Tibial Plateau Fracture Recovery

[bryce73]

Hello everyone,

I'm glad I found this thread! No secret why I'm here, I had a PTF a week ago (30/8) while MTBiking. What happened is I lost my equilibrium while I was on a narrow mountain track with a very sharp edge and rocky ravine at this place, which made me go off my bike and fall into the ravine, stopping falling a few meters below. In my fall I had the bad reflex to straigthen my leg in order to protect my left patellar tendon which was just recovering from a recent cut, which made the thighbone impact the shin (didn't know that at the time). I had to be rescued by helicopter and transported to the nearer hospital where I had X-rays and CT scan which revealed PTF. The young doc there said it would need surgery which made me feel devastated as I had struggling for one year to recover from two precedent injuries and was just about to enjoy sports again.

Exams revealed I had a spiral fracture minimaly displaced associated with a tear of the tibial spines and a multifragmentory fracture of the posterior part of the lateral PT. I had surgery on the 3/9 and the fracture fixed with a plate and 6 screws (pain was just bloody hell). Nonetheless, my OS said it wasn't that bad as the soft tissues weren't touched and the posterior fracture situated behind the meniscus. Still, as many here I'm quite worried about how I will recover, mostly with the flexion of the knee. Having working hard during the last 4 months to recover from my RPT, I know it sometimes possible to fully recover but this injury seems to be a pretty nasty one. Anyway, I'm pretty willingful to do the best I can to recover.

Before leaving the hospital, a PT advised of exercises I have to repeat troughout the day (some of them each hour) in order prevent a loss of flexion, due to the immobilization (NWB for 2 months and leg in a zimmer splint). I think this is very important, also with appropriate nutrition.

Just a few questions in case anyone had some insightful infos that might help me :

How about bits of bones left in soft tissue? part of my rear's lateral PT had been smashed up into pieces left in the flesh. Due to their locations (on the inside/rear part of the knee), I'm a bit afraid they may bother with the flexion of the knee, or the flexion hamper the healing of these small pieces of bones? Any thoughts or experience on this?

Due to the surgery, I have a pretty big numb area situated on the foreward and little external side of the tibia. It gives a rather unpleasant sensation, as if you had a "hole" or a piece of numb wood stuck into your leg. Doc said it was the incision for the plate that cut some terminal nerves and it may come back but very slow (growth of 1 mm/year for a nerve). Has anyone also had issue with that? had did you manage with it? did you recover some sensations?

Thanks,
I wish you all good luck!

[nessle]

Hi Everyone,

I have been looking in the internet about Tibial Fracture and found this .

Im Thea, 22 years old , Phl.

Unfortunately, I had a motor accident last November 18 . My brother was driving the motorbike and Unfortunately we didnt notice the oil spill along the road because it was dark and there is no sign at all.

My brother is ok but My left knee is not.

The Xray shows Fracture of the Tibial Plateau

But the MRI says more
1. Comminuted Fracture of the Proximal Tibia including Tibial Plateau with subtle depression of the subarticular fragments

2. grade II meniscal tear, posterior horn of the left medial meniscus

3. thickened anterior and posterior cruciate ligaments

Now , I undergone a surgery last November 23, According to my Ortho he stitched the meniscus and put a plate and screw on the fracture.

However The doctor said there is a gap between my tibia and femur that suppose to be need to have a bone graft but since My doctor and myself is not prepared for it , he didnt do the bone graft. and also to prevent infection since I was exposed in the OR for couple of hours.

He said since Im young let us see if the bone grow and if not I will undergo Bone graft if complications occur.


Im quite devastated because I cant go to school anymore for this semester and I have difficulty doing things like sitting and going to the Comfort room.

Now I feel pain if I try to sit . I always need a support for my back..

I will meet my PT on December 1 for some strengthening exercise for my right leg and to instruct me how to properly used the crutches non weight bearing.

I feel like my world fall apart or Im just to overacting .. hehe.

[corky7]

Just thought I'd update any readers .
At 11 weeks since injury and subsequent op, I impressed the surgeon by showing I could walk without crutches so they were handed back !!
At that time I pointed out that there was a sensation in my knee that felt like something catching, it was what I had suspected , the tendon rubbing over the surface of the plate and screw heads. This should, I was told, ease off, sure enough it did.
I continued with my physio and saw the surgeon again at 4 months, he was delighted with my progress and suggested no further checkups for 6 months.
I got a bit carried away and although I didnt try running ( I knew I couldn't ) I was cycling up to 30 miles on a few occasions, as cycling doesnt put any impact on the joint, however what I failed to realise was muscles further up my thigh just wern't up to what I was asking of them, after the long layoff. I had been given a different physiotherapist as my original one had been seconded to another post and my new Physio was not best pleased with the way I was dealing with recovery (way ahead of myself basically)
She said that all the leg muscles had to catch up in order to support my leg properly and that over burdening them to cut corners was not an option...basically you can't cheat time on returning the muscles to the right strength , so I was put back to basics with the addition of a 1kilo weight on my ankle for leg raises, squats with chair to support and step ups , even today at 6 months she has said just increase weight gradually over next six weeks or increase reps ( usual stuff)
I just walked about 4 miles on a muddy, undulating cross country path and slipped a couple of times, yep a little pain, but my physio says build strength and the confidence will return. I need to lose quite a bit of weight that I have put on since break, but hopefully as I build up the activity levels that wont be a problem.
So main lesson here is be patient and build things gradually or your body will complain!!!

[CollinWheeler]

Can I go on a rant?
I'm going to go on a rant.
I am a 23 year old lifelong skier.
Moved to Driggs, Id in the spring.
Working for Habitat in Driggs and TGR on weekends
12/18/15 skiing at the Ghee. I was out skiing with my roommate, super heavy snow, skiing pretty slow. Went to set a turn and my left ski just kind of "stuck" and I went OTB.
Heard and felt a "click-click-click-click", landed on my feet and couldn't put any weight on my left knee.
Skiied to the bottom via cat track and could barely get out of my binding. Couldn't even think about standing or walking on it.
Went home for the day, went to ER next day for X ray.
Insurance wouldn't cover MRI, so I drove over to a Jackson few days later and said it happened that day.
Took a CT scan and found a tibia plateau fracture.
I'm still under my parents terrible insurance, so I'm out of network out here and I have to travel back to Michigan for surgery.
So 4 days ago I find out that I am also being kicked out of my condo because it was originally built for "family housing" and the HOA has decided to enforce that again.
My roommate and I have no violations or complaints, get along with our neighbors, who are on the HOA board.
We were told we need to be out by 1/15/16.
So now in the midst of having a Tibia Plateau, I'm still 2 weeks pre op, I have to vacate my home and find a new place to live.

I can however put weight on my hurt leg, walk on it with a crutch, and bend it quite a bit.
I am in a thigh high knee brace though.
Sorry for the sob story, just havent slept in about 4 days.
Here is my x ray for your viewing pleasure

[kyates8]

hey guys,

is it possible to overdo it when finally walking again? I got clearance to full weight bearing a week ago, and was feeling so great - no pain - so I overdid it.. probably walked a few miles the other night... and now there is pain inside my knee! Could I have screwed something up? Or is this just inflammation from overdoing it?
thanks!

[m93b53]

On 1/10/16 I had a fall at work and wound up with a TPF, full ACL tear, MCL tear and a lateral meniscus tear. On 2/19/16 I got surgery to repair the fracture (2 screws and bone cement), a new ACL, and had the meniscus cleaned up.
I am non-weight bearing for 2-3 months, have started PT and am on a CPM machine for 6 hrs a day currently. I have been speaking with my physical therapist and orthopedic surgeon about using an EMS/NMES unit for rehab. My goal is to prevent any further atrophy, get some strength back, and minimize my time from being able to bear weight on my leg to being able to get back to work and play.
At this point both my ortho and PT think it would be beneficial, and I have request in with workers comp for a home machine. However, neither my ortho or PT have a whole lot of insight into what machine would be a good choice. After some research I'm tempted to just go buy a Compex sport elite, but there is not a lot of good information about these things ou there.

So, I'd love some input on what machine to get, and how well they worked for ties who have used them.

[bourbonisgood]

I am non-weight bearing for 2-3 months, have started PT and am on a CPM machine for 6 hrs a day currently. I have been speaking with my physical therapist and orthopedic surgeon about using an EMS/NMES unit for rehab. My goal is to prevent any further atrophy, get some strength back, and minimize my time from being able to bear weight on my leg to being able to get back to work and play.
At this point both my ortho and PT think it would be beneficial, and I have request in with workers comp for a home machine. However, neither my ortho or PT have a whole lot of insight into what machine would be a good choice. After some research I'm tempted to just go buy a Compex sport elite, but there is not a lot of good information about these things ou there.

So, I'd love some input on what machine to get, and how well they worked for ties who have used them.

EMPI Phoenix if you can find it (DonJoy has recently eliminated the EMPI brand). Very easy to use and will perform the two functions you have mentioned.

[m93b53]

EMPI Phoenix if you can find it (DonJoy has recently eliminated the EMPI brand). Very easy to use and will perform the two functions you have mentioned.

Thanks,
you're right that would have been a good choice. That's too bad about them doing away with the Empi brand. That knocks a couple units off my list.

[m6cae3]

Hi, I had an accident while horse riding, which unfortunately ended up with me in hospital, undergoing an operation to repair fractures to both tibial plateaux. I now have a large screw type pin in one knee, and in the other, a plate and screws. I started knee flexes with a machine the 2nd day after surgery, and PT shortly after leaving hospital. My six week check up with OS went very well, and I started crutches at 10 weeks. I still have fluid on both knees, which becomes worse the longer I am upright, and I get tired very quickly. I spend around 25% of the day walking with either special walking frame or crutches. I put ice on knees 2/3 times a day to keep swelling down. I know it will take longer to recover from injuries as both knees were damaged. I wondered if there was anyone else who had the same problem, that is both knees fractured, and how long did recovery take?

[m67798]

Hello everyone. I'm trying to find some answers to a few different issues that I haven't found elsewhere. I skimmed through the forums here, and it seems I have found at least a few people who may have some answers. I've asked my questions to every doctor I have visited, and a few more. None seems to understand my question, or tune out and assume they know the entire question before I am done asking it.

I'll start out by saying I used to bike quite a bit more than in the last year. I used to average 26-40 miles a day, and when unemployed, I would ride on my trainer and manage 180-200 a day, while playing video games. I decided to attend school for a third time, and a fourth degree. I guess I just get bored quickly. Anyway, the trip to Platteville was where it all began. Unfortunately, it's a bit of a story, and my injury is not related to biking. You can skim through, or if you'd like the details, feel free to read the mini-novel.

I took my placement testing, registered for classes, met with professors, toured campus, and got everything ready to go. I was, unfortunately, required to live in the dorms for a semester. Being 26, it was quite strange. I was placed into a dorm room in a building for students over 21. I was, by 3 years or more, the oldest there. I got unpacked, and settled. I met a few others who had moved in, and they were all going to the local bars, to get the feel of the scene. They asked if I wanted to go along, and so I went. I stayed the most sober of the group - a BAC of .01. I got the group together at bar close and we left. As we passed another bar, a seperate group came out, headed toward a frat house rather than the dorms. The second group began throwing racial slurs toward my group, as there were some African Americans in my group. I stepped between the groups, and pushed mine forward toward the dorms, telling them to ignore the second group. I was trying to prevent an altercation/physical fight. My group continued onward as I walked along about 100 feet behind them. I was walking backwards, keeping an eye on the second group. I came to an intersection, and turned to check for traffic. One guy from the second group shoved me over. I ended up falling, landing on my left knee, and bracing myself with my right wrist to prevent a head injury. After yelling and screaming a bit, I managed to get on my feet, limping the 1/4 mile back to the dorms. My group had ignored everything a bit too well. I got to the dorms, and made it up six flights of stairs. I got to my suite, where my group had continued to drink, waiting for me. I gave up, and decided to call it a night. I managed to get my boots off, but had some issues with my shirt and pants. I tried to climb into bed, but fell backward, landing on all my folded up boxes. I couldn't get back up. I called 911. Ambulance took me to the ER. Xrays and an MRI were taken. I was confirmed with a Schatzker tibial plateau fracture with diaphyseal discontinuity (VI) injury. They were amazed because it appeared I had been struck by a vehicle. They were further amazed, as the injury and xrays showed that the initial impact was over 90% of the damage. The limp basically tore my muscle apart, and allowed some fragments to move about. I was rushed by ambulance to Madison, as the ER in Platteville had no orthopaedic specialists. I was immediately rushed to surgery in Madison, as I had compartment syndrome, to the point my skin was starting to split. Long story short: two major surgeries, external fixation system, two weeks in the ICU, and a Long battle with aftercare. The wrist has 7 screws and 1 plate. The knee has at least 21 screws (I say at least, because the angles are not the best on the xrays) and 3 plates. I was told that I was very lucky, that someone "upstairs" must be watching over me. They had already booked me to get the leg amputated, from mid-thigh down. The surgery who looked at my leg "knew a guy" and had me sign a waiver from the amputation. They flew a doctor in to fix my knee.

So, now that a large part of the story is out, it is time for a few questions.

Has anybody here had foot drop aftercare their surgery? If so, what did you do for therapy? I've been doing anything I can find on the web in addition to my doctor's recommendations. I do his excercises every other hour, and it is only getting worse.

Has anybody here had significant nerve damage due to their injury or surgery? Before the surgery to fix the knee, I had full feeling in my foot and leg. After, I have feeling down one side of the leg, but None on the other. I cannot move my foot up or to the left, but can move it down and to the right. Does anyone have ideas or suggestions as to what to do?

Has anyone been stuck with an AFO After a similarly damage knee? If so, did the AFO help, our cause problems? My doctor is pushing hard for me to get an AFO, but I would think that a KAFO might be a better solution, as it will take months, If not years to rebuild these muscles. Any thoughts?

To anyone who answers these questions, thank you. This entire experience has been hell on earth. It would be nice if the doctors understand exactly what I am asking, and took the time to give me answers or find me answers. Maybe they should require orthopaedic surgeons and doctors go through the injuries they fix, so that they can figure out why so many questions and issues come up. My doctor in Madison actually called me a "whiny, bitchy, piece-of-shit crybaby," as I had many problems with my casts. I had swelling issues, which cause the casts to be uncomfortable in the extreme. They never washed the leg or arm before recasting (casts cut off, wounds inspected, stiches and staples removed, and so on and so forth). I had modified a wire hanger, shrink wrapped it about a half dozen times to prevent stabbing/impaling/tearing... and they had told me I had nothing but stiches. Well, the staples tore free.

One of my middle visits, I was dizzy a day before about an hour After scratching my leg. I had managed to tearing out 18 of the 26 staples, and was dizzy due to blood loss. The cast held the blood, and when they began cutting the cast off, there was a "spurt" of blood... about 2 pints worth all over the room. The blood had "scabbed" on the top, but due to the huge amount of blood thinners (I had thrown a clot After surgery), most of it was still liquid. Oops.

Just wish I couldn't find people who understand THIS level of "fun." I hope someone here can help answer my questions.

I want to get back to riding as quickly as possible. Looks like it will be a Long wait, and a very Long time before I am back to where I was.

[m43aa4]

hey guys, I'm 4 months after my injuries. Crashed my dirt bike while racing my brother through some trails up north. Hit some trees at 80, and broke 3 cervicals in my neck, my left femur, my right tibia, my right tibia plateau, my right femur, my pelvis, and my left arm. My left leg is back to full ROM ( 1-145 ext and flex ). My right leg can get to 100 flex but still at 25 extension. My knee cap is pulled to the outside of my leg, Doctor says this is because there was so much scar tissue that it got moved over. I had X number of screws put in my tpf along with a plate, and rods in both femurs. I had a manipulation and hardware removal done. ( hard ware removed from the left leg, MUA done to both legs. ) I am going to see a sports Doctor this week, to hopefully schedule a surgery to get my patella tracking right again. I lived a very active lifestyle before this injury, on the wrestling team for 4 years, ran track for 2 ( 100 meter and high jump ) been racing motor cross since I was 4 ( ranked nationally twice ). Also was kind of considered a gym junkie cause I would go to the gym every day of the week lol. I just wanna know if there is any one out there who had a similar situation that I am in after thier tpf? Other then my knee being out of track, I have made great gains. Am able to ride the bike now, walk while on crutches ( thank god, was losing my mind being in a wheelchair ) and can get in and out of cars, and bathtubs. I'm pushing myself every day, whether it be at therapy or at home with the home work outs, but this right knee seems to limiting me so much. The doc says after the surgery to get it tracking right again, I should be saying gains relatively soon. ( keep in mind they may remove the hardware from my right tpf as well which may help with extension and flex ion ). Doctor says I may not be able to get to full extras tension again but will still be able to live my active life style as before. I've come to terms with the fact of this being a marathon and not a sprint. So I'm taking it day by day, writing music to keep me occupied. I wanna go to college to ironically be an orthopedic surgeon LMAO and I just wanna know if this could limit that? If any one has any advice, or can relate to my situation it would be nice to hear some of your stories, and how you were able to reach the peak of the mountain. Thank you!

[marwaha5]

Hello people
Like most of us here me too stumbled upon this forum in search for tpf recovery
I fractured my right tibia on 4jun16 when a biker fell on me with his bike and my bike all on my leg.
I was operated the next day with a titanium plate and four screws. I was hospitalised for weeks as my fever won't go and for that I got bacteria cultures which was done by opening an incision on the wound. The reports showed no growth but that opening in the wound had to be dressed everyday. It made a hole at that point. The surgeon left it as it is and advised to get dressing to heal it.
For ROM he asked me to extend and flex the leg which i cud do easily after the initial 2-3 days and keep moving my foot. I was nwb without any cast just had my leg wrapped in crape bandage.
So for next 1 month i kept doing that. I had swelling on my leg and foot. The area around my ankle was turned black and I cud hardly move my foot.
During the course of dressings two more holes came up and after a month i had to get the sutures again but that too opened up as fluid was seeping through.
Now it's around 10 weeks post op and still my wound hasn't healed. I'm losing on ROM due to this. My leg can extend to 0° and i can bend it around 100°. The swelling is gone from leg and foot, only little on the ankle and foot remains darker maybe I've not washed it for 2 months. Little pain when I twist my ankle. Pain on outer side of leg near the joint. Sometimes weird shooting pain in area where the plate is. Does anybody else wound took so long to heal?
The calf looks shrunk and there is lots of muscle on thigh as well, the injured leg looks thinner than healthy one.
Also I'm toe touching and surgeon told me to FWB from next month.
My major concern is I don't have access to PT all I've been doing is by searching the internet so it would be a great help if anyone can guide me from their personal experience that what exercises need to be done and how to progress from pwb to fwb
Ive already lost a lot of imp healing time due to my open wound and if I get some info on what pt needs to be done ill be able to recover
Kindly help me out folks.

[MiddleOfNight]

marwaha5:
dang, that's a lot. Apologies for novel.

I am no expert. Take all this with a *boulder* of salt.

My experience: 36yrs, 170#, good health, very active. Early summer I had a tibial nail installed, 2 breaks mid-tibia (don't ask). Internal dissolving sutures and steri-strips on the incisions (stayed for 2 weeks).

Wound healed in 2 weeks. No sign of infections. So, sorry, can't really speak to your wound healing questions.

'My' Surgeon (yep. Mine.) is world class. feedback: A++++, would get titanium sledgehammered from him again!

I was under general (duh), but the results speak for themselves. Plus I like him - he's a good dude, which is oddly comforting and important to me.

I know you said you don't have access .. but IF there is ANY way for you to consult a PT, I can't recommend it enough. It's really helpful. Certainly with timeframe of healing.
I bet one would work with you remotely via email, skype facetime, or whatever, if it's a geography thing (these days they must, right?). Or if you could see one even once to lay out a plan? They could give you lot of good PT for home.

A PT can request the surgery report from your ortho surgeon, and they can work with the surgeon's people to create a recovery PT timeline specific to you, your goals, your injury, your surgeon, and your hardware. I don't think what worked for me will necessarily work for you - our situations, well, they're each a horse of a different color.

'My' PT (mine) is also world class. (A+++++) And I like her. Brought her some crops.

She got with Ortho for the surgery report, and made a big bubble matrix of activities broken out in a chart, showing which exercises/activities I could add each week as the bone/soft tissue healed and weight bearing increases. I saw her 3x/wk for a month, and 2x/wk after. She gave me homework to do at home every day I didn't see her (no equip req'd). My chart goes out 24 weeks, but I won't go that long.

PWB on crutches I started at 30% in a big plastic boot. 30% of 170, 51# ... Good leg on ground, other on the bathroom scale until I got to 51 .. as I hobbled around with the crutches, replicate that amount of weight on the hurt wheel. It went well and I got to add 10% each week.
My loose understanding is that bones heal better with a little bit of graduating load and stress, so gradually adding WB is important.

muscle shrinkage: hard to know, what kind of tissue damage associated with your injury? I did exercises to keep muscles firing without compromising bone repair. unweighted ankle pumps, quad sets, etc. Plus keeping those muscles moving can lower the risk of getting a blood clot. (taking your aspirin?)
You have to expect a little, cause you're not using the hurt wheel like you are the good wheel. My PT was very mindful and I didn't lose much mass. Barely noticeable.

Range of Motion: My main ROM focus was knee, because of how he accessed the top of the tibia. PT gave me some patella manipulation things to do at home to flush inflammation (up down, side to side), and helped show me how to break up the scar tissue with massage and movement. Also massage patella tendon and quad tendon above/below patella (unless open wound is there?). The enemies are inflammation, swelling, and scar tissue. Work them out both through exercises and soft tissue massage. I used a fit-ball a lot to work on ROM.

The reality is that your soft tissue still will heal up faster with some professional help. Call a PT. I can ask mine if they do remote consultation. PM me if you want.

I went 100% WB 4 days ago. Trot in the saddle.
I'm not back to being a total horse's ass yet ... thx to Ortho and PT .. soon.

So look the hell out :-)

Best of luck in your recovery. keep your chin up and never underestimate the power of positive thought.

[WoundedKnee]

Hey folks

Like everyone else, I'm damn glad I found this forum. There's precious little info online about TPF. I'll post my tale and try to follow up as I progress as that's exactly the sort of thing I was looking for here: progress.

I took a bad fall while hiking August 27, 2016. At first I didn't even realize my leg was an issue, since I landed face first on a rock and was far more worried about a skull fracture. Turns out I have a hard head. Tibial plateau, well not so much. It also hit a rock on impact and pretty much shattered. I've got five screws and two plates, and a whole lot of bone cement was used according to the OS, who described it as looking like a ritz cracker someone had stomped on. He wound up calling a knee specialist in during surgery as the meniscus was detached and he had to anchor it. Cartilage was also severely damaged, and he has already warned me about arthritis in the future.

I was in a knee immobilizer for four weeks following surgery, absolutely no bending or weight bearing. Was given dilaudid as a painkiller, and the side effects were not fun. Muscle spasms, which in a broken leg sucks - and they hit all limbs. Also severe night sweats. I weaned myself off them during the second week. After four weeks x-rays looked surprisingly good as far as alignment. OS gave the okay to bend the leg by hanging it off the bed. Still no weight bearing; follow up will be at the 7 week mark, and he's suggesting I can start physio and some weight bearing then. He even suggested he might have me try to walk short distances around that point, which is far ahead of his original estimate of 12 weeks.

I'm curious if anyone else has had issues with the meniscus combined with TPF, and what their recovery was like. I've definitely got a severely stiff knee and after one week with the immobilizer off, I can't get to 90° flexion. Maybe 80°. I'm 37, very independent, and while I'm not an athlete I walk, hike, jogged one Summer a couple years ago (never really enjoyed it so dropped it), swim, work out etc. Really hoping to get as close to normal as possible. I know everyone's knee is different, I'm just curious as to whether this is typical, atypical, and if there's any way to judge how much improvement I should really expect just hanging the knee off the bed.

Best of luck to everyone!

[fredtpf]

Hey folks,


Very glad to find this forum while I am going mad in the hospital wtih my new TPF!
I am healthy 61 year old active male with no major issues.
Last week I was involved in a motorcycle accident and received a type IV TPF.
X-rays showed bad medial plateau break with tibia shaft split all the way to the ankle with intact fibula.
I retained control and sensation in my toes but soon started developing severe blisters. The ER doc called them fracture blisters instead of compartment syndrome and didn't go for a fasciotomy. Now awaiting surgery in 2 days while my blisters heal.
The doc mentioned that type IV is the worst of all TPFs and to be prepared for prolonged rehabilitation time, which I resigned myself to mentally.
But this young resident doc tells me to resign to the idea of not ever having this leg back to normal in my life due to my age!
More than everything else, this one is depressing me.
Even if I try hard, at my age, Do I not have any chance of ever gaining the ROM for everyday activities? and if out of crutches, live with a poor gait the rest of my life?

Sincerely appreciate any advises and thanks for reading.

[fredtpf]

Pedalwrench - Thanks, man, good to join this forum understanding similar stories! Sorry to hear your tough time post-surgery, but glad to see you're on better path to recovery now.

From my side, I am going through similar hell since 2 weeks looks like - had my surgery finally and was sent home, only to find it got infected and am back on antibiotics now.
Similar post-surgical misery with pain and swelling...
Let's see how it goes, trying to stay positive but getting damn harder everyday...

[WoundedKnee]

pedal thanks for the reply, and fred, welcome to the club (not like we have a choice in joining!). Keep your spirits up. The depression can be a real pain, but once you start getting a little more mobile, even on crutches or a walker, you'll start feeling better.

An update for my case: I'm at 7 weeks today, got my second set of X-rays which still look good, but looks can be deceiving. Literally was told by the surgeon that he's thrilled with how the bone looks, but knows how bad it really is, so he wants me off it another four weeks. That means no weight bearing until 11 weeks; another four weeks is going to be a nightmare. Was really hoping to start physio but he wants me to wait, aside from some simple home ROM exercises. He literally told me to Google some. I'd already done that anyway.

ROM has gotten a little better, he was pretty happy to see me at 90 or just past it now. Slow and steady I guess. One thing I asked him point blank is if there's any indicator as to good/slow progress, and he says it's different for everyone, which is what I keep hearing. It's super hard not being able to know if I'm progressing as well as I'd like to be. He mentioned he had to create a tunnel for my meniscus which I wasn't even aware of, so that likely complicates things. And he didn't get to use the plates he intended, just screws, which I also didn't realize. Just screws and bone cement.

Also asked about cartilage replacement in the form of a graft, he says my damage is too extensive, but he thinks I should be good for 20-30 years before a knee replacement is necessary. Hoping technology saves my ass before then

Anyone else wind up with super dry skin on the injured leg/foot on that leg? I wound up giving it a good soak and was like a snake shedding its skin. Gross. I'm assuming that's because it's not in use, so circulation isn't as great. I don't have any issues with motion in the foot/ankle and found a few other references to it so I'm not overly worried, just wasn't expecting it originally.

[m2d918]

I had a TPF on January 2, 2016...almost at the 1 year mark. I also spiral fractured my tibial and fibula and tore my meniscus. I have a plate the whole length of my leg and approximately 22 screws. I was completely NWB for about 12 weeks and then slowly added weight. I won't sugar coat it, this will be a really long recovery. But, It does start to get better. I was training for a half marathon when I had a skiing accident causing my injuries, so my legs were very strong, but i still lost all the muscle in my leg. It takes a long time to come back, but keep working at it and it will. PT is the most important piece of all of this. The ROM exercise and strength training are so important!!

I have already had two surgeries to repair the fracture and I just scheduled my next (and hopefully last) to have as much of the hardware removed as possible. I refuse to let this injury define me. Today was the NYC marathon, a race I was hoping to run this year before my accident. Now I am more determined than ever to do this.

This is a really long journey, and it is definitely a marathon not a sprint. Some days will be better than others and I won't tell you that 11 months out I am at where I was before because I am not. I still can't run bc I can feel all the metal (hence the removal surgery), but my awareness of how long the recovery is, from speaking with others who have been here before, has really helped me not feel sorry for myself or get depressed. Stay positive! It really will get better!!

[bryce73]

hello everyone,

I haven't been much on the thread since my accident which is more than one year now. As for me the recovery was long but one year after the accident I was able to get almost full ROM, been able to walk and mountain bike without pain on long distances. So it gets better with time and lots of work to regain the ROM and muscles (although I think my tp was not properly aligned during the surgery)

I just had my harware removed 2 days ago, so I'm back again on crutches, but that shouldn't last long and hopefully will be the last shot. Thanks to a post on the thread if I remember correctly, I found a very active group on FB for this injury. It helped me a lot at the time right after the accident/surgery. So you guys might want to check it out. the group is named "tibial plateau fracture recovery". Good luck everyone!

[WoundedKnee]

Another update - at 11 weeks I got the all clear for minimal weight bearing, progressively adding more (will find out how that will play out once I start physio, which is next week). Right now I'm taking little baby steps assisted by a walker, and I can go to the bathroom standing up balancing without the walker. Even stood up in the shower for the first time.

Definitely lost a ton of quad over the past few weeks. Seems like that really accelerated past the 8 week point, it's a shame I couldn't get the okay to do any exercises sooner. I got the all clear to start using a recumbent bike also so I'll be starting that shortly. Also need to get a leg brace to off-set weight from the weak point of the TPF. Good thing I'm insured, because it's $1000 and above for a custom brace.

On the plus side I'm in far less pain (i.e. if I bump my knee I'm not screaming) so that's good. Stuck right around 90 for flexion still, physiotherapist says she's going to have to do some manual manipulation. Looking forward to getting that process started!

[Tecate]

Jumping in as a new guy on the forum, spotted this thread, haven't read everything before this. Sorry if I'm being redundant.
I had a TPF in March 2015, 6 screws to repair. Leg took a very long time to recover from atrophy and I never got the last 5% flexion back. Pain is minimal in general, running sucks as do moguls. My bump days are done.
I don't use a brace but have considered it so if your insurance will cover definitely take it.
Tough injury, best of luck!

Another update - at 11 weeks I got the all clear for minimal weight bearing, progressively adding more (will find out how that will play out once I start physio, which is next week). Right now I'm taking little baby steps assisted by a walker, and I can go to the bathroom standing up balancing without the walker. Even stood up in the shower for the first time.

Definitely lost a ton of quad over the past few weeks. Seems like that really accelerated past the 8 week point, it's a shame I couldn't get the okay to do any exercises sooner. I got the all clear to start using a recumbent bike also so I'll be starting that shortly. Also need to get a leg brace to off-set weight from the weak point of the TPF. Good thing I'm insured, because it's $1000 and above for a custom brace.

On the plus side I'm in far less pain (i.e. if I bump my knee I'm not screaming) so that's good. Stuck right around 90 for flexion still, physiotherapist says she's going to have to do some manual manipulation. Looking forward to getting that process started!

[Tecate]

I noticed you mentioned getting your hardware out. Mind if I ask why you went that way? I still have mine, 6 screws, and have wondered if pain/discomfort can be attributed to those. Have you noticed improvement since getting them removed?

hello everyone,

I haven't been much on the thread since my accident which is more than one year now. As for me the recovery was long but one year after the accident I was able to get almost full ROM, been able to walk and mountain bike without pain on long distances. So it gets better with time and lots of work to regain the ROM and muscles (although I think my tp was not properly aligned during the surgery)

I just had my harware removed 2 days ago, so I'm back again on crutches, but that shouldn't last long and hopefully will be the last shot. Thanks to a post on the thread if I remember correctly, I found a very active group on FB for this injury. It helped me a lot at the time right after the accident/surgery. So you guys might want to check it out. the group is named "tibial plateau fracture recovery". Good luck everyone!

[Tecate]

Sorry for the title, TGR isn't letting me post with a URL.
The site mytpf dot com has a lot of good info and helped me, maybe i will help people here too.

[Tecate]

Once more healed up I started getting on my knees while supporting my weight with my arms and lowering slowly to gain flexion. Almost two years out I still do that occasionally just to stretch. Similar to the wall strategy pedalwrench suggested it lets gravity do some of the work.

I didn't have any issue w my meniscus, but I can say it took me just over a month after surgery (no immobilizer after surgery) to hit that 90deg. It was incredibly stiff. Hanging it over the bed helped a lot. So did massage to break up the scar tissue in the knee, my PT does this every visit.

Lastly, after getting past 90, best stretch I've found is to lie on your back with your legs straight up in the air. Helps to be right up against a wall. Then slowly let your foot slide down the wall as far as it'll go. Hold, straighten back out. Repeat until you're sick of it.

This had the added benefit for me of helping reduce swelling, since it was elevated so much.

[mc6029]

Hi all,
I'm 61 years old and I had my TPF on Feb 25th in a car accident. I needed surgery to insert a plate and 9 screws. This was done under an Epidural, I was surprised that this was offered, but my surgeon suggested it since I had had a difficult time years back under general anesthesia for knee surgery on the other leg. The surgery went well, and I surprised a lot of Doctors by A) only needing pain killers for 36 hours, and B) being able to lift my leg 24 hours after surgery. I don't know if I have a high tolerance for pain, of if I was lucky and my Surgeon did a great job on my surgery, minimizing the Post surgery pain. I kind of suspect the latter.

I was NWB for 8 weeks, and PWB for another 4 weeks. Because I lived alone, I spent the first 8 weeks in a recuperation facility, where there were nurses around the clock to help us (Paid by the Quebec Government, we are totally No Fault insurance, Could not sue the negligent tow truck driver). I wore a straight brace for 8 days after my surgery, then was fitted with an articulated brace. But the old saying that for every cloud, there is a Silver Lining, in my case, I met a woman my age who had been hit as a pedestrian by a car pretty much the same date I was in my accident, she broke her hip, and Tibial plateau. The hip required surgery, but not the knee. We were even in the same hospital room for a few days, but we got to know each other at the recuperation facility were were transferred to, and started dating when we released from the PT hospital. I'm still with her.

In the facility, I would spend most of my days in bed with a pillow under my knee, as keeping it straight for any length of time was uncomfortable. I would go to the common kitchen to eat my meals, but could not stay very long after I'd finished, as I would need to get the pillow under my leg quickly after my meals.
There was a PT nurse there, she had me do leg flexion and straightening exercises on the bed, at first I was -20 degrees in straightening, and about 110 degrees in flex. In the second month there, The straightening improved to -10 degrees, and the flex improved to about 128 degrees.

After 2 months, I was transferred to a PT hospital for a month, where I would really work hard on improving flex, straightening and increasing my muscle strength. Then what followed was another 2 months of PT near my home (I had gone back to work after the PT hospital). I was using a walker (No weight on the leg) in the recuperation facility, Arm crutches in the PT hospital (PWB), then after leaving that hospital, I was on regular crutches for another month (FWB as much as I could stand). After that, I used a cane for another 3 months.

In November, I started working in a gym on a recumbent bicycle (I have a regular recumbent bicycle that I use outdoors, but November is too cold to ride outdoors in Montreal). At first, I took it easy, as I was totally out of shape, and my leg was still pretty weak. For the next 5 months, I would increase my tempo, and increase the resistance, gradually getting back in shape.

But in April, I went to see my OS to see if I could get the plate and screws removed, as the plate was causing me continual discomfort, it felt like it was rubbing against the tissues inside, and causing me to limp after 15 minutes of walking. The surgeon agreed to remove it, as he felt that if it was bothering me, the bone was fully healed, and the plate should be removed. But due to hospital waiting list being long in Quebec hospitals, that surgery would be in approx 1 year, unless there was a cancellation.
I continued riding outdoors in April, up till July 20th. A series of cancellations opened up a spot for me, and I agreed to that date. I never thought I'd be eager for surgery, but I was for this one. The day surgery under another epidural went well, and I went back home the same night, took pain killers for about another 36 hours, was on crutches for a few days, on my cane for another week, then 2 weeks later, was walking comfortably without a limp.
In late August, I got back on the bike, and continued increasing my pace, building my quad back to where it should be.

Now, in Late December, I'd say I'm approximately 95% recovered, My leg muscles are fully recovered, and my physical conditioning is where I want it. the only negative is that my knee joint is a touch weak, when I go up stairs, I notice that it isn't quite where I's like it to be, but really not that bad. My Flex is up to near 160 Degrees, my straightening is equal to the other leg. I still can't run, but I couldn't run before my accident due to arthritis causing swelling the next day after running. There are also some days, when the weather is going bad that my knee aches a little, but it doesn't last too long.

I need to thank my OS, Dr. Rosen, who I feel did a great job on my surgeries. I had moments of doubt that I'd ever get back to near normal activities, let alone normal.

So keep the hopes up, it takes time.

Denis