Tibial Plateau Fracture

**Rockband** · 11-23-2007, 11:16 AM

Well, I think I screwed up my knee/leg pretty good this time.

Day 1, Keystone (Tree 1, Rockband 0) Caught an edge funky like, loss of control speeding toward the trees, couldn't quite split the gap, & my shin hit the tree flipping me upside down, stupid fall & injury.

Pretty much shattered the Tibial Plateau, five pieces, meniscus damage, six hour surgery.

Looking for any info on PT or tips for a quicker recovery. Been popping the Glucosamine, & trying to move my ankle as much as possible right now. Should be out of the Ex-Fix next week & then the workout is on.

**peterslovo** · 11-23-2007, 03:20 PM

Ouch!

Nothing to say except Positive Vibes. Any chance of making spring turns?

**drmark** · 11-23-2007, 08:10 PM

Did they put plates and screws in the upper tibia? If so, why the external fixator? Hopefully it will be off before 4 weeks. It it stays much longer than that, the knee may never really bend very well again, and sports will surely be off the menu.

**SkiEvil** · 11-23-2007, 08:21 PM

I did my TP in 1996. Luckily it was a non-displaced fracture. I tore the MCL/LCL and ruptured the lateral meniscus. Luckily I did not need surgery or a cast. I was in a brace and on crutches for 8 weeks. I started swimming almost immediately after I was diagnosed. 10 years later I have no ill effects. Good luck!!!!

**TAHOEDOWN** · 11-23-2007, 09:15 PM

I had a similar injury from a motorcycle wreck in 01. Unfortunately, the trama surgeon fucked it up and it healed retracted (couldn't straighten my leg). I had to have it re-broken and wore a freaky external fixator called an illizirov for 6 months to straighten it out. The worst 6 months of my life, but I am all good now and have no ill effects. The doc that finally got me right said that eventually I will probably need a knee replacement because of the bone is uneven in the joint. I take glucosamine and condroiton like it's candy. Also, no ibuprofen during recovery (inhibits bone growth). Enjoy the vicodin.
Find a gym with a rowing machine and put your bum leg to the side. I rode that thing for hours.
Best of luck bro!

**Rockband** · 11-23-2007, 09:33 PM

Originally Posted by drmark

Did they put plates and screws in the upper tibia? If so, why the external fixator? Hopefully it will be off before 4 weeks. It it stays much longer than that, the knee may never really bend very well again, and sports will surely be off the menu.

Yep, second surgery they put plates & screws in the upper Tibia. Initially they were not going to put the Ex-Fix back on, but after getting in the OR more damage was done than thought & they wanted to make sure my bones would fuse.

My Dr. said that out of the 15 years he's been working orthopedics, my fracture was one of the worst he's seen.

I also kind of hold the belief that the sooner this thing gets off the sooner I'll recover. Next Friday will be about 3.5 weeks in the Fixator, & then I should be able to start flexing it.

**Rockband** · 11-23-2007, 09:45 PM

Originally Posted by POWHNTR

Also, no ibuprofen during recovery (inhibits bone growth). Enjoy the vicodin.

Thx for the ibuprofen tip, I was taking it occasionally to supplement my percocet when I didn't need it. Wont do that anymore. Rowing machine & pool exercises will def be in my future.

**splat** · 11-25-2007, 04:17 PM

Comfrey tea, Bro.

the bone knitter....

**Rockband** · 12-01-2007, 12:33 AM

Update on the recovery, got the ex-fix off today & damn is my leg sore.

I got to check out the x-rays, my leg looks like an erector set gone wrong. Apparently they also had to reattach the patellar tendon, woo.

Before

After

**drmark** · 12-01-2007, 03:50 PM

I am the first to say when I think work isn't good enough, but the plate osteosyntheis is actually quit excellent.

what I don't understand is why you didn't get to enjoy the benefits of such good work by following it up with early motion.

**GoNads** · 12-01-2007, 04:33 PM

Jesus christ... I will never again complain about the stress fractures and small 4cm divot in my tib plateau EVER Again. Vibes, and speedy rehab. Don't rush it, make sure you do it RIGHT the first time.

**stompinlines** · 12-13-2007, 07:10 PM

I hope your orthopod was honest with you...
regarding the early onset of arthritis.
Has he spoken to you about the likelihood of a TKA?
Work your tail of with your PT.
They are your best friend.

**Rockband** · 12-14-2007, 03:58 PM

Yep, pretty well informed on the fact that arthritis is possibly in my future, I'm only 23 so my odds are good to not have as many problems. I have been taking glucosamine, and just as a preventative measure will probably continue the rest of my life.

Atleast as of now there is no reason for any sort of TKA, are you saying that this is likely, from experience? It is my understanding that with my age and the success of the surgery I should be ok.
I of course understand there are always possible problems, especially as I get older, but at that point I will hopefully be dialing down the activities.

**caddah** · 12-15-2007, 09:01 PM

HOLY SHIT, thats alot of metal. I had small tibia plateau fracture when i dislocated my knee. they put me in the ex fix for quite a while. it sounds like you will be good to go once all the bone fragments heal. i had some serious knee issues and have been relegated to occasional groomer runs ever since i hurt myself.

heres a link to my thread about my injury, it has some info on what i did for rehab.

http://www.tetongravity.com/forums/s...ad.php?t=42924

maybe its something you'll find helpful. good luck with the rehab

**mjturley** · 12-16-2007, 12:47 AM

How is your graft doing ? How much swelling do you still have ? When did you have it done ? I broke the shit out of my ankle and had an ex-fix & free flap.

**caddah** · 12-19-2007, 10:36 PM

not to hijack the thread, but my swelling is still a concern. I had the fasciotomy done 2 years ago. still swells up in those spots. i have compression pants i wear for it. keeps the blood flowing.

rockband....hope the PT goes well for you. the effort you put in is worth it. your right about being young still. I know that helped me, as other people with my injury tend to loose legs. things heal up much better when your young and healthy

**caddah** · 01-02-2008, 03:54 PM

had people tell me the link was wrong in my previous post, so i fixed it for anyone who was trying to look at it.

**nancie2k** · 01-06-2008, 06:16 PM

http://tetongravity.com/forums/showthread.php?t=48788

welcome to the club no one wants to be in
i am scheduled for tkr feb 19, scared to death of more pain.
have never been right again. hoping for a straight leg
good luck to you!!!!!

had some help from this site
http://www.kneeguru.co.uk/KNEEtalk/index.php

**Rockband** · 02-09-2008, 06:19 PM

Wanted to update my recovery timeline. 11/4 (Injury)

Saw the doc on 2/8 and was cleared for weight bearing, he said I should slowly ramp up the weight amount. I have been shuffling short distances with no crutches, & longer distances with one.

Leg feels surprisingly good, only have pain in the foot from non-use. My flexion is only at 90*, I tore the patellar tendon so lots of stiffness there, trying to bend my leg as much as possible.

Super psyched that I'm that much closer to being back in the game. Looking forward to a solid mtb season.

**skibuminwyo** · 02-09-2008, 07:24 PM

Speedy recovery mangs.

**Rockband** · 10-23-2008, 07:29 PM

So.. Here I am almost a year later, recovery has been long and hard but my leg is working very well. My injured leg is still not 100 percent but pretty damn close. I am super happy to be athletically functioning at my current level and thank everyone here for their positive vibes and suggestions.

I need to set up an appointment with my doc regarding screw removal. What is the general consensus on this? I know after having two removed in my ankle that it will put me down for a while, but how much worse is 10+, or whatever they can take out going to be?

My biggest concern is that I will be out of commission for more than a couple months and miss the ski season. Would it be worse to wait ie. harder to get them out in say.. May? I am positive that some of my minor pain can be attributed to the quantity of metal in my leg, and at some point I want as much of it out as possible, but when?

**SponsoredByDuctTape** · 10-23-2008, 11:03 PM

Thanks for updating. I was stoked to find your thread when I had my own TPF in March. Nice to have another skier to relate to. My situation was not as bad as yours I don't think - only 2 or 3 pieces of displaced bone, same meniscus tear. Although, I also tore my MCL and the ACL was avulsed. Not sure if you had these issues also. Same 5-6 hour surgery, but just one surgery and no external fixator.

Regarding the screw removal. My surgeon told me that there was no real "need" for it, but that I could have the hardware removed if it started bothering me. For comparison, I only have one plate and 5 screws - I would guess about 1/3 of what's in your knee based on your x-ray/avatar. From what I remember (haven't talked to the surgeon in about 4 months), he said it would be about a month between removal and back to normal. Don't quote me on that though. I don't see why it would be more difficult to remove if you left it in longer.

I have some questions for you: How is your range of motion? How was therapy? Where are you as far as athletics? What would you say is your overall "percentage" of recovery (is your knee 50%, 100%, etc.)? Any other comments or advice you could hand out would be appreciated.

**Orthoski** · 10-25-2008, 08:54 PM

That was quite the fracture....how does the tree look? You don't necessarily need to remove the hardware from your tibial plateau. There are specific screws that are routinely removed from some ankle repairs (the ones that bridge the tibia and fibula in your lower leg - these "syndesmotic" screws will break if they're not removed, though the truth is it doesn't do anything if they break except make the xray look ugly). As far as your tibial plateau hardware, however, unless it's prominent and bothering you, you can likely leave it in - I would defer to the treating surgeon who obviously spent a lot of time working on your knee. The unspoken realistic advantage of removing it now is that if you are predisposed to knee arthritis down the road, removing it now will make the total knee replacement in 50 years easier, but that isn't urgent.

**sparkletarte.** · 11-02-2008, 05:18 PM

This is my club! Only 2 screws though, 2 inchers. Fib and tib plateau, bashed a tree in mid Feb maybe 5 yrs ago. My knee hurt the following winter. I got the screws out- was told I had to keep them in a year minimum, did it about 14 months after. My knee hurt before I got them out, pretty much the next day it felt better and once I was off the crutches (maybe 10 days to full walking after removal) it was amazing, all pain was gone. I wanted them out simply because I don't like the idea of having foreign objects permanently in my body, but it did help a lot to get them out, and lots of people had said it would feel better after doing so to encourage me. They also took the chance to do some tidy up, trim cartiledge, etc.

It was weird getting them out. I opted for the spinal so I could watch it on the tv, but it didn't take fast enough. I got the gas, then woke up part way through to hear the tools at work. I felt the pressure of the screwdriver, but not any pain. I would try for the spinal if you can, so you can see it all in action, if you are up for that.

Good luck with the rest of your recovery!

**icequeen** · 11-11-2008, 02:12 PM

I have had a similar injury but due to a motorcycle injury. This thread has been very informative. I have 2 plates 9 screws & a couple rods. I am non weight bearing for 6wks which I am into my 4th wk. They just switched me off of vicodin and onto ibuprofin. I read the response about the ib affecting bone growth where can I find information about that? How long were you in pain?