Tibial Plateau Fracture Recovery

Iph, thanks again for info!! Yes I am so thankful that this is not one of the really "bad" ones!!!! SOOO thankful! But still just very scared that my knee might never be the same!!! Im scared about leaving the "joint depression" but Ive hear so many horror stories about the hardware it seems that niether way is "perfect".. For someone like me who is so afraid of surgery it seems I should just focus hard on PT and try to get my stregnth back asap!! (That seems to be a big issue too) As worried as I am about how that dip in my joint thing might change my knee function I just cannot wait to start PT so I will have that to focus on!!

so i'm looking for physical therapy ideas
due to scheduling and holiday issues it was 13 days post op before seeing doctor and getting ok for pt. Then when I went to make appointment for pt it was a week (which will be this wednesday) before I could get an appointment. I feel as though the golden hour for getting ROM back is going by without anyone saying anything so I started doing pt at home
So I'm looking for active ROM non weight bearing exercises to do until my first appointment (and after). If you have any (especially with link to pics or videos) post em up. also any active non weight bearing strengthening exercises for quads, calfs, hamstrings, etc or anything that i'm missing. i think i'm pretty on track for where someone should be at this point. i can put my knee on the floor without a towel but not yet with a towel under the heel. flexion is past 90 i would say and i'm working on the strength but i wanna kick this thing in the ass and am looking for variety compared to the few exercises i have.
thanks

Just set up an account here, hoping for some positivity, support, and advice on recovery.

I fractured my tibial plateau while longboarding in May 2012; an external external fixator was surgically placed on my leg until the following surgery; one plate and five screws two weeks later in June 2012. I had been non-weight bearing for almost four months. I had been in physical therapy ever since the injury, about 2-3 times a week. I am still experiencing a lot of pain after walking around and my knee does not feel as stable as it used to.

Recently, I went to see a new surgeon, who is highly qualified in knee surgeries, and found out that my tibia was not placed correctly during the first surgery. I also found out that I no longer have an ACL. My surgeon who did the initial repair surgery did not tell me ANY of this information and acted as if everything was healing accordingly, even after watching my terrible limp. I am now being faced with upcoming surgeries; hardware removal (in order to get an MRI done), a bone graft to level out my tibia, and an ACL reconstruction. All of these must be done separately. It is shocking that none of my physical therapists, let alone my original surgeon, said anything about the issues I have been having with my knee. It took the new surgeon one look at my x-rays to know that something had not been done correctly during surgery.

I do not think that it is fair that I am in this position as a result of a poorly preformed repair surgery. I have already been to hell and back during my last recovery time as well as horrible hospital experiences. It makes me very anxious knowing that more surgery is necessary to get me back to normal again. All of this is a lot to take in as I am only 20 years old and almost halfway through college. I have been feeling extremely down lately, because I feel like I am putting an important part of my life on hold as a result of my injury.

I am wondering if anyone else has experienced anything similar to this? If anyone has received surgery for hardware removal, ACL reconstruction, and/or bone grafts and what the recovery looks like? I am also wondering if anyone believes this makes me a victim of a malpractice, as I am considering looking into hiring a lawyer regarding the initial surgery.

Thank you!

daisyhaze --

hardware removal is pretty straightforward....1 hour procedure....crutches for 7-10 days. not painful. all of this depends on where your screws are.

my tibia plateau did not heal correctly either....sometimes they don't depending on the severity of the injury. not doc's fault necessarily

depending on how bad your TPF was, they may not have fixed your ACL until the TPF was healed anyway.

can't comment on suing.

Maker,
Sounds exactly what has happened to me. Saw my OS today, looks like "loss of bone height on medial plateau". Scheduled for 3D cat scan tomorrow or next day (gotta love waiting on insurance pre-certs)for full evaluation so we will "know where we need to go from here". No further rehab for me until he decides if I need more surgery. Hope your rehab is going well.

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Originally Posted by Skiobsessed

Hi everyone. Im so glad to have found this thread.. I love skiing more than anything in the world and 2 weeks ago I got a Lateral Tibial Plateau Fracture in a "dumb" fall.. I am VERY worried now that I may have made a mistake in not getting surgery. My OS gave me the option as he said he was on right in the borederline of whether I "had to" have the surgery or not. I was terrified about getting the metal plate and screws put into my knee, which is what he was going to do.. But now that I have been reading Im not sure if I should have backed out of the surgery. My joint depression is between 4mm and 5mm. Apparantly they say anything above 5mm has to have surgery and anything below (as long as the knee is "stable") can chose to be treated non-surgically.
Has anyone on here has a similar injury (lateral tibial plateau) with a 5mm depression and NOT had the surgery??? I would really love to know how your recovery has been if so. I am just super bummed that I will be off of my leg for so long, 2 1/2 month of no weight baring..at only 2 weeks in I am having a lot of trouble even imagining not being able to walk for that long and I am dying to do some type of workout. Mainly I am terrified that my skiing might never be the same.. Please if anyone has any knowledge or experience with my situation please let me know!! I would really appreciate it so much! Thank you all and good luck to everyone on your recoveries!!!!!!!!

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I chose non surgery route 14 years ago. Also had a lateral meniscus tear along with LCL and MCL damage. I started to swim as soon as I could bend my knee. I swam every day for 10 weeks. Crutches for 8.... Wore a brace the next season, then dumped it after that. Have had zero issues.

SkiEvil, thanks f

SkiEvil, Thanks for the info!! That is SO awesome you had such a great recovery!!! I really appreciate you lettin me know! Do you remember how far down your fracture part was (or I mean like what the dip in the joint or "depression" part was) ? I know its been a long time for you but just wondered if you remember.. Mine lateral plateau is depressed 4-5mm. But hopefully I will be good as new by next season anyway!!
Oh that is GREAT to know about the swimming!!!!! Im def gonna do that!! I am ALL about the rehad and PT!
Thanks again!!

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Originally Posted by Maker

daisyhaze --

hardware removal is pretty straightforward....1 hour procedure....crutches for 7-10 days. not painful. all of this depends on where your screws are.

my tibia plateau did not heal correctly either....sometimes they don't depending on the severity of the injury. not doc's fault necessarily

depending on how bad your TPF was, they may not have fixed your ACL until the TPF was healed anyway.

can't comment on suing.

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Yeah, hopefully everything will go accordingly with these surgeries. Need to get an MRI after the hardware is removed to see what the damage looks like. It seems that I have been seeing quite a few posts saying that other people's tibias did not heal in the correct placement. The most important thing right now is getting my knee stable so I can live a normal pain-free life again!!! Thank you for replying!

Hey everyone, I got my hinged knee brace unlocked yesterday and was told its ok to start bending my knee, But Im wondering if any of you know the best way?! My dr says I can bend it with the brace off or on, is there a benefit to leaving it on??
The brace is really heavy and its hard to get the straps tight enough for it to not fall down when I walk with my crutches, so it puts a LOT of pressure on both sides of my knee in order to stay tight enough.. Im not sure if thats good or bad?? The DR never saw it, just the "brace fitter person" so Im a little worried about how it fits..
Anyway, I got the OK to start PT next week and first appt I could get was WED. So until then I just wanna work on bending and would love to know if anyone things I should to that with brace off or on? Thanks

depends but i would go with brace on unless you hear otherwise. during my first pt appointment i was scolded for doing a couple exercises w/o the brace whereas others didn't matter. otoh, the guy was very impressed with my progress as I have already reached the goals set by the doc for next appointment on the 26th.

Thats awesome! What goals did ur Dr give you? Mine didnt really give me any he just said "start bending".. I wish I had some idea of where I was supposed to be?! I guess I will find out much more info when I get to my PT appt! I cannnttt wait till Wed!!! Ha.

Oh, how hard do the circle parts of the brace push on ur knee? Mine press super hard.. I know its supposed to apply pressure but not sure if mine fits right... Another thing I wish I knew!!!!!

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Originally Posted by Skiobsessed

Hey everyone, I got my hinged knee brace unlocked yesterday and was told its ok to start bending my knee, But Im wondering if any of you know the best way?! My dr says I can bend it with the brace off or on, is there a benefit to leaving it on??
The brace is really heavy and its hard to get the straps tight enough for it to not fall down when I walk with my crutches, so it puts a LOT of pressure on both sides of my knee in order to stay tight enough.. Im not sure if thats good or bad?? The DR never saw it, just the "brace fitter person" so Im a little worried about how it fits..
Anyway, I got the OK to start PT next week and first appt I could get was WED. So until then I just wanna work on bending and would love to know if anyone things I should to that with brace off or on? Thanks

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I used a basketball under my knee, only lifting the lower leg, in the begining I could only lift it a 1/8 inch, now I can do 3-4 inches.

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Originally Posted by Skiobsessed

Thats awesome! What goals did ur Dr give you? Mine didnt really give me any he just said "start bending".. I wish I had some idea of where I was supposed to be?! I guess I will find out much more info when I get to my PT appt! I cannnttt wait till Wed!!! Ha.

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He wants me to be able to go from -5 degrees (super straight) to 125 degrees flexion. At my first pt appointment I was at 0 and 120 with relatively good strength. Not sure if he rally gave me those goals per se, or if I just overheard him telling the pt guy.


Hard to say about the brace without knowing more. Depends on the size of the brace and shape of your leg plus swelling, etc. I do know that due to loss of muscle mass my brace is now prolly a size bigger than it should be so it's hard for me to even get the circles to touch my knee.

My brace is too big too (I think) the lower two straps prolly float a good 3 inches above my leg, I have them all pulled tight as they'll go because the whole thing slips down when I walk on my crutches.. I worry about that thing pulling down on my leg like it does especially since I didnt get the surgery so my bone is not being held in place by anything, just healing.. The circles on mine are able to press hard on my knee even with the other straps not really touching my leg, it worrys me to have the circle on the lateral side (the side where my bone is bent down) pressing in that exact spot before its fully healed. It actually make a bruise in the shape of a circle on that side yesterday.. So I hate my brace..ha. I just think there has got to be one that will fit me better, but gotta wait till at least Mon to find out I guess!

That is really great about your flexion, I think I can only do about 105, Im not sure what excersises I should be doing as I am still waiting for first PT.. I was hoping someone would post some when you asked cuz I was wondering the exact same thing, just didnt have answers.. How have you been doing most of your bending?

heel drags mostly. therapist told me to be careful with those. not sure why. also laying on my back with feet in the air riding a ghost bike. prolly should have the brace on to keep everything in line.
i just googled different terms to find what seemed reasonable.

Cool yeah I was doin the ghost bike thing too, with brace, I really wanna get a different brace tho cuz I dont think it should be making a bruise, or falling down while walking! Super annoying!
Thanks again for all the tips and nice work on ur flexion! :)

Well. Broke my tibial plateau in two places yesterday. Had two plates installed. Stuck In the hospital until tomorrow at the earliest.

Sounds like a long road from here on out. Pretty nervous about the future.

Hi all. I had what seemed like a really small fall on 12th dec 2013. I heard a crack and thought I'd torn my acl but was diagnosed with a compression fracture of the tibial plateau and oedema in the bone after an X-ray and MRI. The specialist said it wasn't bad no surgery was required and put me in a brace non weight bearing for 6 weeks or so, or so he said. I started with some water therapy and passive movement machine and putting my foot on the floor but no weight other than the weight of the leg itself. By Christmas the pain was getting worse with the knee feeling like I could cook on it, it was so hot and it was getting more painful. I iced it many times a day with no effect. The doc upped the pain medication and I had another MRI and a ct scan which didn't seem to show any changes. By 6 weeks there was no change so another MRI X-ray and ct later it looked like small fissures were starting to appear in the tibial plateau. On 4th feb 2014 I had 2 screws inserted to stabilise the plateau. Then a brace no weight bearing water physio etc. pain increased as before so then got as plaster cast. Further more detailed ct showed more fissures appearing so I went in on 5th March and another 3 screws were put in. Still non weight bearing and I know it's only a few days and I've not even had the stitches out but the same cycle seems to be repeating itself. Leg is getting hot and pain getting worse. If I flex my foot or even attempt straightening the knee with my physio, I get very little pain at the time but later on it is awful. It feels like the bone is pulsating
Has anyone had anything similar?

Oh I forgot to add that I had a bone bruise diagnosed as well I don't know if that's significant

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Originally Posted by Famcam

Hi all. I had what seemed like a really small fall on 12th dec 2013. I heard a crack and thought I'd torn my acl but was diagnosed with a compression fracture of the tibial plateau and oedema in the bone after an X-ray and MRI. The specialist said it wasn't bad no surgery was required and put me in a brace non weight bearing for 6 weeks or so, or so he said. I started with some water therapy and passive movement machine and putting my foot on the floor but no weight other than the weight of the leg itself. By Christmas the pain was getting worse with the knee feeling like I could cook on it, it was so hot and it was getting more painful. I iced it many times a day with no effect. The doc upped the pain medication and I had another MRI and a ct scan which didn't seem to show any changes. By 6 weeks there was no change so another MRI X-ray and ct later it looked like small fissures were starting to appear in the tibial plateau. On 4th feb 2014 I had 2 screws inserted to stabilise the plateau. Then a brace no weight bearing water physio etc. pain increased as before so then got as plaster cast. Further more detailed ct showed more fissures appearing so I went in on 5th March and another 3 screws were put in. Still non weight bearing and I know it's only a few days and I've not even had the stitches out but the same cycle seems to be repeating itself. Leg is getting hot and pain getting worse. If I flex my foot or even attempt straightening the knee with my physio, I get very little pain at the time but later on it is awful. It feels like the bone is pulsating
Has anyone had anything similar?

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Might want to get an ultrasound. Depending on where pain is (if deep in muscle tissue like calf), could be deep vein thrombosis, which is a blood clot.

But probably more likely, it is just muscle soreness. You will get all sorts of weird pain and soreness...eventually it gets less.

Hi Folks, Thought you might like to hear from a 61 year old female that is now 1 year and 7 months post tibia plateau fracture along with a tibia fracture. The injury was sustained when I fell off a step and while airborne, the knee twisted and the femur depressed into the tibia plateau. I heard it crack before I even landed. My treatment involved cadaver bone replacement into the depression and 4 pins and a plate for the tibia fracture. At this point, I still have a rt. torn medial meniscus which my ortho said he will not go back in and repair. In addition, I have no cartilage remaining. So needless to say, my knee is for crap. The only thing I can say that I am fortunate for is that surprisingly I do not have constant pain. It aches when the weather is changing but that is it. However, the knee is so unstable that I have had to have a second railing installed on my steps just in case it buckles while descending the steps. It also buckles when I attempt to step over anything or turn to go around objects. I can hear and feel it snap in these instances. This is not an easy injury to come back from if you are up there in age. I would give anything to get back in the pool to help strengthen the leg but I need to have a torn rotator repaired first (when it rains it pours). At some point, I will be looking at knee replacement but I will hang in there for a couple more years before I have that done. Every year the technology is improving and I am walking that line between being too old to have it done and technology making great leaps. Good luck to all of you that have sustained these injuries.

I was advised by my ortho to leave the hardware in place. Not worth running the risk of post-op complications. Just an FYI folks if you are thinking about having this done. Unnecessary anesthesia too.

I had the same issue with my brace, spent more time pulling it up than actually having it where it was supposed to be. It didn't matter how tight I pulled the straps. My OS finally told me to leave it off at home, and that I only needed to wear it when I went out. More for protection against being bumped in public than for bracing the leg.

Quote:

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Originally Posted by Skiobsessed

Hey everyone, I got my hinged knee brace unlocked yesterday and was told its ok to start bending my knee, But Im wondering if any of you know the best way?! My dr says I can bend it with the brace off or on, is there a benefit to leaving it on??
The brace is really heavy and its hard to get the straps tight enough for it to not fall down when I walk with my crutches, so it puts a LOT of pressure on both sides of my knee in order to stay tight enough.. Im not sure if thats good or bad?? The DR never saw it, just the "brace fitter person" so Im a little worried about how it fits..
Anyway, I got the OK to start PT next week and first appt I could get was WED. So until then I just wanna work on bending and would love to know if anyone things I should to that with brace off or on? Thanks

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