Tibial Plateau Fracture Recovery

[marnyonthemend]

I found this forum in the wee hours this morning while trying to figure out if the severe pain in my leg was due to a clot forming or because they had repositioned my brace yesterday to 30" to allow some bend in my knee, I believe it was the latter! I am two and a half weeks post surgery following a skiing accident in Utah on the 13th of February. I fractured my TP and Fibula, but the TP was a closed fracture and the bone was pretty much shattered.. I elected to return to DC to have surgery here and my surgeon and his team seem to have done a pretty good job. I have experienced what I expected pain wise pre and post surgery, but have been trying to reduce the pain medications over the last week. I started out on Oxycodon and then Hydromorphine straight after surgery for about five days and then back to Hydrocodon and Celebrex. For the last few days I am only taking Hydrocodon at night and a muscle relaxant and Advil during the day and was doing okay with that, until last night - For the first two weeks post op, the leg was kept straight and elevated. I have seen my Orthopod twice in his offices since I left the hospital and yesterday I had the staples removed and they repositioned the flex on the brace.. I was fine with the discomfort and the aches which I presumed to be normal - that is until about 2 a.m. this morning when I woke up in extreme pain in my knee that was radiating up into my quads. It became worse as I moved and when I sat on the side of the bed and reached for my crutches, the pain was so intense I passed out.. My husband was sleeping in with one of the kids , but woke up when heard me, luckily I passed out on the side of the bed and didn't hit the floor but cleared the bedside table of the water jug and glass. Has anyone experienced this sort of reaction to repositioning? I have read a fair amount of posts up here but didn't come across anything specifically related to repositioning of the cast?

[skiplct]

Hi All- I cannot find a post from a user named Altrunner that 2 people have mentioned and priased. where is it? What date posted? What page? Was it deleted by the poster?

Thanks,

skiplct

[debrobinson1205]

I broke my tibia plateau on 01/26/13 while skiing and had surgery on 01/30/13. Wednesday marks 6 weeks post surgery and I have a doctor appt on Tuesday. I was hoping to start weight bearing but after reading several posts on this forum it sounds like i may not be weight bearing for a while. I have been putting in an hour a day on the exercise bike with zero resistance and doing 40 minutes of leg lifts per day for the last 4 weeks just like the doctor ordered. I have very litle pain and rarely take a vicodin or percocet. I am 56 yars old. I guess I should plan on being non-weight bearng for another 4-6 weeks? I travel for my work so I am not able to work until I can run around airports at warp speed. any suggestions?

[Rider155]

I had my TP fracture April 13, 12. I was I a car accident with an open ulna fracture with 7 torn tendons which I figured was the worse injury of the 2. I had surgery the next morning and they installed a plate and about 14 screws Not much pain in my knee as I had broken my knee when I was 12 and have had 2 ACL surgeries in the past 5 years ( all on the opposite knee) which all seemed much worse than this. My TP surgery seemed to go well and I continued to focus on getting my hand to work again which was going real slow and it had me worried. I was able to move my knee fairly quickly and had minimal pain from about 1-2 weeks after. Any pain I did have seemed to be from the brace being out of place. About a month after surgery I thought I would be weight bearing which was not the case. This is when the Dr enlightened me on the severity of my injury. I started reading about it and found this forum which frankly scared the heck out of me. I too traveled a lot for work by air and had to learn to crutch it as I was on crutches NO WEIGHT for 3 months. Once off I was walking and riding my bike. Now nearly a year later and I went for a 3 mile run with no limp or pain! I ride my mountain bike at least weekly and it feels good. I have even crashed on it once or twice with no ill-affects. I guess I'm now waiting for the discomfort from the plate and screws to set in to make me get them taken out, but for now it's good. I felt compelled to chime in on this forum since I was so bummed about the injury and reading everyone's comments but thought this would give some of you hope, it does get better.

[debrobinson1205]

Thanks Rider155. I see my doc today. Wish me luck.

[skiplct]

Mostly to all my friends from this site from summer and fall: I have stopped posting to and tracking the forum, mostly because my status is so much more compromised than others and I don't want to depress you lovely people who were so supportive to me in the ultra-crisis months.... and honestly I don't really want to read more posts about "running 3 miles with no limp or pain", or doing "an hour on an exercise bike", or "running at warp speed around airports" for people lucky enough to be employed. I've seen the mentions of the Facebook site but I don't have a FB account and don't want one. If there is anyone else out there who is, like me, still carefully planning your trips to the supermarket, pet food store, bank and other errands to minimize steps-- after 35 years of running 6 mi/day before fracture-- and who never take 1 single step from the bed to the toilet without thining about it and steeling yourself for pain, and who have zero support network-- please know that you are not the only one who isn't mountain biking, jogging w/o pain and minimally "bothered" by your hardware. God bless all of you. and best wishes to all.

[Mxs45]

Fractured my tibial plateau in Jan but avoided surgery. I'm now in PT' getting pretty good range of motion, 50% weight bearing. I really want to quit wearing the brace--especially at night--just can't get a decent nights sleep! PT thinks I will be full weight bearing in two weeks. Right now, still on crutches, still have some swelling, stiffness and MCL pain.
Any potential repercussions to stop using the brace at this point?

[debrobinson1205]

Well, I saw the doctor yesterday and I can start weight bearing. 25% to start, if that goes ok for 4-5 days, then increase to 50%, if that goes ok for 4-5 day etc.... til 100% weight bearing. I see the doctor in another month. Today marks my 6 weeks post surgery. I am so happy to be progressing. Hope to be back to work in 6 more weeks.

[sjewett33]

In 2009, I had a lateral tibial plateau fx while skiing in Durango. A plate, 8 screws, 8 weeks NWB later, and 6 weeks of PT later...I was pretty good. Unfortunately, I could not flex greater than 95 degrees so I had to have a manipulation under anesthesia (MUA) in order to regain ROM. 1 year later, I had another surgery to remove the hardware since the screw heads were causing issues. I still have some weakness but I am able to ski (a lot). For those of you recovering, hang in there...it will get better. As I tell my patients, (ironically, I am a PT) it is marathon, not a sprint.

How soon did you have the MUA? I am at 10 weeks post op. Stuck at 90 for the past several weeks. I was immobilized in full extension for 4 weeks. No ROM. Per the OS this was due to the severity if the fracture. Although, he cleared me for PWB at 6 weeks. I have an avulsed ACL and torn medial meniscus. The plan is to go in and scope and MUA if I don't get moving in the next 3 weeks. I am anxious to make progress, but seems like many people do not go back in quite so quickly. I do not have a lot a faith in my OS and am seeking a second opinion.

[itsdeenah]

So sorry I havn't been on here in a while and hope you are doing ok. My 2nd. surgery was orthoscopic and the OS removed pretty much all my meniscus or cartilage it was ripped and torn sticking inbetween my knee joint. He also removed scar tissue that was built up and shaved down my bone graph. I still don't have over 110 degree ROM but that aweful pain is gone. Hope you are doing better

Date of Injury 4/20/12
Surgery 4/27/12
Type IV TPF with 1+" communited depression of the plateau surface
Fracture of the Tibial Shaft
Shattered meniscus
Torn MCL, ACL
2nd. Surgery 12/4/13
Orthoscopic Removal of meniscus
Removal of scar tissue
Shaved down bone graph

Hey itsdeenah,

Thanks so much for replying. Im really in heaps of pain and just keep getting told by my PT that its a muscle imbalance or i need to back off a bit on the exercises, but even when i back off it doesn't get any better. Im so frustrated cause all seemed to be going well and then this pain... i feel like im going backwards. I'm absolutely going to request a MRI. I've done everything they have said to the T and its getting worse everyday.
Physio has me taping my knee cap to the medial side (inside) of my leg cause she says my pain is from the glute muscle being weaker on the inside of my leg, pulling my kneecap out of track but tapping doesn't seem to be helping.

itsdeenah you had a 2nd surgery for this right? Can you tell me what they did in the surgery, time frame for your recovery and how you feel now etc.
Thanks again for your reply - i was feeling a little discouraged and a bit hopeless

[fncrutchesrnofun]

I am now 11 weeks out from my tibial plateau fracture and partially weightbearing for the last week and a half. Extension seems to be stuck at 4-6 degrees. I saw a chiropractor friend of mine who I have seen in the past for chronic overuse of certain muscles for running. He specializes in active tissue release. It helped tremendously and I am currently at 0-2 degrees! I highly recommend this technique for chronic muscle/tendon adhesions due to over or under use. Definitely consider if you are stuck with flexion or extension. Beats a manipulation under anesthesia!

[Marianaope]

Hi! I am so glad I found this site... I've found lots of answers to my questions and concerns!
My story: I'm 24 years old, I got hit by a car on Feb 9th while crossing the street... My femur bone entered into my tibia bone fracturing the plateau (1.5 cm depression)...I needed one external fixator for three days and then a second surgery where they added one plate and 9 screws. I am now 5 weeks post-op, going to PT twice a week... I have full extension and I'm at about 95 degrees flexion. My doctor said I need to be at 110 degrees by mid-April so I have 4 weeks to get there. I still cannot bear any weight until the first week of May. I am using crutches for now...
I got an MRI done one day AFTER my surgery to see if there are any damaged ligaments...bad decision from my doctor since the image was very difficult to read since there is already a plate in my knee.... so they think I have one damaged ligament (exterior), which could heal by itself...otherwise I will need a third surgery to repair it, later on...doctor will let me know on my next follow-up on April 19th.
It is such a long process!!! I was working full time and doing my masters part-time before this happened...The hardest part of all this is that you go from having an active lifestyle to not being able to do absolutely nothing by yourself, it's so frustrating! Luckily I have lots of people helping me out! my boyfriend is able to work from home to stay with me...and my parents take me to PT whenever I need to go... According to my doctor I should be able to go back to work on June 1st, the main problem being that I have to walk about 15 minutes and take the subway to go to work, so I need to be able to go up and down the stairs by myself...we'll see how it goes!!

[justathought]

Just a quick update. Type IV ..... Nov 2, 2012 injury, external fixator for one week, ORIF nov 9. PWB January 7, WBAT Feb 9

As of Thursday march 21 FWB.... Still using cane first thing in morning and late at night... Still limping, but its getting better, still walking slowly....but it's coming

[Pierced11]

I had a Tibial Plateau Fracture over winter break on the 12th of January. My surgery was on the 24th of January and I have 9 screws and a plate now in my leg. I've been going to PT and am still on crutches. My doctor said there is a possibility I may get off crutches in 3 weeks on the 15th, I'm ecstatic. I'm currently in college and it's been a very difficult semester. I try not to get too depressed and can't wait to be walking again. If anyone out there is in college, I need a little support

[Pierced11]

Helpful tips to others- Such awful constipation after surgery… I recommend Miralax

[acwheel]

Hang in there you will recover. I'm not 24 or in college, but I can offer some encouragement. I broke my TP in November of 2011 while Skiing, shorting a jump and landing flat, something I should not have been doing at 48 years old. I'm very active and enjoy mountain and road bike racing, trail running, dirt bike riding, skiing to name a few. I was back on my road bike riding outside after about 6 weeks, my quad and calf muscle had atrophied severely, yes I was riding my bike before I could really walk and bear weight, but I was cleared by my OS. After some hard work I have full range of motion and can do every activity I did before, except trail run, because the hardware bothers me, it's not severe just irritating and needs to be removed. In two days on April 3rd I'm going in to have the plate and 6 screws removed.

The best rehab for me was cycling, I set some goals and starting riding in January of 2012 and by late May, I was racing my mountain bike again, then by August, after qualifying, I raced the Leadville 100 mountain bike race placing 101st out of about 2000 starters, nothing to brag about, but I felt I had made a full recovery.

Crutches suck!!

[Scarr78]

Has any one had scar tissue issues under their kneecap? My knee cap feels like it is grinding across something. You can hear it and feel it. It us not too painful but it makes walking and ROM under pressure difficult. It's making Pt really difficult. Any ideas?

[Marcos_88]

I had my tibyal plateau fracture on 6th march in a very stupid motorcycle crash ... at a very low speed ... After i fell down i thinked that i`m ok and i tried to stand on my leg ... bad decision.
I was rushed in hospital and the next day i was operated. I have now two big cuts on my leg, about 9 screws and a plate. My doc said it was one of the worst fractures he had in months, both condyles broken and also few more pieces in there broken . And if that wasn`t enough i also made a deep vein trombosis that made almost impossible for me to get out of the bed for the first 2 weeks post op (even with crutches, ofcourse). I was 12 days in hospital with lots of pain all day.
Now i`m at 5 weeks and a half post op and i`m doing a lot of rehab all day. I`m doing 90 degrees easy if i warm up the leg (my doc said not to go over 90 until he checks me up again), i still have some pain in the leg but not very much. The thing that bothers me mostly is my sleeping position ... only on the back.
Anyway, what i wanted to ask, if someone experienced the same thing ... for about 3 or 4 days i started to feel in my leg when exercise something like a click just under the knee, maybe where the pattelar tendon inserts into tibya. I asked other people to check me up and they do feel that click, very slighty, but they feel it. It is not painfull, but it disturbs me. Anyone else had the same sensation ?

[Scarr78]

Marcos_88 I feel that same thing! Mine is a bit more grinding but that is exactly where it is. It's not all that painful but it gets in the way and it sorta stops my knee cap from moving. Mt PT thinks its just a combo of scar tissue build up and tracking issues from muscle atrophy. My OS is a couple states away so I haven't been able to talk to him. I wish I could tell you what it is but I can tell you that I feel it to. Let me know if you learn any thing different. Good luck healing!

[Thedude1]

haven't posted in a while: Here's an update:
Type ll. lateral TPF. ORIF on 12-3-12 with Plate and 8 screws and grafting and torn meniscus.
Declared myself FWB on April 4th. ranging -3 to 160 actively. Used a cane for the first day but was not impressed so i ditched it and walked to the gate and back, felt so good decided to climb the staircase (3x) since then, activities have included a 2 mile bike-ride to the river and back (where i won a bet that i couldn't cross the volley ball court sand) and walking a couple miles down the beach yesterday. Going back to climbing this week. think i'll do a cartwheel next week. Oh yeah..it is ON! There is life after TPF!....

[Thedude1]

Has any one had scar tissue issues under their kneecap? My knee cap feels like it is grinding across something. You can hear it and feel it. It us not too painful but it makes walking and ROM under pressure difficult. It's making Pt really difficult. Any ideas?

you can break down the scar tissue and adhesions with manual massage. don't be afraid to dig your fingers and thumbs in there unless your swelling up, this hurts like hell but will make valuable space for the chords to stretch to capacity and improve patellur motion and ROM

[Thedude1]

I had my tibyal plateau fracture on 6th march in a very stupid motorcycle crash ... at a very low speed ... After i fell down i thinked that i`m ok and i tried to stand on my leg ... bad decision.
I was rushed in hospital and the next day i was operated. I have now two big cuts on my leg, about 9 screws and a plate. My doc said it was one of the worst fractures he had in months, both condyles broken and also few more pieces in there broken . And if that wasn`t enough i also made a deep vein trombosis that made almost impossible for me to get out of the bed for the first 2 weeks post op (even with crutches, ofcourse). I was 12 days in hospital with lots of pain all day.
Now i`m at 5 weeks and a half post op and i`m doing a lot of rehab all day. I`m doing 90 degrees easy if i warm up the leg (my doc said not to go over 90 until he checks me up again), i still have some pain in the leg but not very much. The thing that bothers me mostly is my sleeping position ... only on the back.
Anyway, what i wanted to ask, if someone experienced the same thing ... for about 3 or 4 days i started to feel in my leg when exercise something like a click just under the knee, maybe where the pattelar tendon inserts into tibya. I asked other people to check me up and they do feel that click, very slighty, but they feel it. It is not painfull, but it disturbs me. Anyone else had the same sensation ?

clicks and pops are perfectly normal at this stage of healing when the weaker muscles and chords are being overcompensated by the stronger ones. i would advise that you seek out any pain or weakness (OUTSIDE of your incision area) and push it to the limit to re-stretch and strengthen the supporting mucles from hip to toe. (this hurts like hell by the way, it's supposed to, suck it up) i say outside the incision area because that area has likely not re-gained enough sensation yet to remind you that your pushing too hard but will let you know by swelling. when your not doing that, elevate as much as possible. rest and recovery time is crucial...good luck brother

[Nurse Nina]

It's been a while since I last posted. I fractured my right tibial plateau on 3/11/12 in a ski accident last winter. At 48-49 years, I did pretty well over all, but felt I wasn't progressing after the 10 month mark. I still have a slight limp and can't go down stairs without landing hard on the opposite leg. I have almost full flexion in my left leg and could just about sit on both heels but only for about thirty seconds. Considering I had done yoga for years and was very flexible it wasn't where I needed to be. What bothered me most though, was that I couldn't sprint or get lift in my right leg when I tried to jog. The anterior tibialis muscle would swell and get irritated whenever I tried. More than likely it was the hardware getting in the way.

So now, I am 4 days post hardware removal and 25 stitches later, have a swollen and bruised right knee and leg. It in no way compares to the pain of the fracture and what I went through in the first 6 months of recovery. After 6 months of PT I had 0 degrees of extension. Now, I already feel my knee able to get back to the negative extension I have in my left leg. For those of you considering it, you first have to wait a year. I can't do any kind of twisting moves, or high impact exercises for at least 6 weeks. I am at risk for refracturing where the eight holes are from the screws that were removed. I am taking extra- strength Tylenol for pain, and will be back to work on Monday. I will keep you all posted on my progress. This type of fracture is a 1-2 year healing process and we have to be patient.

[NORTHRONA]

Not sure how to input this! I am 56 and had accident on ornamental bridge in back garden on Christmas eve 2012. Surgeon described it as horrific injury!
Had 7 hours of surgery and Christmas and New Year in hospital (try and get a wine list!) and have gone from full cast to now weight bearing and walking on crutches and getting out of the house. Up stairs to own bed, in shower, in to car, what a relief after bed pans. Also had 21 huge liquid filled boils on leg after cast removal which set me back 3 weeks until I could start Phsio.
Lucky to have no pain, but leg feels like it is not mine at times. Next milestone is to drive - any ideas of timescale? Not a skier but grateful for this website. Good luck to you all.

[SoccerGirl]

It's been about a year since I've been onsite... (Nurse Nina I think I remember your posts! Glad to hear how you are.) Thought I'd provide an update, maybe let some of you know what to expect at 14 months. My TPF occurred Feb. 2012. I am sooo much better, but still not able to play soccer. If I try to kick with any force, leg just does not feel good/stable and it scares me -- the ankle, the knee, the metal, everything. PT says there's a bit too much laxity in the knee joint (from side-to-side). But I can do lunges now (though not as well with injured leg), which is exciting -- was impossibly painful for so long. The MCL-area pain has greatly subsided, but took over a year to do so (until recently i was unable to sit cross-legged at all, etc). I can't really sprint still (when I try it's esp. my ankle that feels very unstable/weird...), and I still am reminded regularly of my injury (stiffness, pain) if I twist too much/ for too long in a certain position or something...

Leg still a whole inch smaller in diameter -- so strange, considering PT strength tests say my two legs' strength is pretty even now! (Has anyone else found this i wonder?)

Skin still mostly numb in that whole fracture area -- too bad cuz was told if it's not back within a year it's pretty much over. I do on rare occasion get weird nerve pains/ sensations in that area though. Maybe there's still hope!

Really want to get the hardware out and plan to meet surgeon soon to discuss. For one thing it looks bad -- esp. this large, weird bubbly pouch/lump at the bottom of my scar, which docs say may be just the muscles coming off the plate or something. I just don't like having metal in me, even though it doesn't cause me certain physical pain really. I have hopes i'll be able to sprint and kick balls better without the weird feeling of the metal clanging around (that may be psycological i know!)

I was told that during removal, screws might break off and then you can't remove it anyway, which is scary... (sounds like someone above had something like that happen!) I'm very nervous/ afraid it will overall hurt me more than help (hardware removal), but it sounds like many have had positive results?