Tibial Plateau Fracture Recovery

[crystalteras]

So an update on me...6 weeks post op and my dr had me get X-rays. He was concerned bc of the extent of my injury do he also had me go get a CAT scan done. Apparently I'm healing well so far so that's good! I start PT now for the next 4 weeks and then he said depending on how I'm doing, he may let me go to partial weight bearing yay. I'm soooo scared tho! More scared of the pain but I know I have to push through. I also asked him while I was there about the type of TPF I have. He said I definetely had a type 6 TPF w/ depression. He told me again, that it was the worst he's seen and just kept mentioning how horrible it was. Kinda funny how they keep saying that to me and at my 2 week appt, they were surprised at how much pain I was still in. Now, they don't question my pain. Which is not all the time, but still when it's there, it's bad! Which is now maybe once a day instead of all day long so that's a plus!

[itsdeenah]

Hi @greg33
You are deff not alone here...glad you found the forum. It's helped me out alot especially trying to explain this type of complex injury to friends and family. You soon become an expert on knowing all the details of the injury and knowing that at least on here everyone can understand the physcial and emotional tolls you're going through. Best wishes - Keep posting and good luck with the recovery!

New member....37 year old male, I sustained a tibia plateau fracture to my right leg on 04/06/2012. I was riding a motorcycle and got broadsided. Bumper into the right knee. Crushed the outer portion of the tibia plateau. Surgery on 04/12....plate and I think 8-9 screws. Grafted cadaver bone to attempt to rebuild the joint surface. Torn MCL, detatched PCL, meniscus damage blab blah. I'm 12 weeks post op tomorrow. I'm at 80 degrees flextion and 0 extension. Two doctors have told me I will never run again and walking will be painfull. No cartilage left in my knee.
So today I went for a CAT scan of both knees. Doctors are exploring a bone allograft. They want to cut the top of my tibia off and graft a "donor" tibia in from a cadaver. Doctor feels this will give me a better joint surface and better quality of life. Which means another surgery and starting all over again.
Started the long process of trying to walk...right now with both crutches. Feels very weak. I'm doing PT twice a week and just started strength training for my bum leg last week. My crash happened while I was working and I'm being told I will not be able to return to my current job. Which sucks....but I haven't thrown in the towel just yet. I have a wife and two young boys.
Reading everyone else's posts has been helpfull....now I know I'm not alone here! I wish everyone luck with their recovery!!

[peaton]

Hi France,

I am doing pretty good, in my opinion, and my OS is very pleased with my progress. I am still NWB, but am able to extend completely with a little pain and am at 90 deg flexion, at 7wks out. I can't seem to get past this point though (I'm not supposed to be pushing it yet either). My knee is still swollen and I think I'm fighting old fluid that has gel'd up. I am completely off pain pills, that is a blessing, don't have to worry about my balance and sleeping all the time. I go back the end of July so hopefully I will have more good news. I have the feeling the rest is going to be slow going. I am having problems with some locking when flexing. So I will have to have a discussion with my OS about that and some problem areas.

I am finding ways to be a little more independent so I'm feeling a little better about myself.

I too, hope that we will prevail and prove the doctors wrong. Can't wait to be back horseback riding, running my dogs, walking and hiking. Funny the things you learn and take for granted. I listen to people gripe about going to work, doing house chores, etc. these are things I would love to be doing.

Take care everyone, stay positive and do the work. We will get there!

[peaton]

Scjohnson07:

How did your follow-up appointment go?

New member 26 years old. Fx my right tibia plateau in may along with torn acl, mcl and meniscus. Dr opted to let my tibia heal before doing the ligament repair however I'm afraid of how weak it will be after I heal. I am a horse trainer that was thrown from a training horse and I have to get back to 100% eventually. I also was told 3 months post injury is how long the leg needs to remain immobile. It is now "locked" with hard swelling around my knee. I go for a follow up appt tomorrow anyone else had this treatment? My fx is a vertical fracture in my tibia plateau. I also have tingling in the bottom of my foot and toes that goes away somewhat with a compression sock (I've been evaluated for DVT and circulation problems in the foot and everything checked out).

[vaper]

well, i'm at 6 weeks post-op, can flex almost all the way and hyper-extend my leg and have no pain ever, but i'm not cleared for walking yet. my biggest fear when i start walking is the weakness in my ankle and how much my foot will hurt, what are exercises to strengthen up my ankle and foot w/o putting weight on it?

[scjohnson07]

Peaton: thanks for asking. My dr did a bunch of scans yesterday and decided that he will wait for surgery until after I start using my leg in about another month and a half or so. My leg is extremely atrophied and he doesn't want to do anything to it now. My bone is healing nicely from what he said. His words were pretty much something to the effect of a puzzle that is put together on a table looks good and put together but you go to try and pick it up, bend it and move it and it falls apart. He wants to see what ligaments he needs to repair once my leg is mobile again. Everything he said seemed to make sense I just am impatient and want my life back! His explanation for the tingling and nerve issues was my knee immobilizer brace is pushing on a nerve in the back of my leg (which explains why it comes and goes). I have a long way to go and have had to make some decisions as far as my horses go but I have faith I'll return to riding. He did say my acl isn't that stable but it's still somewhat attached and my meniscus is in bad shape.

[scjohnson07]

The locking sensation in my knee he said is most likely due to the meniscus and scar tissue. My PT will be painful I'm sure!

[peaton]

Scjohnson07:

At least you got some answers to your questions. It doesn't take long for muscles to atrophy, mine is terrible too. I have started some floor exercises like leg lifts and what not so hopefully when I do start PT I will be ahead of the game.

If you have people that are willing to help with your horses, make sure to communicate with them about your recovery. Don't make any rash decisions, especially if you are on pain meds.

Keep busy, have someone help you down to the barn, you can groom and love on your horses even though you can't ride them. I find it very therapeutic! Good luck in your recovery.

Peaton: thanks for asking. My dr did a bunch of scans yesterday and decided that he will wait for surgery until after I start using my leg in about another month and a half or so. My leg is extremely atrophied and he doesn't want to do anything to it now. My bone is healing nicely from what he said. His words were pretty much something to the effect of a puzzle that is put together on a table looks good and put together but you go to try and pick it up, bend it and move it and it falls apart. He wants to see what ligaments he needs to repair once my leg is mobile again. Everything he said seemed to make sense I just am impatient and want my life back! His explanation for the tingling and nerve issues was my knee immobilizer brace is pushing on a nerve in the back of my leg (which explains why it comes and goes). I have a long way to go and have had to make some decisions as far as my horses go but I have faith I'll return to riding. He did say my acl isn't that stable but it's still somewhat attached and my meniscus is in bad shape.

[scjohnson07]

Thanks for your kind words. Unfortunately I'm a career trainer and have 7 of my own to include mares in foal. I have family to help care for them but one of my show horses and lesson horses can't sit and do nothing for a year or more so I have decided to lease out to keep them busy. Your right it is good therapy to visit the barn and check out my guys. I did get answers yes unfortunately I was hoping that he would tell me I would ride sooner and recover completely. Guess breaking 2 yr olds won't be in my future but instead finish work on training in the years to come. The atrophy sucks my leg is half the size of my other one and looks like a skeleton! Glad he opted out of surgery for the time being until i get some of that back. I wish I could start moving it and doing leg lifts myself unfortunately I'm not to that point. It can't come soon enough! I bet there will be lots of pain involved but I've given birth I can do this! Lol

[peaton]

Scjo-hnson07:

I do understand where you are coming from, I won't be riding until next year either. I have a 7yr old Morgan that I was working with. I bought him last year and was thrown from him, and partially tore my MCL. I then had several more experienced people on him, in which he decided to test them as well. Lets just say, we did a lot of ground work and bonding over the course of the winter and early spring. I was feeling really good about getting on him this year, which isn't going to happen now. Now, very nervous about getting on him next year, already! Don't want to re-injur my leg. I am pretty positive he is a horse that you need to bond with before he will let you ride him. So I now have another year to work on that. I'll let you know how that goes down the road.

It will come soon enough for the exercises. You must get healed up first. Stay positive!

Thanks for your kind words. Unfortunately I'm a career trainer and have 7 of my own to include mares in foal. I have family to help care for them but one of my show horses and lesson horses can't sit and do nothing for a year or more so I have decided to lease out to keep them busy. Your right it is good therapy to visit the barn and check out my guys. I did get answers yes unfortunately I was hoping that he would tell me I would ride sooner and recover completely. Guess breaking 2 yr olds won't be in my future but instead finish work on training in the years to come. The atrophy sucks my leg is half the size of my other one and looks like a skeleton! Glad he opted out of surgery for the time being until i get some of that back. I wish I could start moving it and doing leg lifts myself unfortunately I'm not to that point. It can't come soon enough! I bet there will be lots of pain involved but I've given birth I can do this! Lol

[scjohnson07]

Good luck with your horse (and your injury. Ya on top of all of it I had to send all of my clients elsewhere . I trust my doc I just wish he could miraculously fix me and send me on my way! Of course I had to have the most complicated injury haha. I've been riding for 21 years and have lucked out to never get tossed and hurt and I've ridden some questionable training horses that have given me a run for my money that I can stay on. This happened on a 13.2 hand evil welsh pony!

[soonerstacy]

Thought I'd give a little update here. Just started PT yesterday, finally!! I'm glad to have made it this far. So I'm 50% PWB for the next 3 weeks. Its a little crazy when they tell you to go ahead and walk with crutches. It takes time to get used to that. I keep getting charlie horses when I try to stretch my calf, OUCH! The foot is tingly when I'm walking on it, but not bad. I'm very happy to be able to just stand on two feet again. It's the little things....

How many of you had a PT who was experienced with TPF? I know not many of them out there have dealt with TPF. They stuck me with a therapist who is fresh out of school, like she just graduated in May. I didn't realize how far in advance the physical therapy places booked up (apparently neither did my OS). This was the only place available within an acceptable driving distance from my house. And now that I'm working 5 days a week, I need after 4 appointment times. Should I ask to switch to a more experienced therapist? Or should that not matter. I kinda got a weird vibe from her, like she was just ready to go home and could care less about me. Then again, it was 4 PM on a Friday. So who knows.

Scjohnson, Its nice to see other riders out there! My injury was from a horse as well. I'm not a professional by any means but my spouse is. We have 4 horses and a donkey out at our place, in addition to several in training. I can't wait to get back on. Just not going down the road anymore on my gelding, he is always bad for me there. Going to stick to trails and arenas in the future.

[soonerstacy]

One more thing.

I think I'm going to get a sign for my exam room at work that says:

Yes, I am on crutches and broke my leg. Please refrain from asking me questions about it. Thank you. LOL

I am getting very tired to explaining to my patients what happened. Its nice that total strangers are concerned for you, but seriously, telling it 8-10 times per day gets OLD. I am overjoyed if someone DOESN'T ask me.

[scjohnson07]

I totally understand about the thousand question game!! I get the same thing and as soon as you say it's about a horse then you get people's life story on how they rode a horse once 30 years ago or something like that. I'm tired of the story too I wanna make up something ridiculous like a parachuting accident or a plane crash lol!!

[soonerstacy]

Uh yes!! Let's see my fun accident story will be I fell off a zipline or hang glide accident. Lol! Yes people have told me about the one experience they had on a horse, like I care??

[Shazza]

Like a few others I've joined because this seems to have a lot of info on Tibial plateau fractures.

I did mine 7 years ago at the age of 23 playing touch rugby where I got tackled by a guy ( I am a fairly small female) ending up with a 1 night stay in hospital and only 1 mm displacement so no surgery. Also discovered I'm allergic to codeine/morphine so no drugs after that day in hospital.

Went back to work at 3 weeks, total of 3 months nwb. Best advice is to use elbow crutches but cover them with tennis/squash racquet tape for comfort. I still keep my crutches under my bed and have been used by my husband recently for his knee ops.

It took a good 2 years to get muscles back, and if I can suggest anything it would be a rehab program. I was never offered one but the rehab of my husband after his knee ops would have gotten me feeling confident a lot quicker.

What I am trying to find out is long term issues associated with tpf's. In the winter here I get bad knee pain. Went for a walk for an hour and for two days I had pain and a limp. In the past if I do too much my knee occasionally gives way with associated pain but the next step feels fine. I play Floorball in summer ( think a mixture between field hockey and ice hockey) so need to run but just can't keep up the fitness over winter.

Other than taping my kneecap whenever I run, I now have to tape the same ankle as it was overcompensating for my knees lack of stability.

Has anyone been told they will need a total knee replacement in the future? How long down the track?

I was also told not to put weight on while you are nwb as it will be harder/hurt more to walk again.

[scjohnson07]

Haha soonerstacy I'm glad I'm not the only one. I think it's the interesting things/people horses attract.

[skiette]

Hi TPFers

Week 14 for me. I've been walking a mile or so and using ski poles on uneven ground. Feels pretty good, though lots of clicks and tingling. I really don't like the feel of metal in me and I know it's way too soon but I wondered what others have done about removing it.

Is it recommended? How soon after having it in does it come out?

Thank you all so much for all the valuable input here.

[csmart2323]

BAM BAM, i hear ya on your butt hurting from sitting so much. My lower back hurts from sitting so much and from having my leg in an immobilizer brace. I broke my tibia about 6-7 in. from the knee cap. I also tore my LCL and tore my ACL. I have read that it is common for the meniscus to be torn, but I did not cause injury to my meniscus. I tore my LCL and ACL. I have not been able to find if those two ligaments to be torn?

[Gav29]

Hi, suffered a tibia plateau injury on 6/23/12. From what i picked up from surgeon, i shattered the lateral and fractured the medial. Had surgery on 6/25/12, with plate and screws. They were going to use an external fixator but didnt have one big enough as leg was very swollen. After surgery, in hosp for 4 days due to swelling, with few sessions of 40 degrees ROM on knee bending machine but cast on since 6/27/12. From reading post, getting a little worried about ROM of knee as am still in a full leg cast. Due to get hinge cast on the 7/18/12.

[greg33]

Started "weight bearing as tolerated" on July 12th. At first it felt really weak....like my knee wanted to buckle. But other than that I really don't feel pain....just feels different/weird. I've been geting a little more ambitious with the amount of weight I'm putting on it. Today I put a pretty good amount of weight, at least in my mind it felt like a lot. Just don't trust it. Still a good amount of swelling in the knee and ankle. I'm surprised how much trouble the ankle has been giving me considering I didn't injury the ankle.
Got on the exercise bike for the first time. I lack the ROM to go all the way around but the pt had me go as far as I could go front then back and hold it for a good stretch. Felt good. Can't wait till I can get all the way around so I can maybe start getting a cardio workout.

[seanwieland]

Hi All,

I just got back from vacation, a bareboat charter vacation in the BVI's. I was apprehensive before leaving because I was still using a cane, and the idea of being responsible for a 41' boat (and my family) was a little unnerving. Because you can't use a cane on a boat of that size, it was stowed when we got on the boat on 7/4. And it hasn't been used since! I continued working on my PT, and it was sore a bit, but all the motion/exercise I think helped!

I am just past 12 weeks, have been FWB for almost 2 weeks. The more I use it, the more it hurts, but ice helps. I was measured today at 145 degrees flexed, -3 degrees straight. The pain is more sore than anything. no pops, clicks. I'm going to get back to 100%, I know it now for sure!

Good luck to all!

Sean

[Dgw3369]

Skiette about the removal of the hardware it's also very uncomfortable for me too. It's the only thing that hurts in my knee occasionally. I too want it out when I can. When I was at my last os visit when he told me everything healed and could fwb, he said the hardware is doing nothing anymore now that the bones are healed. So basically could come out now if I wanted. But going threw surgery all over again so soon doesn't sound fun to me. Also I heard you lose more range of motion and it takes a week to start walking on the leg again. I'm feeling great now and just starting to beat this injury so not looking to go backwards any time soon. Maybe in a year I'll have it removed cause it does cause discomfort and when bumped on the exact spot a little weird.
Update on condition of my knee ( tpf) around 15 weeks post op and 3 weeks fwb. Yesterday I went on a hike threw the woods, over rocks and fallen trees, down steep loss terrain and my knee held up great! It was a 9 mile hike in total, non stop, that took 4 hrs for me to complete. I have to admit going down hill where you have to slow your momentum is still a little iffy along with going down steps and alternating legs is too. But getting better every time I do them. This is the only things I need more strength in my leg to do without fear or worrying the knee will give in. I'm regaining the extensive muscle loss in my thigh a lot at this point. I try to walk at least 3 miles a day to rebuild it. It's probably about 75 percent of the size it used to be. Keep up the great work everyone and push threw it! Let's beat this together!
Week 14 for me. I've been walking a mile or so and using ski poles on uneven ground. Feels pretty good, though lots of clicks and tingling. I really don't like the feel of metal in me and I know it's way too soon but I wondered what others have done about removing it.

Is it recommended? How soon after having it in does it come out?

Thank you all so much for all the valuable input here.[/QUOTE]

[peaton]

I have a similar injury as yours, with a few differences. Also fractured knee cap and 2 fractures down the shaft. Injured on 5/23 & had surgery on 5/30. Wasn't told I could start any ROM until 6/28. At which point I had already started on my own when my brace was off. I don't suggest you do this, it is just what I could do without any pain and thought waiting that long to flex was going to be a huge issue. So you are already ahead of the game, don't worry too much. Also, my bone grafting for the shattered lateral side dropped down and didn't hold, so I no longer have a smooth surface. With me flexing he is hoping that the scar tissue and gel'd fluids will fill in, build up, replace some of the meniscus damage to where it won't be so painful to walk. So on the flip side, I may have slid myself backwards by flexing too early. Be careful, don't push it even if you feel you can, do what your OS says. Main thing is stay positive, hard to do with this injury.

Hi, suffered a tibia plateau injury on 6/23/12. From what i picked up from surgeon, i shattered the lateral and fractured the medial. Had surgery on 6/25/12, with plate and screws. They were going to use an external fixator but didnt have one big enough as leg was very swollen. After surgery, in hosp for 4 days due to swelling, with few sessions of 40 degrees ROM on knee bending machine but cast on since 6/27/12. From reading post, getting a little worried about ROM of knee as am still in a full leg cast. Due to get hinge cast on the 7/18/12.

[vaper]

since no one answered my last post, i'm gonna ask again. does anyone know any strengthening exercises for the foot and ankle before fwb? would really appreciate it!