Tibial Plateau Fracture Recovery

[mc6029]

I forgot to thank my Girlfriend in my previous post.
We underwent the same issues in our recoveries, pain and limited ROM, but we were continuously encouraging each other to go just a little harder, do a little more.
We were able to keep the other's spirits up during the long process of rehab. It's what really helped our relationship grow.

I love you dear.

Denis

[CollinWheeler]

My scans one year apart.
No ligament damage.
No surgery.
Never even had a cast put on.
Just got the green light to start skiing again!

[TexasGortex]

My mother was t-boned by a drunk driver a month ago and broke her tibial plateau as well as fibia. Coincidentally, she had been scheduled for a total knee replacement this month (which is obviously not happening). She is immobilized NWB, but thus far no surgery or cast.

Other than "long", none of us really knew what recovery would look like... OF COURSE tgr has a mega thread for it, it's a gnarly injury after all.

There is a wealth of information here, thank you all for posting it.

[sparkletarte.]

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?

I removed my hardware a year after as I didn't want foreign stuff in my body and was having pain so I hoped that would get rid of it. Almost instant improvement in pain. I have none. It's been 15ish years. Never would know aside from the scar. btw I ski bumps (never did before actually!) and ski/ride better than ever. Also never used a brace.

You got this peeps!

[bryce73]

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?

Sure, actually I had a plate in my right ankle and one in my left knee. The plate in my ankle was giving me discomfort when I was kneeling and doing sport. The plate in my left knee has giving me much trouble at the beginning, when doing sport like mtbiking, the lowest screw was working through the bone and I had strong inflammation (couldn't touch the area). It got better with time but I still had pain in my shin for 2 or 3 days following an intense sport session. I also prefered the idea of not having a foreign body inside.

I don't regret one minute. It remains a surgery but it's much easier than the one to put the hw in. All of the discomfort and pain I had are now gone. :-) The best surprise was that the numbness I had on the external side of my shin has much improved. For whatever reason the plate (in the medial side) was definitely blocking some sensations. It's not like before but way better than before hwr. I'm 3 months post hwr and still have good hope for improvement.

I'd say if the pain is due to your hw don't hesitate to have it removed. If it doesn't bother you, it's up to you, but apparently not necessary

[ZGimpy1963]

I am so glad to find this thread. My injury happened 8-29-16. I was hospitalized for 3 days waiting for the swelling to go down. Unfortunately this did not happen, so I was given an external fixation attached to my thigh and lower tibia. On September 15, 2016 my tibia plateau was fixed with two plates and many screws. I was in a wheelchair, non weight bearing for 12 weeks. I am currently using a cane, walking with a limp. I go to PT 3 times a week. My ankle swells every day. I have only been back to work for 2 weeks. I am very tired at the end of the day, and can't wait to put my foot up on pillows.

My question is how long is PT required? I am going broke paying the co-pays for therapy, but I do not want to stop until I can walk without a limp.

[dannynoonan]

...

[sparkletarte.]

I am so glad to find this thread. My injury happened 8-29-16. I was hospitalized for 3 days waiting for the swelling to go down. Unfortunately this did not happen, so I was given an external fixation attached to my thigh and lower tibia. On September 15, 2016 my tibia plateau was fixed with two plates and many screws. I was in a wheelchair, non weight bearing for 12 weeks. I am currently using a cane, walking with a limp. I go to PT 3 times a week. My ankle swells every day. I have only been back to work for 2 weeks. I am very tired at the end of the day, and can't wait to put my foot up on pillows.

My question is how long is PT required? I am going broke paying the co-pays for therapy, but I do not want to stop until I can walk without a limp.

You should aim to never limp. If you do with a cane, go back to a crutch. You are training your knee to heal wrong, in a limp pattern. It took me about a month/6 weeksto go from weight bearing to no cane.

Hopefully you can put your leg up often at work. It,s important to reduce swelling as much as possible as that really slows recovery.

Get or borrow a bike trainer. That will help a ton. Can you do stuff at home or the gym instead of physio? You mostly need to regain rom and muscle mass.

[himavan]

This week is the five year anniversary of my Tib plateau shattering - the worst kind - a schatzker VI from a failed gap jump over a cat track. Also broke my fibula and my tibia split in two down to my ankle. My first surgeon said I would never ski or hike again, that I would likely limp, and would definitely need a total knee replacement within 5-10 years (which would suck as they don't last that long and I was only 37 and my wife was pregnant). So I found a new surgeon and flew from Canada to Harborview in Seattle, where Dr. David Barei fixed me up with three plates and 19 screws. A combination of good fortune, an amazing surgeon, and not giving up on physical therapy has done wonders. It took me a while to learn to walk again, and then to relearn how to ski from scratch and trying to keep up with the tiny tots. Now I'm finally skiing the whole mountain again, not favouring my good leg too much, even progressing in certain ways beyond where I was pre accident, and able to do decent size airs and handle the compression. I still have tough days, require a few Advil to bang through bumps or crud, ice at night, and have to stay on top of my knee (If I'm inactive for just a few days it starts to stiffen up and feel kind of shitty). Anyhow, my biggest recommendations is to get a great surgeon (my first made some mistakes in the initial stabilization, leaving some floating pieces of bone, that had to be fixed) and not giving up hope. It's a long long road that requires a crazy amount of perseverance and determination to get through rehab when hope keeps bottoming out, but no one know's what the possibilities of your potential are. Keep up the grind!

[Johnnyfive]

Greetings fellow TPF recoverers,
What is you blood thinner protocol at home?
I was on Lovenox for 30 days post op and then put on 325mg daily aspirin till weight bearing. The aspirin upset my stomach and they gave me a month script of Lovenox, seems like a long time, although my 8 weeks post op has been mostly in bed or wheelchair. The only risk factor I have for DVT is the TPF type V fracture with ORIF surgery. Thanks.

[BuzzD]

Hi all

My first time on any forum!
March 2017 I had a ski wipe out in France broke fibia tibia (plateu) 6 ribs and 2 bones in hand, spent 2 weeks in French hospital.
I had plates and pins and screws inserted into tibia and was making good recovery for 9 weeks then got an infection in leg! which set me back big time, so six weeks antibiotics finished last week and infection looks like returning.
Next problem discovered 2 weeks ago was my bone has delayed or non union!
I'm in loads of pain when weight bearing and have been advised I need another operation if union fails in next 2 weeks, options are bone graft or cutting tibia to re-join with external fixation.
has anyone had any experience in infection and second operations?

PS my ribs and hand have healed ok.

[Mcvsdeer]

So, my name is Bill and I've been lurking here for a while. Here is my story. October 15th my motorcycle met deer. I was left with #2,3,4 and 5 rib broken in back, type 5 seperation in right clavical and a tpf #6 right knee. Not sure what the depression was in cm but it was significant. Rushed to hospital in Staten Island NY and had an ex fix placed, one week later made my way to Hospital for Special Surgery in the city. October 23rd had 2 plates and 12 screws placed. Dr. Wellman did an amazing job. I came out of surgery moving my knee in a brace. The brace was never limited and started cpm 1 day after surgery. I ended up with P.E and spent 3 weeks in Cornell. That was caused by a reaction that I had to heparin. It does not mix with my blood properly. Fast forward. It is now December 15th. I am at a +10 hyperextension which is the same as my left (good) knee and I am full Rom at 120°. I will be allowed FWB January 1st 10 weeks post op. I am looking forward to that.

[Finsternis]

Apologies for reviving a long dead thread... I had a pretty minor crash a few months back, ended up with a tibial plateau fracture. I hit a slalom gate dead on with my ski tip, it spun me round and I fell backwards and to the side and heard my knee "pop". I remember lying on my back thinking it was probably bad but actually didn't hurt too much at the time. Gradually as my knee swelled up (presumably with the contents of my tibia :-| ) the pain increased. Local doc missed the fracture on x-ray and sent me home with some paracetamol for a night of 8/10 pain.

Subsequently MRI showed a Schatzker 2 fracture with about 5mm depression. I discussed the scans with some surgeons here (Switzerland) and back home in the UK and they recommended surgery which I had 1.5 weeks after the accident. They reconstructed the plateau surface from underneath with a bone graft and studk in a plate and 8 screws. Physio started the day after the operation and I was allowed 10kg weight bearing after a few days. Fixed knee brace for 6 weeks followed by a hinged brace which I am convinced was sold to me in the wrong size. Was allowed to use a stationary bike after a few weeks.

Injury was in October and at the beginning of January I was cleared to get rid of the crutches and brace, and start some gentle jogging. Still getting physio 2x a week though I switched to a more sports oriented company than the one at the hospital which I felt was more "rehab". I have been skinning up the mountain at weekends and just last Saturday tried out the baby slope (on my AT skis) which was fine. Apparently it is very easy to do ligament damage while it's recovering so not doing any "actual" skiing for a few more weeks yet.

In terms of recovery of function, I have nearly complete range of motion back, the knee won't hyperextend a few degrees like the other one but it goes to 0 and I think 140 flexion so definitely good enough. Power through that leg is quite a bit down still and I haven't been jogging at more than 10kph or for more than 20 minutes yet.

Anyway seems to be going about as well as I could expect, I am trying to be as conscientious as possible with rehab exercises and at the same time not getting too adventurous. Tough balance. Thanks for reading!

[t-the-east]

Well, I done fucked myself up good this time. Figured this was a good place to post a few pics and hopefully I’ll remember to update it with some good recovery experiences and tips for anyone else that is in recovery.

Took a random trip out to Bozeman to visit my buddy as I get to do every year or two. Had some awesome days at bridger, then we headed down to Big Sky for day 4. Headed up the tram before the line got too long. They had just finished blasting and patrol in the tram told us Lenin was skiing real nice. So we hit it. Got through the traverses and did a few beautiful turns in about 6-8” of fresh, caught an edge ( looking back I think it may have been the avy debris underneath, or a rock), and started somersaulting. About the 2nd or 3rd somersault I felt and heard a huge pop/snap and kept sliding and somersaulting until I could self arrest about 100 yards down from where I started the fall. As soon as I stopped and tried to move my leg, I knew I was done. Patrol was there within 20 minutes to help me out.



^ My son and buddy stomped out a pad for the sled while patrol tended to me.



^ A goofy picture I marked up to show friends/family at home the scene of the crime

Patrol took me down in the sled, probably around 3500 vertical feet. Much respect. If anyone knows patrol ( guys name was Keenan, Keegan, something like that ) let me know, I owe that guy many many beers.
Got x rays -

^ clearly that ain’t right. Fractured tibial plateu in 3 large chunks

Got an external fixator at Bozeman hospital ( this pic could be graphic depending on your tolerance level )


Flew home last night, which is probably close to the same amount of pain as the actual accident, if not worse. But the time I got off the second flight my leg was huge and bleeding bad.


2nd Surgery tomorrow morning to remove the fixator and put in the plates and screws. So overall, yeah, fucked myself up real good. Life altering. I’ve probably skied Lenin 20 times and maybe 50+ runs off the tram. For some reason I just came in real hot. We were having fun and the snow was good. I’ve replayed it a million times in my head, I wish I would’ve used just a slight bit more caution.

Now I’m 41, healthy and in good shape, but I fear this accident is gonna fuck me for the rest of my life. Gonna hit PT hard as soon as I’m allowed and see where it gets me. My true joys in life are skiing, biking and hiking. So I feel like I don’t have much choice but to get back to 100%.

This post brought to you by whatever pain killers they have me on now. Thanks for letting me vent.

[spanky]

I also suffered a TPF skiing at Alta on 1/1/19. t-the-east, check your PMs.

[t-the-east]

I also suffered a TPF skiing at Alta on 1/1/19. t-the-east, check your PMs.

Thanks spanky! 5am, on my way to surgery #2. Appreciate the support!

[buttahflake]

Best of luck today, t. Sending positive vibrations.

[Doremite]

Ugh. Best of luck w recovery. Accidents happen so stop second guessing yourself. Sucks you can’t wind back time on these things. You could ski that pitch 100 more times and not catch anything lurking beneath. Hope surgeries all go as smoothly as expected +vibes

[jackstraw]

Best of luck today, t. Sending positive vibrations.

2nd that one.

Ugh. Best of luck w recovery. Accidents happen so stop second guessing yourself. Sucks you can’t wind back time on these things. You could ski that pitch 100 more times and not catch anything lurking beneath. Hope surgeries all go as smoothly as expected +vibes

Yup, good words man. Gotta move foward.

[detrusor]

You’ve not fucked yourself for life. Back in the game next year. Good luck and vibes


Sent from my iPhone using TGR Forums

[t-the-east]

Thanks Buttah for the positive vibrations right before surgery! And thanks to all for the kind and encouraging words!

Was in surgery for 5 hours yesterday. The surgeon was very pleased with the outcome and said he was able to get every single little piece back in place. I’ll spare you guys a picture of my leg post surgery.

It’s gonna be a looooong recovery, but I’m gonna stay positive and hit it PT hard as soon as I’m allowed.

And thank you again to all, a little encouragement goes a long way when you’re up against such a huge obstacle, so it’s very much appreciated

[jackstraw]

Dude, like they say...it could always be worse. Just gotta push forward [emoji106]

[CarlB]

I sustained a TPF in March 2017 at Snowbird. It was, according to my doctor, a 6.5! I had an external fixator applied at the Intermountain hospital. A week later I flew back to Boston and had to wait another two weeks for surgery because it took that long for the swelling to go down. I had to purchase an entire row on Delta. It was the flight from hell.

My doctor was the head of orthopedic trauma surgery at Beth Israel Hospital. He installed two plates and 20 screws during a 2.5 hour operation. Unfortunately I had some complications that made my recovery a bit of a nightmare. The long and the short of it is that I sustained two infections afterwards plus a blood clot. This slowed my recovery significantly. The first infection almost caused them to take one of the two plates out. My doctor said that he really didn't want to do that because my bone would not heal straight and would adversely affect me going forward. But the infection was bad enough to consider it. Fortunately the infectious disease team at the hospital got it under control. I took several weeks of two types of intravenous antibiotics. I had a pic line in my arm to administer them at home once a day. After that I took antibiotics in pill form for another 6 months! The blood clot was controlled with three months of a very expensive drug. In all I spent 17 nights in the hospital between Utah and Boston.

After about ten weeks I was able to put half weight on my leg. I began physical therapy and worked my butt off for 5 months to get my leg strength back. By the fall I was hiking moderate hills and feeling encouraged. But my leg kept swelling badly every day with significant edema on the inside portion of my leg. But I still thought I was on track to ski during the 17/18 season. I had both plates removed in late November 2017 because of the swelling which I felt was due to irritation from the plates. But because a lot of bone had grown over the plates, the surgery was more complex than anticipated. The recovery was also much longer than I had been led to believe. My goal of skiing that season was put on the shelf. It never happened.

During 2018 I continued to work out regularly to build up the muscles. This all led to me being able to ski during this season. Admittedly I'm not back to where I was before the accident. My knee gets sore and my strength is not 100% yet. But I've been told that it could take 3 full years to recover fully. I'm hopeful that I will get there. I did take another trip back to Utah this year and skied Atla and Snowbird for 6 straight days. I can't hit the steeps quite like I used to yet but I did do them. The first three days where better than the last three. My leg got progressively sore.

I was told by some that I may not be able to ski again but I never believed it. I didn't want to. So I worked as hard as possible to get my strength back and prove them wrong. I'm 60 years old and have been skiing for 45 years. I plan on skiing for at least another 20!

My message is to never give up! Think positive and take PT seriously.

[t-the-east]

Damn. Good story CarlB! I know the flight from hell, one of the worst feelings.

Timely bump too, just got back from my 2 week follow up, surgeon is happy that everything is aligning properly and looking good. Stitches are out and I got my first look at my new hardware - [emoji15]


5 more weeks til my next appointment. No weight bearing or knee movement at all until then. Guess I’ll have time to catch up on that office work I keep putting off...

[t-the-east]

Update bump - just back from my final surgeons appointment yesterday after 4 loooong months since surgery. Been doing PT 3 times a week for the past month, plus all the exercises at home. Fully cleared to bike, hike, and ski. Doctor was very pleased with the final xrays and my progress.

I wasn’t full weight bearing til about 11-12 weeks. Off crutches now but using a cane for rough terrain. Been using the bike trainer for about a month, can’t wait to get back on some (mellow) trails. And back in the woods for some hikes.

Doc says I could take the hardware out in 6 months if i want, but only if it’s really bothering me. Then I’d be a month recovery. Tough decision.


Long story short, tibial plateau fracture, type 5 on their weird scale of 1-6, “major trauma” says the surgeons and doctors. Overall, not a fun experience, but I’m at the tail end and it feels damn good.

It’s absolutely insane how your entire life can change in a second. 41 years young, lots more time to explore.