Tibial Plateau Fracture Recovery

I had surgery on my broken tibial plateau in early March (I'm 24 years old) while bike riding. The displaced fracture required a plate and 5 screws. I also had a meniscus tear.

It's been just over 2 months since surgery. I've been doing lots of PT for the past 8 weeks and just recently got the clear from the surgeon to start bearing weight! My extension is good (nearly 100%) but I'm still not able to flex (bend) my leg all the way. I'm currently able to walk with a limp a bit around my apartment (about 25% of the day) without much pain, however pain begins to build up around the knee after a day of walking around a bit. I'll be able to increase my weight-bearing time week-by-week, reaching 100% in about 3 weeks. I just wanted to get some input on how much more recovery time I should expect to face. I've done lots of research and have gotten lots of different stories on recovery. Will I not be able to run for a whole year? Any thoughts would help. Thanks!

I broke mine last June. From what I've learned in the last 11 months is that the answer to your questions are all "it depends". It seems like a particularly nasty part of the leg to break. It seems like the outcome depends on how badly you broke it to start with, how well your surgeon put it back together, and how well you follow a good rehab routine. Results can go from full recovery all the way to knee replacement.

I feel like I'm doing alright with mine after almost a year, but I wouldn't even consider running and won't for probably another year. I skied for the first time this year just a few weeks ago and didn't feel real confident or strong. It still hurts and I feel it all the time, but it is still getting better. I can do things without pain today that I wouldn't even be able to do just a few months ago. For me, the recovery has been a slow, steady experience.

Your knee is something that you'll use for the rest of your life, so don't do something stupid right now that will mess it up forever. Take it easy and let it recover.

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Originally Posted by treemaker

I had surgery on my broken tibial plateau in early March (I'm 24 years old) while bike riding. The displaced fracture required a plate and 5 screws. I also had a meniscus tear.

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Let Dr Mark know that you found a surgeon that could repair your knee WHILE you rode a bike. Was he on a bike as well or did he drive alongside in a car? He's badass.... so are you.

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Originally Posted by L7

Let Dr Mark know that you found a surgeon that could repair your knee WHILE you rode a bike. Was he on a bike as well or did he drive alongside in a car? He's badass.... so are you.

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Realized the confusion after submitting the thread. Can't edit :(
Has anyone had the same injury that can give me some insight on recovery?
Thanks ahead of time.

I suffered a tibial plateau fracture plus avulsion about 4 years ago now. Its taken about 2+ years to get back from the atrophy to my left leg. I was on crutches for about 4 months, and kinda wimped out on PT before the swelling came down. The flex should come back to >95%, it took me a while If I had really hit it, i'd like to believe i would have cut out a great deal of recovery time. The residual pain for me, I've discovered, is that my quad stopped firing and let my knee cap float to the outside, where the stronger muscles pulled it, and wreaked havoc on any kind of symmetrical strength between legs and caused all kinds of wierd pains in both legs. What helped was electrostim right above the knee cap and REALLY working the injured leg, all on its own + wearing extra weight on it.

Foam roll that IT band.

I don't know how much atrophy you've experienced- but don't quit for a long time, keep it going through the fall/ winter. Its taken a couple seasons to get my ski legs back but that might be all in the mind...

I'm approaching a year out from my fracture.

Mine is looking like a failure, it got better for a few months and I had very minimal pain but no strength and it was hardly functional. Now it's getting much more painful as I gain strength and functionality. I was told before the surgery that full soft tissue recovery is 18-24 months and the repair will last from 2-20 years, way too many factors with something like this to predict how yours will do.

Either way, as far as I can tell you are basically fucked with a tibial plateau.

Got any cool pics or x-rays?

Sorry to hear about your lengthy recovery, karpiel. Unforunately, I don't have any gross post-op pics handy.

It's been about 2.5 months since surgery and I'm walking fully about 50% of the day. Pain around the knee is minimal at first but it does build up by the end of a full day of walking around. I'm also feeing stress around my hamstring area after the day. I'm having a hard time with balance and walking without a slight limp (leaning over to the side of the bad leg). My extension is where I need it to be but I'm still unable to flex all the way. Basically, my right leg is still quite weak but the strength is coming back thanks to physical therapy.

Finding others who have had this injury over the web has been quite hard. I apologize in advance for using this forum as means to learn more about recovery and comparing my state to other victims of the TP fracture. Any thoughts or comments would be encouraging. Thanks

You sound like you're on a good track, treemaker. As long as you keep following up with your surgeon and making sure the xrays look good, then it just takes time to rehab from a major injury like a tibial plateau fx. The bone itself takes 3 months to heal, but that's not the ultimate end point. Your overall condition continues to improve over the course of at least a year as people have described.

As far as subsequent activity, depending on how bad the fracture was (they range in degree of severity), you may do better w/ non-impact sports like biking or skiing (with a minimal dose of bumps/jumps) as opposed to running. Your surgeon will have a better sense of how to advise you in this regard.

Good to see you are recovering. It still looks like a nasty fracture.

I am working in physical therapy with a lady who fractured her tibial plateau and she is beginning to walk without an assistive device after a few weeks of seeing her.

Its a long process to returning to prior level of function...all due to that whole part about being unable to walk for awhile.

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Originally Posted by BlechMan

Good to see you are recovering. It still looks like a nasty fracture.

I am working in physical therapy with a lady who fractured her tibial plateau and she is beginning to walk without an assistive device after a few weeks of seeing her.

Its a long process to returning to prior level of function...all due to that whole part about being unable to walk for awhile.

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You are lucky if there IS a return to the prior level of function. I guess if you are a typical person that considers walking exercise, then yes, you can return to normal.

I was glad to find this site. I was getting so depressed reading all the info on my fx. I am a 60 y.o. active retired expat (originally from Colorado and now in the Dominican Republic) who was on vacation in Hilton Head SC and was on a bike and was hit by a car. I had a depressed plateau fx repaired with plate and screws then two weeks of rehab at Univ. of Ga. Now back home here in the DR and continuing with PT. It is really going to be hard to stay "down" for another 1-2 months. My PT here wants to start some Pool excercises. Has anyone done and PT in a pool for this injury?
Thanks
Bob K

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Originally Posted by Bob K

I was glad to find this site. I was getting so depressed reading all the info on my fx. I am a 60 y.o. active retired expat (originally from Colorado and now in the Dominican Republic) who was on vacation in Hilton Head SC and was on a bike and was hit by a car. I had a depressed plateau fx repaired with plate and screws then two weeks of rehab at Univ. of Ga. Now back home here in the DR and continuing with PT. It is really going to be hard to stay "down" for another 1-2 months. My PT here wants to start some Pool excercises. Has anyone done and PT in a pool for this injury?
Thanks
Bob K

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Pool therapy is awesome. Nothing felt better ever in my life then getting into a pool and feeling free, makes you feel human again.

It helps work out a lot of little unexpected issues with walking.

Karpiel

Thanks for the imput. I am looking forward to starting working in the pool in about two weeks.

Bob K

Man, you all have/had some tough recoveries. If you search, there's a guy who posted in fair detail on here about his recovery who was still having big problems coming back from his plateau injury. Shit, I'm 14 months out on a menisectomy that's just starting to feel good....the thought of injuring my tibial plateau gives me the shudders.

Bob K, I started in the pool 4 weeks out from surgery. Just being able to move around without crutches was incredible. I was in a straight brace for those 4 weeks after surgery and wasn't allowed to bend my knee until I got into the pool. If you get a chance, post your xrays up in the [ame="http://www.tetongravity.com/forums/showthread.php?t=168252"]broken bone/xray thread[/ame]. Add it to the collection of other broken plateaus, legs, arms, etc.

Splat, I think you're thinking of Karpiel who isn't having the best time with his recovery.

No, dude from Mammoth. It's been so long, I forget his name....

A couple of questions for those of you who have gone through this:

1. Is developing fluid around the knee common, and will it resolve with out tapping the knee??
2. It is now 6 weeks from surgery and still having increasing ankle swelling as the day goes on. Is this normal at this stage of recovery? My ankle is basically normal size in the morining and 3x normal by evening.

Thanks

Bob K

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Originally Posted by Bob K

A couple of questions for those of you who have gone through this:

1. Is developing fluid around the knee common, and will it resolve with out tapping the knee??
2. It is now 6 weeks from surgery and still having increasing ankle swelling as the day goes on. Is this normal at this stage of recovery? My ankle is basically normal size in the morining and 3x normal by evening.

Thanks

Bob K

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I still had swelling almost 3 months out, It would travel down my leg if I spent time upright and formed bulges anywhere it could, like top of my shoe and between the straps on my brace.

Thanks that makes me feel a little better. The doc here in the Dominican Republic tried to tap the knee three very painful times with out success. I told him we should just watch it for a while if it does not get worse.

Bob K

Just did this Tuesday. Finding out about surgery tomorrow.

Hev,

Good luck. I am 6 wweks into it with a long way to go.

Small world we moved from the Conifer/Evergreen area 4 years ago to retire to the islands. Worked ski patrol at Breck many years ago.

Bob K

Doctor said mine break was one of the worst he's seen. Split in both directions and compressed the bone :-( - surgery will involve some bone graphing from the femur. I am surprised to hear that I will be moving the knee right after surgery. Doc said he wants my knee at 95% within a couple weeks! No weight for 3 months.

Glad to find this thread. Will keep you guys posted.

Lawless,
You were correct. The pool is wonderful and i have been in it every day for the last few days. For the first time I feel as if I am gaining back some control over the situation.
Driving this past week for the first time also helped wtih the "control" issue.

Bob K

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Originally Posted by hev

Doctor said mine break was one of the worst he's seen. Split in both directions and compressed the bone :-( - surgery will involve some bone graphing from the femur. I am surprised to hear that I will be moving the knee right after surgery. Doc said he wants my knee at 95% within a couple weeks! No weight for 3 months.

Glad to find this thread. Will keep you guys posted.

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That sounds familiar, but worse. Less then 6 hours out of my surgery I was in a CPM.

I also have a tibial plateau fracture. My surgery was May 3rd. Next week I will finally be able to put weight on my leg. The Dr. said I can start with 40lbs. It's crazy that this injury takes so long to heal. I wonder how long it will take to be active again?? My butt hurts from sitting so much!!

As far as the swelling goes my PT put some kind of type on my leg. It really dose help with the swelling! My ankle looks a lot better.

Update on my end. Doing pretty well considering. I am up to 110 in the CPM. Flex seems easier than extension for me. Otherwise doc said it went together great and I get my staples out next week. Hoping to get in the pool as soon as possible but I am still quite swollen. Pain is off and on. Some good night, some bad always building in the afternoon.

I know what you mean about the sore butt. I am 8 weeks out today and just started with 25lb of weight bearing. It feels good to put my foot down so to speak.
Flluid on the knee is also resolving along with the foot swelling. So things are on the up hill climb. It certainly does take a long time. What a way to spend my summer vacation.

Bob K

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Starting to feel pretty decent most of the time. Off the pain meds completely and trying to do 300 leg lifts / day to keep my quad in shape. Knee motion is good, and I am finished with the CPM. Ankle is pretty stiff and swollen still but making progress. My incision is clean and mostly healed but still covered with steri-strips. I am able to shower, but find it is pretty high risk. Doc has forbidden the pool for this reason but I am allowed to place the foot on the ground while on crutches which seems to help the ankle get back to normal.

Unfortunately life is far from normal with this injury. The boredom and depression of spending the summer seated is pretty acute. My apartment is pretty accesible for me, rolling around in my office chair, but I am moving and the new place is less so.

Been getting tons of help from friends and family.

HEV
There is light at the end of the tunnel and I am realizing it is not a train. I am now 9+ weeks out and just got the ok to "walk" with the crutches and 50% weight bearing on the leg. My ankle is still swollen by the end of the day but "normal" looking in the morning. Last week I was finally free of the brace and have been in the pool the last 3 weeks. I am even doing PT in the pool.
It was VERY depressing living in a wheel chair for 8 weeks. We live at the ocean and I still have not seen the beach or water since early April. You are right it is a hell of a way to spend your summer, but it will get better.
I am hoping to be walking with a cane in 4 more weeks.
Hang in there.

Bob K

Don't let yourself get depressed, Hev. I'm sure we can find things to do that don't require walking. Like sitting in an air-conditioned titty bar or casino, fer example. http://www.tetongravity.com/ubb/cool.gif Or drinking Robitussin and shouting obscenities at traffic. :fm:

Thanks guys. This thread helps. I am starting to venture out of the apartment, which also helps. Pretty stoked on the move to the new place despite the challenges. Pinner, you'll have to swing bye.

A big thing is the no-driving. I have handicap parking tough so let's do it!

Up to 150 leg lifts / set. I think I'll be skiing late season.

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Originally Posted by Bob K

Hev,

Good luck. I am 6 wweks into it with a long way to go.

Small world we moved from the Conifer/Evergreen area 4 years ago to retire to the islands. Worked ski patrol at Breck many years ago.

Bob K

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Doctor said mine break was one of the worst he's seen. Split in both directions and compressed the bone :-( - surgery will involve some bone graphing from the femur. I am surprised to hear that I will be moving the knee right after surgery. Doc said he wants my knee at 95% within a couple weeks! No weight for 3 months.

Glad to find this thread. Will keep you guys posted.

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Originally Posted by hev

Thanks guys. This thread helps. I am starting to venture out of the apartment, which also helps. Pretty stoked on the move to the new place despite the challenges. Pinner, you'll have to swing bye.

A big thing is the no-driving. I have handicap parking tough so let's do it!

Up to 150 leg lifts / set. I think I'll be skiing late season.

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I did mine June 5 of last year and did some skiing late April this year. Although my doc would probably not have approved, it was necessary for my sanity. My leg didn't feel great, but it felt good to get outside, hike up something, and actually make some turns. The biggest issue for me was having vibrations going through my knee. That didn't feel good.

I'm a bit over a year out and have been mountain biking (x-country) without any pain, and I can walk around fine, but I can't run or jump. I see my doc this week to talk about hardware removal. It's a long road, but hang in there. It will actually get better some day.

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Originally Posted by Lawless

I did mine June 5 of last year and did some skiing late April this year. Although my doc would probably not have approved, it was necessary for my sanity. My leg didn't feel great, but it felt good to get outside, hike up something, and actually make some turns. The biggest issue for me was having vibrations going through my knee. That didn't feel good.

I'm a bit over a year out and have been mountain biking (x-country) without any pain, and I can walk around fine, but I can't run or jump. I see my doc this week to talk about hardware removal. It's a long road, but hang in there. It will actually get better some day.

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That's pretty apples to apples. Thanks

Doing well. Swelling in my ankle is good, but kind of depends on how active I am during the day on my crutches.

So is the hardware just bothering you Lawless, or was it the plan to take it out?

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Originally Posted by hev

That's pretty apples to apples. Thanks

Doing well. Swelling in my ankle is good, but kind of depends on how active I am during the day on my crutches.

So is the hardware just bothering you Lawless, or was it the plan to take it out?

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I still have pain in my knee when I do certain things or it's at certain angles. I had broken my tib/fib the year before and had a bunch of hardware (22 screws and two plates) installed in my lower leg that bothered me. I got that out because the screwheads were down by my ankle and it killed to wear a ski boot. In that case, my pain went away immediately after getting the hardwear out, and I felt pretty close to 100%. Apparently my muscles were rubbing over the hardware causing it to bruise everytime I flexed it.

I've got a bunch of stuff in my upper leg now (24 screws and two plates), that runs from mid tibia up into my knee. I'm still getting better, and I'm going to give it until next spring, but if I still have pain, I'm going to get it out. If nothing else, it eliminates the hardware as being the source of pain. Recovery time was super quick for me last year when I got it out and it allows the bone to fill in the screw holes and really return to normal.

That said, if I feel pretty good by next spring, I'll probably leave it in.

As far as driving, I ended up buying a $1,500 96 F-150 that had a bench seat that i could lay my leg across. It helped a lot with just being able to get out and do my own thing.

13 weeks and I graduated to a cane for the next month or so. Maybe the beach by Sept. and scuba diving before the year is out. One can hope....

Bob K

Well the progress continues. I have developed calcifications in my colaeral ligaments but not much to do about that. I also am cane free and walking freely for the first time since April. Boy what a long spring/summer. I think it will take another 2-3 months to get a good part of my strenth back, but in the mean time.....................I am HEADING TO THE BEACH!!

Bob K

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Originally Posted by Lawless

I'm a bit over a year out and have been mountain biking (x-country) without any pain.

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I bought an xc bike for rehab a while back, rode it a bit around town then rode it once on the section of trail I crashed on, next week I was back on my HT jump bike 4 days a week casing jumps :rolleyes2. That led to getting it scoped, another week on crutches and another 12 weeks PT.

I see lots of this in my future.


:)