Tibial Plateau Fracture Recovery

[East Mtn]

I've learned that there is no consensus on how long one should wait for PWB after a TPF fracture.

The most recent study I could find is at http://www.jbjs.boneandjoint.org.uk/...6/817.abstract, and I did purchase the full text, which I can share offline with anyone who'd like to help with further literature research.

The study starts with a survey of the prior literature (relevant footnotes below):

Recommendations vary from non-weight-bearing for 12 to 16 weeks,[4] nonweight-bearing for six to eight weeks,[5] nonweight-bearing prescribed on an individual basis[6] or immediate partial weight-bearing for all patients.[7,8] Encouraged by the results reported for patients who underwent immediate post-operative partial weight-bearing,[7,8] our institution has adopted this rehabilitation strategy. However, there are no data on the effects of weight-bearing on the stability of the fracture, or on how early partial weightbearing might affect the stability over time.

For the study itself, they started seven patients with PWB immediately after surgical plate-and-screw treatment of Schatzker type II lateral TPF's. They went up to 35kg weight in 2 weeks and then "as tolerated without pain." Using radiostereometric imagery analysis (RSA), they found average 0.00mm vertical displacement under load of the plateau fragments at 52 weeks, and 0.34mm total migration. (Migration less than 3mm is considered not to affect outcomes.) Two other studies, involving another 98 patients with a variety of TPFs, also had favorable results, though they had used less precise imaging. A study using RSA on patients who were NWB for 12 weeks showed similar results to this study.

So there seems to be good evidence for early PWB in most cases. In my case, there was complete disagreement between the Operating Surgeon in Salt Lake and my local ortho trauma surgeon. The OS recommended 25/50/100% at 6/8/10 weeks. The local doc considered 12 weeks NWB a Standard of Care and established medical consensus.

Since a look at the literature and websites of trauma practices around the country did reveal a variety of approaches, I've gone with the OS's recommendations.

In fact, today is 10 weeks post-op for me. The PT I went to on a trip last week to CA was emphatic that I should use assistive devices as needed to avoid limping, so I've just gone to one crutch and may try one or two trekking poles. Putting full weight on the leg feels a bit ooky, but there's no pain, and I presume comfort and stability will improve as I get used to actually walking on it again.

In case anyone would like to look them up, here are the footnotes for the part of the study I quote above:

4. Whittle AP. Fractures of the lower extremity. In: Canale ST, Beaty JH, eds. Campbell’s
operative orthopaedics. 11th ed. Vol. 3. Philadelphia: Mosby Elsevier, 2007:3085-236.
5. Cole P, Levy B, Watson JT, Schatzker J. Tibial plateau fractures. In: Browner BD,
Jupiter JB, Levine AM, Trafton PG, Krettek C, eds. Skeletal trauma: expert consultation.
Fourth ed. Vol. 2. Philadelphia: Saunders Elsevier, 2008:2201-87.
6. Egol KA, Koval KJ. Fractures of the tibial plateau. In: Chapman MW, Szabo RM,
Marder R, et al, eds. Chapman’s orthopaedic surgery. Third ed. Vol. 1. Philadelphia: Lippincott
Williams & Wilkins, 2001:737-54.
7. Eggli S, Hartel MJ, Kohl S, et al. Unstable bicondylar tibial plateau fractures: a clinical
investigation. J Orthop Trauma 2008;22:673-9.
8. Russell TA, Leighton RK; Alpha-BSM Tibial Plateau Fracture Study Group. Comparison
of autogenous bone graft and endothermic calcium phosphate cement for
defect augmentation in tibial plateau fractures: a multicenter, prospective, randomized
study. J Bone Joint Surg (Am) 2008;90-A:2057-61.

[ZGHighlands]

Thanks to all for the input,

As I'm progressing into the partial weight bearing stage, it's worth noting that I've only been cleared for 30-35 lbs....which isn't much as I weigh in a 175. Additionally, at all of my follow up visits, my Ortho and Pyhsical Therapist have been in atteddance so that no vital info has fallen through the cracks. I feel that they have a pretty good plan in place to get me back to functional. Also, from reading all of the postings starting at page 1, it seems that my fracture falls on the less severe end of the spectrum.

As for my swelling, I'm in complete agreement that the more you poke it with a needle, the greater the risk of infection. Not going to have it drained again unless my progress reverses course due to swelling. Ice and elevation seem to be working well and better as time progresses. Also, as I experience the worst swelling first thing in the morning, I'm using a rather tight ACE bandage until I've been up for a couple of hours. My PT has been wrapping my leg with KT tape and that also seems to be helping with the swelling.

Keeping a rather anal routine of quad flexing, leg raises, and foot work has also been great advice.

Thanks again to everyone for the advice/support!

Travis

[TimCT]

Hello - found this forum last night and have read all entires - funny how much we have in common regardless of the fracture Level (I-VI). My history below:
1/24/2012: Broke leg skiing too fast at Sunday River Maine - friend had iPhone app that records speed - tucked it and then during slow down hit small moguls and looked down and skis were gone - flew like superman and then converted to Evil Knevil - on 3rd flip right leg stabbed into soft snow and stopped me abruptly resulting in a Level VI+ on the "S" scale. I got up to 60 mph - too fast for this 50 year old.
1/25/2012: Had external fixator installed and had compartment sydrome
1/30/2012: Had surgery to close up wounds - required one skin graph
2/3/2012: released to go home and awaiting repair surgery
2/13/2012: return for surgery to repair damaged bones - 8 hrs - two plates and about 16 screws - much pain for the next several days
2/15/2012: required two units of blood - three surgeries in three weeks took its toll
2/16/2012: blood clots found in lungs - aggressive blood thinner therapy deployed
2/18/2012: two more units of blood given to make me look alive
2/23/2012: released from the hospital
2/29/2012: 1st post op visit with Dr - all looks good - start range of motion
3/21/2012: 2nd post op visit - asked about leg movement noticed during ROM - ankle moves left/right pivoting about knee - bad lateral stability - told just wear leg brace all the time - also told need to wait 16 weeks before PWB can start
4/25/2012: next visit with dr - many questions to ask based on this forum - thanks!

I have had all the same issues as many of you -depression, wondering if I will be able to do simple things like sit in a car or ride a bike - ROM on hold per Dr at 55 degrees - my knee is large and pretty solid to the feel - suspect gaining more ROM going to be much work

I should have used the time at home between surgeries to consider alternates to my Drs plan A (he didn't have a plan B) which was to collect shattered bones into a pad that would be receptive to a knee replacement - not knowing any better the surgery went on as scheduled - this may be the reason the stabilty is so bad - no real plan to do the best to try and use what I have -

I have gone for a second opinion and this dr has a goal to always try and use what you have leaving knee replacement as last resort - should have done my homework earlier although I was not in good shape for awhile after 1st two surgeries.

Question: does anyone have info on methods to improve lateral stability (i.e. bone graph, trim the higher side to improve plateau contact)?

I am OK with the leg brace but fear that I still need to do something as I will be loading a smaller section of the pateau and will quickly wear out cartiledge

[meganoneill]

i am soon to be 6 weeks post op. i have had very little swelling and my rom is back to 'normal'. my biggest concern is driving....i've GOT to go back to work. im broke! i do home pt faithfully. can you typically drive with pwb? i have no ligament damage and only use pain meds sparingly as i feel fine (other than boredom)

[meganoneill]

when can you expect to drive???

i have got to get back to work. im 6 weeks postop, i have the plate and screws it seems like the rest of you. my rom is back to normal and i have minimal swelling, no ligament damage and very littel discomfort (except at night) i have been doing home pt faithfully...but worry im over optimistic. i see the dr next week.

[meganoneill]

i should state that the tpf is on my right leg. i cant find info on how much "pwb"or load it takes to slam on a car break. i just am so hoping to go back and get a pay check. does anyone have experience driving left-footed?

[East Mtn]

when can you expect to drive???

i have got to get back to work. im 6 weeks postop, i have the plate and screws it seems like the rest of you. my rom is back to normal and i have minimal swelling, no ligament damage and very littel discomfort (except at night) i have been doing home pt faithfully...but worry im over optimistic. i see the dr next week.

You should perhaps investigate alternative controls:
http://www.disabled-world.com/assist...es/automotive/
http://www.driver-ed.org/i4a/pages/index.cfm?pageid=1

Major rental car companies offer such equipment when you travel.

(Fortunately, I broke my left leg, so haven't had to go that route.)

[auvgeek]

No experience with TPF (thank god), but I commonly brake with my left foot just for the hell of it.

Not sayin' you should be driving - it's prolly a bad idea, just saying I do brake with my left foot sometimes with no problem.

[ZGHighlands]

when can you expect to drive???

i have got to get back to work. im 6 weeks postop, i have the plate and screws it seems like the rest of you. my rom is back to normal and i have minimal swelling, no ligament damage and very littel discomfort (except at night) i have been doing home pt faithfully...but worry im over optimistic. i see the dr next week.

Hello,

I'm definitely feeling the wallet squeeze as a result of the TPF. I needed to get back to work like 4 weeks ago but nothing more I can do except be dedicated to PT routine.

My injury is to my left leg, so driving my wife's automatic was an early on option. In your case, take a look at the links posted my EastMtn.....great info as always. Here is another idea from when my wife blew out her ACL last year....we took her car to a large, mostly vacant parking lot and did driving 101....once she was good with the basics, we progressed to a few laps trough the neighborhood. Be careful if you do try to use your left foot as human nature under duress may cause you to revert to what you've always done while driving...that is use your right foot.

Stick with the PT as it will continue to serve you well and good luck with the driving!

Travis

[Ryanrene]

I am 16 weeks post op from my TPF VI; I am walking unassisted, albeit not consistently, and not having much pain issues. My gait is affected by me not being able to fully extend my knee, I am about 5 degrees right now. My flexion is pretty stuck and after 9 weeks of PT, I can't push past 78. My PT told me he believes I am being held up by scar tissue. My injury was so severe that I was immobile for over 6 weeks (not just non weight bearing...immobilized). He is recommending that my OS go back into the knee and scope it, clean out the scar tissue and maybe manually manipulate the knee. I wanted to know if anyone has had this procedure done and what the recovery looks like. After 2 surgeries, 6 days in the hospital, 2 plates, 12 screws and tons of pain, I have PTSD of going back under the knife. I've been told by the PT that its a pretty basic procedure, outpatient and that I will be basically wheeled in to PT to get the knee moving right afterwards. He thinks this is the only way I will move past this phase and gain my ROM needed to walk properly.

Anyone have experience with this??

[snowmobiletpf]

Hello:

I have been thread spying for 5 weeks and thought I would finally chime in. First let me say trying to find information on this injury has been quite a challenge. I ruptured by achilles two years ago and finding support for that injury was rather easy. In fact it seemed after I tore my achilles I seemed to run into many other folks who had done the same thing. I start with that injury because it starts a common theme among injuries when you are in your early forties (like me) and are very active. Everyone feels compelled to tell you that you should give up the activities that you love and your days of enjoying sports are over. I simply stopped listening to these debbie downers and focused on rehabbing the achilles faster than anyone. That injury (so I was told ) takes a year to get back to normal activities. I set my mind on doing it in 6 months. I played golf at week 8 weeks, ice hockey at 20 weeks and competitive basketball at 31 weeks. This leads me to my recent accident on 3/9. It was a nice sunny day, snowmobiling with my homies and hit something in a snowbank. Sled flipped and I bailed out landing on my right leg in a hyperextended position. Soon as I hit I knew something was not good. I thought I tore acl, mcl, etc. and tried to tough it out since we were up in the mountains for the weekend. After riding for about 15 miles I need my trip was over. Packed up, left and came home to Buffalo. My good friend is a PT and came over to examine my injury, his assesment after twisting and turning my knee. "dude, you lucked out, acl, mcl , all intacked, looks a deep bone bruise. We had beers and I was happy. Next morning I walked around and had mega pain. He said a bone bruise was painful so I just grinned and beared it. Two days , pain worse and when I stepped the wrong way the pain took me to my knees. Third day off to ortho for xray. Xray up on board and I hear "uh oh, you are not going to Jamaica next week with your family, you need surgery pronto". (Had family trip planned for Negril the following week). The next day I had surgery and a nice new shiny plate and 4 screws. Facture became displaced from me walking around like a dumb ass for 3 days. I did not do any research and thought this injury was no big deal, "hell I told the doc I been through the achilles and that is the worst". He is a spine doctor and told me this surgery was a walk in the park. So now I have set the stage. I returned after surgery. My wife and two boys left for the sun and fun of Jamaica and I sat in the same chair that I inhabited during the achilles adventure. I bought the ice machine thingy, cleaned up the diet and watched daytime TV and read, and read and read some more. I researched the injury and spyed on this thread daily. Each day I read more and more that freaked me out. This injury is a big deal and I underestimated the impact it would have on the long term quality of my life. I coach 3 baseball teams, play basketball two nights a week, play hockey on the weekend and most importantly live for chasing my two boys around the yard. After hours of reading the depression tried to make its way into my brain. The drugs took the initial pain away but made me paranoid about addiction. After 4 days I got rid of the hyrdocodone and asked the doc for tylenol #3. After 10 days of those I flushed them. I now start the part of my long drawn out story for the new recipiants of this very rare injury. Hope. I advised my doctor that I would play golf on 5/28 (my birthday) , told him I WOULD play ice hockey on Sept 27th, and I WOULD play basketball on November 30th. That was/is my timeline and either he could agree or I would find a new doctor who would. He is a young cool dude and said "mark, your goals are aggressive and will take tons of work and a positive mind" My mind is good (wife might disagree) and I know how to do the work from the achilles fun time. I started p/t (formal) at week three. ROM exercises and within 3 appts I had full rom in extension and flexion. While sitting in the chair after surgery I constantly loaded the quad and stretched the calf. I knew without some effort they would disappear. Each day I spent an hour doing the various stretches and rom exercises he gave me nice pictures of. I did not and have not missed a day. In week 4 doc allowed pwb, this meant I got to do some biking and rowing machine. No real pain to speak of, a little uncomfortable but nothing that I couldn't push through. Each time the leg got stronger and each time the doc stretched me it felt more normal. My p/t doc says the knee cap has to move in order to walk/ run properly so we have spent a lot of time getting that sucker mobile. This Thursday I return to ortho for new xray to make sure the fracture is healing correctly. My mind says it is so it is. Friday we transition to fwb with a cane. 44 yrs old and I have to coach a baseball game sunday with a cane. I write this very long winded and grammatically challenged post so everyone who has just returned from the doc and been told they sustained this injury has something positive to read. I could have used it. My pain is nearly gone. The incision feels funny and the nerves as weird for sure, not as bad as achilled though. I sleep fine. I have calluses all over my palms from crutches. The swelling was bad in the beginning but is mostly gone now. The ice after P/T is one of my favorite times of the week. The first few weeks taking a shower flat out sucked. I grew a beard cause shaving was impossible standing on one leg. I cried a few times, especially thinking about my family in Jamaica without me. Everyone has said "you selling that snowmobile now, huh?" I have said NO! I may get arthritis in the knee, I may now, it is not 100%. I may need knee surgery in 10 yrs, oh well it might be outpatient surgery in 10 years. I will run again and it will be in 2012. I don't need to win sprints but I will be able to out run my boys and most guys my age. So I will end by saying, if you need a positive perspective on this injury, just email at mstahlka@gmail.com. I am 100% dedicated to getting back to the way I was on 3/8. I will not accept less than that, no pain, no doctor and certainly no debbie downers are going to change my mindset. My p/t told me today I would be running in 8 weeks. I am committed to proving him right. Keep the mind strong, push through the pain, only listen to people who want you to get better. And if I offended anyone in this post I apologize, I just needed for my own mental recovery to see a positive outlook for this injury even if the words had to be mine. mark in buffalo

[amoparker]

i should state that the tpf is on my right leg. i cant find info on how much "pwb"or load it takes to slam on a car break. i just am so hoping to go back and get a pay check. does anyone have experience driving left-footed?

My doc okayed me to drive right away. My injury was also to the right leg but he said as long as I used two feet and only breaked (is that a word?) with the left leg I would be fine. Accelerating takes very little pressure and it didn't take me long to get the hang of it. It is only the possibility of slamming the brake with the right leg he was concerned about so just keep the right leg away from the brake pedal at all costs!
Amanda

[meganoneill]

I have used my left foot often as i drive long distances and like to stretch. i hope hope hope he says im good to at least try. im mostly in need of getting home! husband is in the service and i split residences. (i work out of state) i did mine in last run of the last day of a wonderful 8 day family ski vaca.at copper..., the kids had already left and we took "1 more and done run" i was on the 'flats' and really just caught an edge. this has shaken my confidence like no other...... i just bit it. i have so many activities that i love, i am just flat paranoid now! i will give up any activity i have to to be able to get and stay active.

anybody have trouble getting back to golfing?

[meganoneill]

yes,he does have good info. i may have to get a hand brake. i am determined to ace all the p.t. i have access to great facilities and will use them as much as they let me. i will be thankful for getting out. there are only so many books i can stand to read or reruns of bonanza i can stomach.

it's the devil that keeps telling me what i cant do this summer....oh man i love golf, horse back riding, hiking our cliffs, fishing in 'bad' weather. got to concentrate on what matters and what im thankful for !

[TimCT]

Met with OS today - 10 wks post op - xray showed bone movement which has patellar tendon attached by two screws (now one) - need to hold off on advancing ROM (flexion at 55 degrees) until next appt (six weeks) - nervous it might completely dislodge but OS has given OK to work muscle toning and 50% weight bearing if all goes well to 100% in one month -

Discussed long term plan with OS - clearly communicated that break very bad only option is total knee replacement. Makes sense looking at xrays - it will provide the best quality of life with respect to walking, etc - assuming all goes well and full ROM acheived

As for my lateral stability question on 4/23 - no need to address that - movement should reduce with muscle growth and I plan to use Bledsoe Brace short term (< 1yr) and TKR long term.

Always follow your OS's instructions (in EastMtn's case - follow your preferred OS's instructions!).

[Nurse Nina]

I would definitely consider the scope. Your flexion is way too limiting if you want to walk normally. You need at least 90 of flexion and zero extension. My Progress has been about one degree per day on average. You need to get there and find out what is preventing you from doing so. Mine still swells up and on days after I do to much I can't get the ranges because if it. Keep working on improving your range, but if you have adhesions and scar tissue, you need to take care of it so you can continue to progress.
Let us know how you make out.

Nina

I am 16 weeks post op from my TPF VI; I am walking



unassisted, albeit not consistently, and not having much pain issues. My gait is affected by me not being able to fully extend my knee, I am about 5 degrees right now. My flexion is pretty stuck and after 9 weeks of PT, I can't push past 78. My PT told me he believes I am being held up by scar tissue. My injury was so severe that I was immobile for over 6 weeks (not just non weight bearing...immobilized). He is recommending that my OS go back into the knee and scope it, clean out the scar tissue and maybe manually manipulate the knee. I wanted to know if anyone has had this procedure done and what the recovery looks like. After 2 surgeries, 6 days in the hospital, 2 plates, 12 screws and tons of pain, I have PTSD of going back under the knife. I've been told by the PT that its a pretty basic procedure, outpatient and that I will be basically wheeled in to PT to get the knee moving right afterwards. He thinks this is the only way I will move past this phase and gain my ROM needed to walk properly.

Anyone have experience with this??

[Nurse Nina]

I'm a little over 6 weeks postop and would like to know if any of you have weird sensations in your legs. I am pretty much pain free except for after PT sessions, but these twinges and scattered sensations are driving me crazy. I am also experiencing soreness in my IT band and an area to the left of my scar that is completely numb.

[kboyd1386]

Today makes 10 weeks since my initial injury. (Motorcycle accident) Dr says tibia plateau was crushed and will probably need knee replacement in 3 to 4 years. The ankle was also dislocated and the bone came through the skin causing multiple fracture blisters. Just started toe weight bearing 15lbs max. Not much pain except during PT. I was in an external fixator for 7 weeks. Most of the pain comes from the thigh and foot where the rods were screwed into the bone. My range on the knee is 2 - 65 degrees. It still looks like I got a long way to go.

[amoparker]

Hi Nina.
I don't have the IT band issue, but I do have terrible pains on the injury side where my leg and pelvis meet up (crotch area). I think I just overuse it from walking improperly. At night when I turn over, some times it feels like I am ripping a muscle in there. Not fun.
Amanda

[TPFxPilot]

Hi Everyone – I want to start by thanking all of the folks who have posted here. I’ve been lurking for the last month, and this forum has proven to be the most active and informative community for TP fracture recovery I have found online. Hopefully, adding my story to the group will help highlight the many similarities (and differences) that future injury suffers may encounter during their healing process. My case may be particularly interesting for some folks because the injury occurred on the job, so the whole treatment and healing process is being complicated by the Worker’s Compensation system. Sorry in advance for the long post – I shouldn’t have spent so much time lurking!

My injury occurred around noon on March 26, 2012, while attempting to prevent a (supposedly) parked aircraft from accidentally rolling into another parked airplane. Yep, you read that right! To make a long and painful story short, I rapidly learned that I’m not Superman, just a 41-yr-old corporate pilot who is vastly outmatched by a 6600 lb airplane with a little momentum! Anyway, I planted my left leg while backpedaling and leaning hard against the nose of the plane, and the rest is physics…ended up with a Schatzker Type IV fracture.

Although I live in Ohio, and my employer is based in Ohio as well, the incident occurred near Philadelphia while we were on a business trip. The emergency room sent me “home” in a long leg splint and crutches later the same evening, armed with a fistful of Percocet and Motrin (no one said anything about the ibuprofen interfering with bone healing…I learned that later). The diagnosis from the ER at the time was just a non-displaced tibial plateau fracture. I was fortunate to have family close by in New Jersey who could come and pick me up, and I ended up staying with them for almost a full week.

Pain from my leg/knee was surprisingly light, and I weaned myself off of the pain medication within 4 or 5 days. Pain from dealing with Worker’s Compensation (WC) was much harder to deal with! After initial emergency treatment, all further appointments, doctors, and treatment measures need to be approved before they are allowed – this system was extremely frustrating and led to many delays during the first two weeks after the injury, but I’ve since gotten used to the process and can stay ahead of things.

After 3 days of wrangling with WC and one cancelled dr appointment (I originally chose a doctor who only worked with NJ Workers Comp, not Ohio Workers Comp), I got in to see an Ortho surgeon in NJ. The emergency room stressed that I should see an OS before attempt to make the trip back to Ohio for fear of blood clots or increased risk of causing displacement while traveling the long distance.

At the OS appointment on 3/29, the doctor looked at the original ER X-rays, recommended no surgery since there was no displacement, and slapped on a long leg plaster cast from mid-thigh to my toes (WC denied his request for a locking brace). Aside from the disappointment of being in an immobile cast, I figured I was fortune enough to avoid needing surgery.

On 4/1, my wife arrived in NJ to drive me home to Ohio…13 hours of bliss sprawled across the back seat because I couldn’t fit in the front with the cast!

On 4/3, I had my first appointment with my OS that I chose in Ohio to finish monitoring my healing process. On analyzing my X-ray, he was emphatic that I most likely needed surgery right away. He stressed that my type of fracture could easily fool a doctor into recommending no surgery due to the lack of displacement, but the knee joint stability was seriously compromised. He ordered a CT scan to confirm, but of course the CT scan needed to be approved by WC, and that didn’t occur until 4/5. It was confirmed that surgery was needed, and it was through the CT scan that I got the official Type IV classification. The good news was that they cut me out of the long leg cast for the CT scan and sent me home in an immobilizing brace…I got my ankle and foot back!!

WC didn’t approve the surgery until 4/9, so my surgical reduction waited until 4/10, more than two weeks after the initial injury. I debated the surgery for many reasons…partially because I was largely pain free by then, and I already was two weeks into the healing process.

Surgery was on the morning of 4/10, one plate and 8 screws, and the operation took less than 90 minutes. When I woke from the anesthesia, frankly the pain was unbelievable! I felt much more like I had a broken leg than when I originally broke it! I was in the hospital for a little over 24 hours, and the pain diminished rather quickly during that time thanks to a battery of pain meds. A physical therapist visited with me just before I was discharged to help me get back onto my crutches. Interestingly, crutching around for the first time after surgery felt like a genuine battle – extremely painful and difficult – especially compared to the pain free crutching I had achieved pre-surgery. Every movement and repositioning of the crutches felt unstable and awash in intense pain even though I felt limited pain while lying in the hospital bed. Once up and down the hall to the next room’s door was enough exercise on that first trip! The physical therapist gave me a half dozen basic leg exercises to do at home, but no other physical or ROM exercise. The doc prescribed NWB for the foreseeable future, in addition to more Percocet and Oxycontin for pain, and a Lovenox injection prescription to prevent blood clots.

The pain from the surgery subsided in less than a week, and I weaned myself off the pain meds fairly quickly, taking the last pill on the night of 4/16. Lots of trouble sleeping, and I had a few other noticeable side effects from the pain meds – difficulty concentrating, ringing in ears, anxiety (mind racing).

On 4/18, I had my first post-op appointment with the OS where a fresh round of X-rays gave me my first look at my shiny new Home Depot leg. Although the OS and assistants were very pleased with the outcome of the surgery and the images, I am still NWB (as expected) and no real PT other than the basic ankle and thigh exercises I was originally given (not expected). I was truly expecting to be allowed to begin some form of ROM exercises, but I am supposed to stay largely immobilized until my next appointment on 5/16.

I celebrated being exactly one month post injury on 4/26 by driving for the first time to take the family out for ice cream! It was a little awkward getting into the driver’s seat with the non-bending leg, but very comfortable once I was situated.

Now I’m just biding my time until 5/16, doing my little thigh and ankle exercises each day, and crutching around inside and outside as much as I can. I’ve noticed that my foot and ankle get much less purple much less quickly now than even last week. I still have 5 days’ worth of Lovenox injections...I can't wait until they're done and my belly can stop being a needle receptacle! Technically I’ve been back at work since about a week after injury. Obviously I can’t fly, which was a large portion of my responsibilities, but I can do all the administrative duties from home as I always did. The huge upshot is that WC covers all of the medical expenses, and thankfully my employer has elected to continue my full salary (for now, at least). I realize that I’m extremely fortunate that I don’t have the added stress of worrying about my financial situation interfering with my recovery.

I’ll keep checking in with (much shorter) progress reports, and follow everyone else’s recovery as well – I find that it’s wonderful encouragement, sprinkled with just the right sized dose of reality! Here’s wishing everyone a relatively quick recovery!

[himavan]

it would be pretty cool if we compiled a whole list of little tips and techniques. Here's a couple I just figured out:
I got rid of my ace bandage and cotton stocking and found a really soft legging in my wife's stuff - way more comfortable and feels better on my hyper sensitive skin (though doesn't do any compression).
My wife is pregnant (she's due in July, so me learning to walk is a pretty stressful issue at the moment) and just got a "snoogle" body pillow. It's been way better than dealing with normal pillows, and best of all I can now sleep sideways for the first time in six weeks because it supports my leg better. It also curls up, so i can support my leg/foot without my heel resting on the ground/mattress (my heel always feels bruised).

I'm now stashing back packs all over my home - that way I can actually carry things around while on crutches.

[SoccerGirl]

Amanda -- i have similar issues with the hip area on that leg... it "pops" constantly when i try to bend, and can't do the butterfly stretch, sooo tight. Hopefully will loosen with time/ usage.

himavan -- Eastmtn and i had talked about how great it would be to have a forum for this type of thing. One you could easily find specific topics/ info. ... we should do it somehow!

At 10 weeks, i'm suddenly progressing rapidly. Within 2 weeks, I've gone from total NWB, to short distances with NO crutches as comfort permits!! --I credit it to taking all that silica/ Vit D/ other supplements, doing the little exercises faithfully, and aquatherapy! but like you East Mtn, PT got on me hard to never go without crutches if there's a limp... don't want develop wrong muscles etc...

for me, with this new WB, it's my foot and ankle that hurt most.
And, i don't know about y'all, but my hamstring took the worst toll, muscle-wise... it's GONE! Man is it painful trying to do the flexion exercises

[meganoneill]

nina, im numb around the scare and imagine i will remain so for a while. i also have weird sensations but now get stabbing pains in my shins on occasion. it makes me paranoid as if i did something wrong.

as far as real discomfort, i get night pains only. my flexion is good, but i sure know ive got a problem if i ride in a car too long. i am going to do everything the pt says and try and join the outside world....still cant drive.

[amoparker]

Amanda -- i have similar issues with the hip area on that leg... it "pops" constantly when i try to bend, and can't do the butterfly stretch, sooo tight. Hopefully will loosen with time/ usage.

himavan -- Eastmtn and i had talked about how great it would be to have a forum for this type of thing. One you could easily find specific topics/ info. ... we should do it somehow!

At 10 weeks, i'm suddenly progressing rapidly. Within 2 weeks, I've gone from total NWB, to short distances with NO crutches as comfort permits!! --I credit it to taking all that silica/ Vit D/ other supplements, doing the little exercises faithfully, and aquatherapy! but like you East Mtn, PT got on me hard to never go without crutches if there's a limp... don't want develop wrong muscles etc...

for me, with this new WB, it's my foot and ankle that hurt most.
And, i don't know about y'all, but my hamstring took the worst toll, muscle-wise... it's GONE! Man is it painful trying to do the flexion exercises

Hey SoccerGirl, I am right there with you. I am now down to a cane instead of one crutch because my PT said I was leaning all wrong when using the crutch and it was going to mess me up. I too am able to walk a short bit around the house unassisted, although my gait isn't quite normal and I am sure if my PT saw it she would not approve. It just feels so nice to do it, if only for a few steps a day. A small taste of normal.
At 9 weeks post op now, I still am striving for full extension and flexion. At my last PT measurement a week ago I had 8 degrees to go for flexion and ten for extension. She showed me how I should not be able to slide any fingers under my injured knee when it is extended, like I can't with the good leg. I am still not there and it is frustrating!
Amanda

[East Mtn]

himavan -- Eastmtn and i had talked about how great it would be to have a forum for this type of thing. One you could easily find specific topics/ info. ... we should do it somehow!

I've made a feeble start on an FAQ, setting up and adding one page at http://tpf.wikia.com/

If anyone would like to pitch in, please go ahead. If interested in helping with administration, send me a PM with your email address.