PT session the next day because you will never experience anything as painful as that first session after a manipulation. I screamed for 30 solid minutes with the nerve block and 10 mg of percocet. But it has to be done or you'll have had the manipulation for nothing.

From my reading online, being manipulated to more than 120 is extremely unusual. I think maybe all the yoga practice prior to the injury and constant stretching as part of early PT played a role in that.

It's been about 2 months since the manipulation (and 6 months since the first surgery) and I'm walking, though still a little unsteady and my quads are still embarrassingly small compared to the left leg. One big thing is maintaining hip abductor strength or you'll weave like a drunk when you walk. Lay on your side and lift your straightened top leg towards the ceiling- make sure your hips are perpendicular to the bed/table/floor.

Do not stop being vigilant. I relaxed for about a week, 3 weeks after the manipulation and dropped from an easy 130 to a struggling 110. I've fought my way back to 128 on the total gym squat machine but it's not easy and it doesn't help that my ankle has stiffened up from so little use. One of the therapists I saw a couple weeks ago said that you basically have 4 months after a manipulation to regain as much range as you can, and then you don't progress much after that point.

Also, if you can hit a certain degree, that's nice. Turns out you don't really have that range unless you can bend to that point and keep it there. Big surprise for me. That squat machine and the stationary bike have become my obsession. Unfortunately the squat machines in the local gyms all have you sitting up at 90 degrees which is a lot harder than the one at PT which reclines.

Does anyone else still have the issue that your knee stiffens up really quickly when you stop moving it? Every morning I wake up and feel like I've done literally nothing with it since the day of surgery. It's slowly getting a little better but, my god, it's taken an eternity just to be able to get out of bed and then sit at the breakfast table and bend to 90.

7.5 weeks left to get as much range as possible and maintain the 0 degrees (according to the 4 month theory).

Also, a great way to straighten if you're having trouble with it. Prop your ankle up on a folded up towel, and put weight on the portion of your quads just above the knee. Weight there helps the muscles glide which increases the straightening. If you are weight-bearing, do kick backs. Stand up, and very quickly try to straighten your knee- almost like trying to snap it into 0 degrees. Not comfortable, but it works.

Hi,

I Just stumbled on this whilst looking around randomly

I broke my medial tibia plateau May 25th 2009 whilst climbing, since then recovery has been a rollercoaster, the best things since surgery for it have been PT, PT and more PT. I say that but I sacked my PT as she was a waste of time and did it myself :)

I was told that basically my hamstring was protecting my knee and was always tense. I needed to exercise the quads, plenty of gym work, swimming and later on running cross country have got me to where I am now.

I ran 5k for my firm in July 2011 with a respectable time of 20:38 and have run my longest runs since (14miles).

Hasn't been easy, dealing with shin splints and all sorts as a result of the lack of muscle in my injured leg, as long as you can believe in yourself you'll be fine. Ignore that clicks they are WAR WOUNDS!!

Look forward to telling the grand kids about your epic injuries!

Can someone tell how long it was before they started with more serious weight training (squats, leg press, etc.). I am 13 weeks out and am only doing light leg press because I get patellar pain with a ball squat.

I want to start gaining back my strength but I feel like I have stalled a bit.

Hello. I had a nasty fx about 8 weeks ago. Shattered and displaced both condyles and had a shaft fx that extended about 2/3 the length of my poor tibia. I had surgery involving bone graft, plate and 14 screws. I'm half-way through with my three long months of non-weight bearing. I've been working hard at PT but am discouraged. My extension is at -6 to 8 degrees and flexion is at about 120 degrees.
My concern today is work. I'm an ICU RN, I work 12 long hours and am on my feet most ofnthat time. I know that everyone's recovery is different, but any guesses on whe I'll get back to work? Any input would be nice!
Thanks!!!! And good luck to you all!!
:)amy

I wanted to post photos but don't know how.....anyone?

I am new to this website but am also recovering from a tibial plateau fracture from a dude diving into my leg while playing volleyball. Surgery required screw, bone grafting and medial meniscus repair. I was only on crutches for 6 weeks then poof, full weight bearing. I only had 5 days worth of PT and have been set free. My suregery was March 10. I now have a stress fracture because of the screw and am in pain when releasing EACH step. I am to have surgery early Sept for screw removal. Everything I have read says to wait a year and most are on crutches for at least 3 months. Any thoughts of what to do now?????

My fracture/recovery was updated here
Check it!

Mind you, my doc had me do very little in the way of early leg movement, the only minor regret. But my fracture and associated swelling was quite massive. Baby steps (literally), the road to recovery is long and hard, keep it up!

Just wanted to update... I had all of my hardware removed on August 11th. Used both cruches through that Tuesday and then did one cruch through about the 19th. I am walking with a "peg leg" again... I had no idea I would be able to recover (not using cruches) that fast and be walking without cruches. I can tell a big difference in my leg and don't have the pressure and the achyness from the plates. My doctor says I can bear weight on my leg as long as there is no pain; the only pain I have is from the gigantic incision where everything was taken out. My leg is still swollen and keep it up a lot and ice it. I had a lot removed. I have to be careful for 3 months while the holes fill in. The surgery hurt; not nearly as bad as having it fixed to begin with. I go back on Wednesday to see what the verdict is on my ACL. My leg now is really weak and wobbly. So far it has been worth having everything removed:)

I waited a year to have 2 plates and 12 screws removed. For me it has been worth it. I had a lot more removed than you will and I was walking without cruches in a week. Everyones fracture is different; you may have to be non-weight bearing b/c of the stress fracture that is already there? Good luck! This type of injury seems to take a while...

I had my TBF on Memorial Day. 2mm depression and some separation. Surgery was a week and a half later, six screws, plate, bone graft.

Started doing ankle weight around 3 weeks post surgery, once the wounds were sealed and I had restablished range of motion for flexion and extension (which took around a week). Started at 1.25 pounds and slowly worked up to 5 pounds in a month.

Cleared for PWB first week of August, and Full Weight bearing a week and a half ago.
Recovery speed and pace of rehab it appears to be on a case by case basis. Doctor gave me a worse case scenario of October before walking again.

I can do squats, lunges, stairclimber, and elliptical. Still not jogging that great on the treadmill. Kind of a hobble jog at 4-5 miles per hour. One legged squats are still a challenge.

I'm 28 years old, around 215 pounds.

I also think trying to be on your feet for long hours even when you're PWB helps out alot in the long run towards being somewhat normal at work when you're full weight bearing. It also increases your capability of working long hours. Of course that's if you're able to and have the arm/healthy leg endurance.

8/15/11 the day my world changed! I was cycling into central park for some active recovery miles when i got tbone by a jerk trying to beat the traffic. I had a nasty larceration on my knee about 6 inch long and deep enough to see my bone. i was operated on 2 days later but the one and only Dr. Lorich. I am an avid cyclist(cat 3 racer) and was putting in 250-300 miles a weak. Weighing 162lbs. and putting out 340 watts for 20 minutes. Wondering if i can do this again:( I was about to start a kickass season in cyclocross after doing the green mnt. stage race in Vermont on memorial weekend. I'll try and get some info on the work done to me(see my Dr. on Friday for follow up). I know i have plate and screws and i'll try to post them. I'll also try to post the day of laceration.
I'm feeling some pain at night mostly. Leg is already half the size. I got some good PT exercises and doing them religiously. I want to come back soooo strong. BTW,how did you athletes cope with sitting around all day?? I've had a few breakdowns,one when i watched a avid runner the other day(literally brought out tears). Well can't wait to swim:) Sorry couldn't download pic....here's a link to my Fb.page....http://www.facebook.com/media/set/?s...type=1&theater

Hiya, i live in the uk and broke my tibial plateau after falling of my bike in january, i had a plate and 5 screws inserted and was not allowed to weight bare until after 3 months, i was in full leg cast and knee brace,as soon as this came off i started pt 3 times a week hydro pool and gym, my knee flex was only 30 degrees when barce came off,i did manage to get that up to 80 but then it stuck i felt the metal work was causing this spoke to my consultant and he agreed to remove this in june surgery was a breeze in comparrison to the first op, was able to walk again and restart pt after 1 week now my flex is up at 95,its been a hard stuggle i have to say am 8 months down the line now, my advice to you is work hard on knee flex excersises and you will get there sounds to me your doing really well alreday, i do have full extension this was almost instant due to the cast. I still get a small amount of pain after walking for a day i can do most things but running for me is still not possible, hope this helps any more questions i will be happy to answer. wishing you a speedy recovery x

Hiya peanutbunny, i am also new to this website, i also broke my tibial plateau did this in january after falling off my bike i had a plate and 5 screws inserted day after, no bone grafting or medial meniscus though, i live in the uk so treatment is a bit different i was not allowed to weight bare for 3 months and am lucky enough to get pt 3 times a week, i also had my metal work removed in june just 6 months after it was put in and i have to say it was best thing i ever did was only day surgey and i was able to walk without crutches and restart pt after only a week , i have full extension this i excpect was instant as i was in a full cast and knee brace for first 3months, my knee flex though was stuck at 80 degrees b4 removal of metal work now its at 95 and the pain is next to nothing,
Hope this helps x

Hi, i have had my metal work removed a plate and 5 screws this was done in june 6 months after my tb fracture and its the best thing i ever did, was only day surgery and i was walking without crutches after only a week i live in th uk so treatment here is different , am lucky enough to get pt 3 times a week and everything is coming along very well.
I hope this helps x

Quote:

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Originally Posted by liamy

Hello. I had a nasty fx about 8 weeks ago. Shattered and displaced both condyles and had a shaft fx that extended about 2/3 the length of my poor tibia. I had surgery involving bone graft, plate and 14 screws. I'm half-way through with my three long months of non-weight bearing. I've been working hard at PT but am discouraged. My extension is at -6 to 8 degrees and flexion is at about 120 degrees.
My concern today is work. I'm an ICU RN, I work 12 long hours and am on my feet most ofnthat time. I know that everyone's recovery is different, but any guesses on whe I'll get back to work? Any input would be nice!
Thanks!!!! And good luck to you all!!
:)amy

I wanted to post photos but don't know how.....anyone?

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Hello,
TPF on 6/29/11 riding bike
7/6/11 surgery 1 plate 5 screws,
slow recovery, was very swollen and painful for the month after surgery.
70lbs wb on 8/22/11
Waiting on referral for PT, but have ankle weights at home and have been in the pool almost everyday. The pool is where I feel normal again.
Flexion 100 degrees
extentsion 15 degrees

Amy get your butt in the pool! it feels great

also very frustrated with PT and how long it will take me to get back to work, also a nurse on my feet for most of 12hrs

Tracy

Hey guys.

Next week it will be one YEAR since my Tibia Plateau Fracture. I feel great but I am still feeling some slight weakness in my leg. I can run (albeit not long distances anymore per Dr orders), I can jump (still building strength). I feel I am 85-90% back to normal.

If anyone has any questions that are not being answered please feel free to email me. I researched the hell out of this prior to and since my surgery and I can probably assist you with what to expect. I am scheduled for an additional surgery to remove the hardware this December.

My email is austintexan2007 at Yahoo.com.

I wish all of you speedy recoveries. This injury sucks and I have felt like I would never get better many times......