Another PTF and questions
Hello everyone,
I'm glad I found this thread! No secret why I'm here, I had a PTF a week ago (30/8) while MTBiking. What happened is I lost my equilibrium while I was on a narrow mountain track with a very sharp edge and rocky ravine at this place, which made me go off my bike and fall into the ravine, stopping falling a few meters below. In my fall I had the bad reflex to straigthen my leg in order to protect my left patellar tendon which was just recovering from a recent cut, which made the thighbone impact the shin (didn't know that at the time). I had to be rescued by helicopter and transported to the nearer hospital where I had X-rays and CT scan which revealed PTF. The young doc there said it would need surgery which made me feel devastated as I had struggling for one year to recover from two precedent injuries and was just about to enjoy sports again. :(
Exams revealed I had a spiral fracture minimaly displaced associated with a tear of the tibial spines and a multifragmentory fracture of the posterior part of the lateral PT. I had surgery on the 3/9 and the fracture fixed with a plate and 6 screws (pain was just bloody hell:cussing:). Nonetheless, my OS said it wasn't that bad as the soft tissues weren't touched and the posterior fracture situated behind the meniscus. Still, as many here I'm quite worried about how I will recover, mostly with the flexion of the knee. Having working hard during the last 4 months to recover from my RPT, I know it sometimes possible to fully recover but this injury seems to be a pretty nasty one. Anyway, I'm pretty willingful to do the best I can to recover.
Before leaving the hospital, a PT advised of exercises I have to repeat troughout the day (some of them each hour) in order prevent a loss of flexion, due to the immobilization (NWB for 2 months and leg in a zimmer splint). I think this is very important, also with appropriate nutrition.
Just a few questions in case anyone had some insightful infos that might help me :
How about bits of bones left in soft tissue? part of my rear's lateral PT had been smashed up into pieces left in the flesh. Due to their locations (on the inside/rear part of the knee), I'm a bit afraid they may bother with the flexion of the knee, or the flexion hamper the healing of these small pieces of bones? Any thoughts or experience on this?
Due to the surgery, I have a pretty big numb area situated on the foreward and little external side of the tibia. It gives a rather unpleasant sensation, as if you had a "hole" or a piece of numb wood stuck into your leg. Doc said it was the incision for the plate that cut some terminal nerves and it may come back but very slow (growth of 1 mm/year for a nerve). Has anyone also had issue with that? had did you manage with it? did you recover some sensations?
Thanks,
I wish you all good luck!
Tibial Plateau - too much too soon?
hey guys,
is it possible to overdo it when finally walking again? I got clearance to full weight bearing a week ago, and was feeling so great - no pain - so I overdid it.. probably walked a few miles the other night... and now there is pain inside my knee! Could I have screwed something up? Or is this just inflammation from overdoing it?
thanks! :)
Looking for input and feedback on EMS/NMES for TPF rehab
On 1/10/16 I had a fall at work and wound up with a TPF, full ACL tear, MCL tear and a lateral meniscus tear. On 2/19/16 I got surgery to repair the fracture (2 screws and bone cement), a new ACL, and had the meniscus cleaned up.
I am non-weight bearing for 2-3 months, have started PT and am on a CPM machine for 6 hrs a day currently. I have been speaking with my physical therapist and orthopedic surgeon about using an EMS/NMES unit for rehab. My goal is to prevent any further atrophy, get some strength back, and minimize my time from being able to bear weight on my leg to being able to get back to work and play.
At this point both my ortho and PT think it would be beneficial, and I have request in with workers comp for a home machine. However, neither my ortho or PT have a whole lot of insight into what machine would be a good choice. After some research I'm tempted to just go buy a Compex sport elite, but there is not a lot of good information about these things ou there.
So, I'd love some input on what machine to get, and how well they worked for ties who have used them.
fractures to both tibial plateaux
Hi, I had an accident while horse riding, which unfortunately ended up with me in hospital, undergoing an operation to repair fractures to both tibial plateaux. I now have a large screw type pin in one knee, and in the other, a plate and screws. I started knee flexes with a machine the 2nd day after surgery, and PT shortly after leaving hospital. My six week check up with OS went very well, and I started crutches at 10 weeks. I still have fluid on both knees, which becomes worse the longer I am upright, and I get tired very quickly. I spend around 25% of the day walking with either special walking frame or crutches. I put ice on knees 2/3 times a day to keep swelling down. I know it will take longer to recover from injuries as both knees were damaged. I wondered if there was anyone else who had the same problem, that is both knees fractured, and how long did recovery take?
On the road to recovery ( 17 years old )
hey guys, I'm 4 months after my injuries. Crashed my dirt bike while racing my brother through some trails up north. Hit some trees at 80, and broke 3 cervicals in my neck, my left femur, my right tibia, my right tibia plateau, my right femur, my pelvis, and my left arm. My left leg is back to full ROM ( 1-145 ext and flex ). My right leg can get to 100 flex but still at 25 extension. My knee cap is pulled to the outside of my leg, Doctor says this is because there was so much scar tissue that it got moved over. I had X number of screws put in my tpf along with a plate, and rods in both femurs. I had a manipulation and hardware removal done. ( hard ware removed from the left leg, MUA done to both legs. ) I am going to see a sports Doctor this week, to hopefully schedule a surgery to get my patella tracking right again. I lived a very active lifestyle before this injury, on the wrestling team for 4 years, ran track for 2 ( 100 meter and high jump ) been racing motor cross since I was 4 ( ranked nationally twice ). Also was kind of considered a gym junkie cause I would go to the gym every day of the week lol. I just wanna know if there is any one out there who had a similar situation that I am in after thier tpf? Other then my knee being out of track, I have made great gains. Am able to ride the bike now, walk while on crutches ( thank god, was losing my mind being in a wheelchair ) and can get in and out of cars, and bathtubs. I'm pushing myself every day, whether it be at therapy or at home with the home work outs, but this right knee seems to limiting me so much. The doc says after the surgery to get it tracking right again, I should be saying gains relatively soon. ( keep in mind they may remove the hardware from my right tpf as well which may help with extension and flex ion ). Doctor says I may not be able to get to full extras tension again but will still be able to live my active life style as before. I've come to terms with the fact of this being a marathon and not a sprint. So I'm taking it day by day, writing music to keep me occupied. I wanna go to college to ironically be an orthopedic surgeon LMAO and I just wanna know if this could limit that? If any one has any advice, or can relate to my situation it would be nice to hear some of your stories, and how you were able to reach the peak of the mountain. Thank you!
Another TPF Patient Recovering
Hey folks
Like everyone else, I'm damn glad I found this forum. There's precious little info online about TPF. I'll post my tale and try to follow up as I progress as that's exactly the sort of thing I was looking for here: progress.
I took a bad fall while hiking August 27, 2016. At first I didn't even realize my leg was an issue, since I landed face first on a rock and was far more worried about a skull fracture. Turns out I have a hard head. Tibial plateau, well not so much. It also hit a rock on impact and pretty much shattered. I've got five screws and two plates, and a whole lot of bone cement was used according to the OS, who described it as looking like a ritz cracker someone had stomped on. He wound up calling a knee specialist in during surgery as the meniscus was detached and he had to anchor it. Cartilage was also severely damaged, and he has already warned me about arthritis in the future.
I was in a knee immobilizer for four weeks following surgery, absolutely no bending or weight bearing. Was given dilaudid as a painkiller, and the side effects were not fun. Muscle spasms, which in a broken leg sucks - and they hit all limbs. Also severe night sweats. I weaned myself off them during the second week. After four weeks x-rays looked surprisingly good as far as alignment. OS gave the okay to bend the leg by hanging it off the bed. Still no weight bearing; follow up will be at the 7 week mark, and he's suggesting I can start physio and some weight bearing then. He even suggested he might have me try to walk short distances around that point, which is far ahead of his original estimate of 12 weeks.
I'm curious if anyone else has had issues with the meniscus combined with TPF, and what their recovery was like. I've definitely got a severely stiff knee and after one week with the immobilizer off, I can't get to 90° flexion. Maybe 80°. I'm 37, very independent, and while I'm not an athlete I walk, hike, jogged one Summer a couple years ago (never really enjoyed it so dropped it), swim, work out etc. Really hoping to get as close to normal as possible. I know everyone's knee is different, I'm just curious as to whether this is typical, atypical, and if there's any way to judge how much improvement I should really expect just hanging the knee off the bed.
Best of luck to everyone!
New TPF patient here, Please advise!
Hey folks,
Very glad to find this forum while I am going mad in the hospital wtih my new TPF!
I am healthy 61 year old active male with no major issues.
Last week I was involved in a motorcycle accident and received a type IV TPF.
X-rays showed bad medial plateau break with tibia shaft split all the way to the ankle with intact fibula.
I retained control and sensation in my toes but soon started developing severe blisters. The ER doc called them fracture blisters instead of compartment syndrome and didn't go for a fasciotomy. Now awaiting surgery in 2 days while my blisters heal.
The doc mentioned that type IV is the worst of all TPFs and to be prepared for prolonged rehabilitation time, which I resigned myself to mentally.
But this young resident doc tells me to resign to the idea of not ever having this leg back to normal in my life due to my age!
More than everything else, this one is depressing me.
Even if I try hard, at my age, Do I not have any chance of ever gaining the ROM for everyday activities? and if out of crutches, live with a poor gait the rest of my life?
Sincerely appreciate any advises and thanks for reading.
it gets better...I promise!!
I had a TPF on January 2, 2016...almost at the 1 year mark. I also spiral fractured my tibial and fibula and tore my meniscus. I have a plate the whole length of my leg and approximately 22 screws. I was completely NWB for about 12 weeks and then slowly added weight. I won't sugar coat it, this will be a really long recovery. But, It does start to get better. I was training for a half marathon when I had a skiing accident causing my injuries, so my legs were very strong, but i still lost all the muscle in my leg. It takes a long time to come back, but keep working at it and it will. PT is the most important piece of all of this. The ROM exercise and strength training are so important!!
I have already had two surgeries to repair the fracture and I just scheduled my next (and hopefully last) to have as much of the hardware removed as possible. I refuse to let this injury define me. Today was the NYC marathon, a race I was hoping to run this year before my accident. Now I am more determined than ever to do this.
This is a really long journey, and it is definitely a marathon not a sprint. Some days will be better than others and I won't tell you that 11 months out I am at where I was before because I am not. I still can't run bc I can feel all the metal (hence the removal surgery), but my awareness of how long the recovery is, from speaking with others who have been here before, has really helped me not feel sorry for myself or get depressed. Stay positive! It really will get better!!
pretty happy with the recovery so far
hello everyone,
I haven't been much on the thread since my accident which is more than one year now. As for me the recovery was long but one year after the accident I was able to get almost full ROM, been able to walk and mountain bike without pain on long distances. So it gets better with time and lots of work to regain the ROM and muscles (although I think my tp was not properly aligned during the surgery)
I just had my harware removed 2 days ago, so I'm back again on crutches, but that shouldn't last long and hopefully will be the last shot. Thanks to a post on the thread if I remember correctly, I found a very active group on FB for this injury. It helped me a lot at the time right after the accident/surgery. So you guys might want to check it out. the group is named "tibial plateau fracture recovery". Good luck everyone!
It takes time, now 18 months post surgery
Hi all,
I'm 61 years old and I had my TPF on Feb 25th in a car accident. I needed surgery to insert a plate and 9 screws. This was done under an Epidural, I was surprised that this was offered, but my surgeon suggested it since I had had a difficult time years back under general anesthesia for knee surgery on the other leg. The surgery went well, and I surprised a lot of Doctors by A) only needing pain killers for 36 hours, and B) being able to lift my leg 24 hours after surgery. I don't know if I have a high tolerance for pain, of if I was lucky and my Surgeon did a great job on my surgery, minimizing the Post surgery pain. I kind of suspect the latter.
I was NWB for 8 weeks, and PWB for another 4 weeks. Because I lived alone, I spent the first 8 weeks in a recuperation facility, where there were nurses around the clock to help us (Paid by the Quebec Government, we are totally No Fault insurance, Could not sue the negligent tow truck driver). I wore a straight brace for 8 days after my surgery, then was fitted with an articulated brace. But the old saying that for every cloud, there is a Silver Lining, in my case, I met a woman my age who had been hit as a pedestrian by a car pretty much the same date I was in my accident, she broke her hip, and Tibial plateau. The hip required surgery, but not the knee. We were even in the same hospital room for a few days, but we got to know each other at the recuperation facility were were transferred to, and started dating when we released from the PT hospital. I'm still with her.
In the facility, I would spend most of my days in bed with a pillow under my knee, as keeping it straight for any length of time was uncomfortable. I would go to the common kitchen to eat my meals, but could not stay very long after I'd finished, as I would need to get the pillow under my leg quickly after my meals.
There was a PT nurse there, she had me do leg flexion and straightening exercises on the bed, at first I was -20 degrees in straightening, and about 110 degrees in flex. In the second month there, The straightening improved to -10 degrees, and the flex improved to about 128 degrees.
After 2 months, I was transferred to a PT hospital for a month, where I would really work hard on improving flex, straightening and increasing my muscle strength. Then what followed was another 2 months of PT near my home (I had gone back to work after the PT hospital). I was using a walker (No weight on the leg) in the recuperation facility, Arm crutches in the PT hospital (PWB), then after leaving that hospital, I was on regular crutches for another month (FWB as much as I could stand). After that, I used a cane for another 3 months.
In November, I started working in a gym on a recumbent bicycle (I have a regular recumbent bicycle that I use outdoors, but November is too cold to ride outdoors in Montreal). At first, I took it easy, as I was totally out of shape, and my leg was still pretty weak. For the next 5 months, I would increase my tempo, and increase the resistance, gradually getting back in shape.
But in April, I went to see my OS to see if I could get the plate and screws removed, as the plate was causing me continual discomfort, it felt like it was rubbing against the tissues inside, and causing me to limp after 15 minutes of walking. The surgeon agreed to remove it, as he felt that if it was bothering me, the bone was fully healed, and the plate should be removed. But due to hospital waiting list being long in Quebec hospitals, that surgery would be in approx 1 year, unless there was a cancellation.
I continued riding outdoors in April, up till July 20th. A series of cancellations opened up a spot for me, and I agreed to that date. I never thought I'd be eager for surgery, but I was for this one. The day surgery under another epidural went well, and I went back home the same night, took pain killers for about another 36 hours, was on crutches for a few days, on my cane for another week, then 2 weeks later, was walking comfortably without a limp.
In late August, I got back on the bike, and continued increasing my pace, building my quad back to where it should be.
Now, in Late December, I'd say I'm approximately 95% recovered, My leg muscles are fully recovered, and my physical conditioning is where I want it. the only negative is that my knee joint is a touch weak, when I go up stairs, I notice that it isn't quite where I's like it to be, but really not that bad. My Flex is up to near 160 Degrees, my straightening is equal to the other leg. I still can't run, but I couldn't run before my accident due to arthritis causing swelling the next day after running. There are also some days, when the weather is going bad that my knee aches a little, but it doesn't last too long.
I need to thank my OS, Dr. Rosen, who I feel did a great job on my surgeries. I had moments of doubt that I'd ever get back to near normal activities, let alone normal.
So keep the hopes up, it takes time.
Denis