Tibial Plateau Fracture Recovery

[chicken158]

Has anyone had experience using one crutch, and 50% weight bearing? Physical therapist told me it was safe, but I feel like its hard to gauge what 50% wb feels like with only one crutch. After she taught me how, I went back to two crutches. Like I feel too wobbly or that I'm doing more than 50%. Don't wanna mess it up now...

It really doesn't feel like 50%, but it's pretty much the only way you're going to build up your bone density and muscle for full weight bearing. I saw it as more like 75% or having the crutch as a stabilizer. It's been around a year post injury for me. I worked 6-8 hour days, it was weird at first, but you'll get used to it.

[France]

Wonderful to hear you are doing so well Peaton! I am so happy for you. Thanks for the update. I am not doing as well as you are as my foot has become a problem. Nerve damage I think or worse? Very painful to stand on. So even though I could be starting to walk at 12 weeks I cannot. I am still on pain pills, well done you for getting off of them before they start becoming a problem. Keep up the good work...and you will be back doing the things you love soon! France

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!

[France]

Hi Vapor You are wise to exercise your foot and ankle. I would flex the foot and keep the Achilles tendon flexible and circle foot and back and forth. It came time for me to be FWB and I discover I cannot use my foot! It has frozen from no use, nerve damage and age related fast appearing Osteoporosis. I wish I had done more foot work the past 12 weeks. Maybe it would have made a difference. Has anyone else had problems walking with a bad foot? Any tips? I am concerned I may never walk again!! My foot hurts, its swollen and feels numb...This injury really is bad. And for the person asking about knee replacement. I have been told I will need one in 5-10 years...but who knows perhaps some of us can make it without one! Try to keep your spirits up everyone...This too will pass, I hope

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!

[pattmarish]

I just had surgery Thursday with 3 screws, no plates getting inserted into my right tibia below the kneecap. Initially my orthopedist told me I wouldn't be able to put weight on it for 6 weeks, but the surgeon said it'd be 12. I know it depends on how you heal, but I would like to know how long other people with similar problems had to wait. I'm 23 and before this, i was working out every other day and playing basketball (which is how it happened) every week. I'd appreciate the feedback. Also, should I just be laying around right now and not walk at all? I've been icing it throughout the day and keeping it elevated.

[peaton]

France,

I'm sorry to hear you are having problems. What has your OS said about your foot? Are you sure it isn't just from not being used like the others on here have talked about? I am also sorry to hear you are still on pain pills. I'm so glad I was able to get off them early on.

I will keep you in my thoughts and prayers that this passes and you are able to move on in your recovery. In the meantime do what you can do physically and stay positive.

[skiette]

Hi France
I missed what kind of pain meds you're on, but I had a terrible time with withdrawal from percocet (7.5mg) after 5 weeks of 5/day and wished like hell I had had better guidance to get off them. Start cutting them in half and then smaller and backing up with Tylenol or other non-narcotic drugs for pain. Icing is great and go easy on yourself ... this is a terrible injury. The support and encouragement offered on this thread is great and helped me tremendously. Thank you everyone so much and you DW for answering my question about metal removal.

[skiette]

EDIT: that was a thank you to Dgw3369

[scotiadallas]

I'm at week 9 post surgery, week 3 without a hard cast. Now I'm just a compression sock and NWB for another 3-4 weeks. Right now my ROM is 6 degrees to about 85 degrees. I am slowly noticing a better ROM every time I go.

I have been going to the pool every day or every two days. I swim laps and kick slowly as I swim. I do this for at least 30 mins. Then, after I get tired of swimming, I put the waist belt on and water run.

When I stretch my knee (ankle to my butt) I always feel a very tight stretching feeling around my knee - like my skin is too tight, pressure too great around my knee. There is pain of course but not overwhelming. When I run in the pool, I'm constantly trying to bend my knee more and straigten my knee more. Things are improving every time I go but my knee is A LOT more sore generally since I've been in the pool.

Can anyone comment on what I'm doing? Is it good or bad? Should I push more in the pool for better ROM or just lay off and let this heal without pushing?

I haven't seen a PT so I feel blind about my recovery. The doc did not comment but did give me some stretches to do to improve ROM. When I was excited about PT and stretching he told me not to rush, take my time and this will improve over months... I have no idea how to push or not push my rehab.
D

[scjohnson07]

I see a lot of responses about exercises without a PT. is this normal? I wasn't told that I will be going to one and am concerned I will do something wrong if I dont know what I'm doing.

[scotiadallas]

I see a lot of responses about exercises without a PT. is this normal? I wasn't told that I will be going to one and am concerned I will do something wrong if I dont know what I'm doing.

While I was in my appointment to see my OS, he never mentioned PT and I never asked (probably because I was so elated to get the news of having my cast removed!).

Now, with no cast and "on the loose" I wonder what I can and can not do. He did give me a sheet of paper with 5 stretches I can do to increase ROM but he seemed unconcerned about ROM issues at the time. In fact, he seemed to only care that I did not put ANY weight on my TBP.

Although my right TBP was fractured, I'm driving (left foot braking, right foot for accelerator) and it gives me a lot of freedom - both physical and mental. I go to the pool everyday for exercise and I try to stretch my leg while sitting around the house. Sometimes, when I spend 30-40 minutes kicking in the pool, my knee is very sore the next day (but not swollen). I worry I'm damaging something...

D

[itsdeenah]

Hi pattmarish, Sorry to hear of your accident and TPF/surgery. In response to your weight bearing - I would play it safe and listen to the surgeon. Maybe ask about toe touches and partial weight bearing first it usually times around PT and healing time? Unfortunatly, this injury is the second most complex injury other than spinal and in my opinion worth the wait for less damage and a clean better outcome. Good luck with your recovery and keep posting and updating with your progress Hang in there!!

I just had surgery Thursday with 3 screws, no plates getting inserted into my right tibia below the kneecap. Initially my orthopedist told me I wouldn't be able to put weight on it for 6 weeks, but the surgeon said it'd be 12. I know it depends on how you heal, but I would like to know how long other people with similar problems had to wait. I'm 23 and before this, i was working out every other day and playing basketball (which is how it happened) every week. I'd appreciate the feedback. Also, should I just be laying around right now and not walk at all? I've been icing it throughout the day and keeping it elevated.

[pattmarish]

Thanks for the response Deenah, I know it all depends on recovery and PT and 3 screws and no plates isn't near as bad as most of the people's TPF's that I read on here. I don't meet my surgeon again until the 1st of August, so it's going to drive me nuts, especially since I was so active before all this. I wonder if it's necessary to keep putting ice on my leg now. The pain is bearable now and I'm not taking painkillers near as much as I was the first few days. Look forward to hearing from yours and everyone elses past experiences.

[itsdeenah]

The waiting is deff the hardest part through all of this - it does seem to move faster when PT starts and you have goals to reach. Ortho is all about the wait I guess. As far as the ice...whenever I have swelling in any part of that leg I use ice & try to elevate it. And now at the PT office after all the pushing & pulling ROM (uggghh) they ice it and apply electric muscle stimulation which is actually quite soothing and takes down alot of the swelling. In the beginning I did alot of ankle rolls at home and leg lifts but ultimately my leg muscles shrunk down to nothin so I'm working hard to build it back up. The OS said it takes 2x as long to rebuild your muscle up. I'm just calling it a whole year of recovery and if it happens sooner then bonus if not I won't be let down. This Thur. I go back to the OS and hopefully go FWB (fingers crossed). Then the real PT work starts!

Thanks for the response Deenah, I know it all depends on recovery and PT and 3 screws and no plates isn't near as bad as most of the people's TPF's that I read on here. I don't meet my surgeon again until the 1st of August, so it's going to drive me nuts, especially since I was so active before all this. I wonder if it's necessary to keep putting ice on my leg now. The pain is bearable now and I'm not taking painkillers near as much as I was the first few days. Look forward to hearing from yours and everyone elses past experiences.

[pattmarish]

Well all that about the muscle loss sucks, as I am an avid weight lifter...how bad was your injury and what all did they have to do in surgery? I hope you can go to full weight that's awesome!

[itsdeenah]

My injury was due to an assault (I tried to stop my cousins bf from hitting her and he picked me up and slammed me into the ground)
Date of Injury 4/20/12
Surgery 4/27/12
Type IV TPF with 1+" communited depression of the plateau surface
1 - Fx's Tibial Shaft
Shattered medial meniscus
The OS installed a bone graph to fill in the hole & repair the tibia (or depression) of the plateau surface along with a plate and 16 pins. I'm waiting to hear if I still need one more surgery to repair more soft tissue and miniscus damage (they stitched what was left). So I know all about the waiting game (3 months NWB) but overall I'm staying positive through the injury just more mental stuff post tramatic from the assault and my cousin still staying with him even after I tried protecting her it's disgusting!! Why do these abused women stay! So frustrating!! I understand about the training I too was training for Warrior Dash when this happened and now I'm just hoping to walk normal.

Well all that about the muscle loss sucks, as I am an avid weight lifter...how bad was your injury and what all did they have to do in surgery? I hope you can go to full weight that's awesome!

[pattmarish]

Dang well you definitely had it worse off then me, mentally, physically, and emotionally. I hope that you pressed charges against him after what he did. I looked into doing the warrior dash, we have 1 coming up in September near Indy that I wanted to try out, and last week i was going to go to the crossfit gym here in town and try that out but to no avail. If you want to talk anymore you can hit me up on facebook if you want..just type in my name..well switch around the p and the m and you'll find me, haha.

[HeatherB]

How pathetic have I become. A week and a half ago i was a full time nurse working 12 hour shifts. I surgery later here I sit on the recliner, home alone, the recliner has lost power and it is tilted up and back, I can't move, I dare not tilt forward in case the chair tilts over and I can't get my leg comfortable, oh and I have to go to the potty. So I am stuck until someone comes home. So yes here I am mourning my loss of independence. Hope everyone is having a better day

[pattmarish]

hang in there Heather..I'm in my bed right now w/ my leg propped up playing NBA 2K12 and I don't have any short term disability, so no income, and I was about to put a deposit down on an apartment, and get my books for school which starts up in 5 weeks.

[HeatherB]

I know that Florida doesn't have short term disability. I hope things get better for you soon pattmarish.

[kiwionastick]

Great thread! I wish I found this a year ago when I had my initial injury.

Had my TPF on June 23, 2011 while playing baseball and collided with another player while going for a fly ball, which I caught and somehow held on even though I blacked out from the pain. The ER doc missed the fracture and dismissed it as an ACL tear. Five days later the ortho finally found the problem. After consulting 3 other specialists, I had my surgery on July 1, 2011, with a plate, 6 screws, bone graft and artificial filler.

I was give T3's for the pain, which were useless and I stopped taking them after a week. I wore a zimmer splint for the first month to keep the leg perfectly straight. The second month was without a splint but no weight bearing.

After 8 weeks, I started physio daily to start building ROM. After 9 weeks I returned to work. And after 10 weeks, I could finally start weight bearing. With PT 3 times a week, I made the slow transition from crutches, to single crutch, to cane, to walking over 6 weeks (mid October). By late November, my ROM was back to 140 and I had started very light jogging on the treadmill at physio. At the end of January I finished physio with light jogging for 3 minutes on the treadmill.

After PT ended, I started at a regular gym 3 times per week with various leg machines, squats and lunges, finishing off each workout with laps of the indoor track until the leg said stop. By the end of March, I was up to running a mile on the rubberized track without pain.

After a year, my legs are almost the same size again. I have resumed playing baseball and ultimate. I bike to work every day (5km). I'm still very stiff in the morning and never go for a walk without feeling the plate in the joint. I had my 1 year x-rays today and am hoping to find out if/when the plate might come out.

Does the plate always come out? Or do some people keep it in permanently?

[scjohnson07]

Scotiadallas- I still have an immobilizer on my leg so I'm hoping that at my next appt when he addresses being able to take it off for some part of the day that he will mention a PT. if not I'm going to request one! I see everyone on here questioning themselves and I seem to be doing the same thing. I don't want to screw it up worse than I have already lol.

[scotiadallas]

From what I can tell, reading all of the posts, it looks like the OS doesn't mention PT until FWB or PWB is established. This makes sense I guess.

It seems like the people motivated enough to do leg lifts, stretches, and whatever they can on their own to improve while they wait have a shorter recovery time. Of course the other variable is how bad their break is...

I mentioned this before (but now I have an addition) - the 3 best things that happened while healing:

1. COMPRESSION SOCK to keep the swelling out of my foot and lower leg. This changes everything. As soon as you are no longer in a cast, GET A COMPRESSION STOCKING. You can get these at any medical products store. I am wearing mine now and don't get out of bed in the morning without it on. It stays on all day and I have a minimal amount of swelling in my foot, even after a long day. Without it, my foot would look like a milk bag.

2. SWIMMING! Find a pool that is wheelchair accessible and go. I crutch into the building, they bring me a wheelchair and I go right into the pool deck. I always show up in my swimshorts with a backpack (on my front). There is a slope into the pool with a double railing and I can "hop" right into the shallow end. Once I get to about mid-thigh, the transformation happens - I feel weightless and normal. I swim laps until I get tired, then switch to a waist belt and water run. When I'm tired of doing that I roll onto my back with a flutterboard and slowly kick, the entire time working to improve my ROM. My muscle mass in my leg is coming back very quickly - absolute joy. If you take the time to find the right facility, this will change your life.

3. ROLLER CHAIR! This one has happened in the last few weeks for me and mostly by accident. I was using an office chair with no back on it as a rolling footrest. Wherever I sat, my wife would roll it over and I would use it to keep my leg up. The breakthrough came when I couldn't carry my glass to the chair so I sat on the roller chair and took my glass to the chair while sitting on the roller chair. Soon, with a bit of light experimentation, I was rolling all over the place. I use my good foot to propel myself backwards and it works very well. Now, I vacuum the floors, I am doing about 50% of the cooking (I usually do 100%) and generally helping out around the house. For me, a lot of my bad feelings came from the burden I put on my wife while I sat in my chair and didn't contribute. It puts a lot of burden on family. I would suggest getting an office chair from a used office supply place (probably $25) and then unbolt the "chair back". This is simple and anyone can do it. You can leave the roller portion in the kitchen or anywhere else useful. I have one in the kitchen and in the garage so I can do basic maintenance (lawn mower, etc.).

I hope these tips can ease the burden and speed the recovery of others...

Scotiadallas- I still have an immobilizer on my leg so I'm hoping that at my next appt when he addresses being able to take it off for some part of the day that he will mention a PT. if not I'm going to request one! I see everyone on here questioning themselves and I seem to be doing the same thing. I don't want to screw it up worse than I have already lol.

[kiwionastick]

Roller chair is a great idea! I ended up renting a wheelchair for 2 months ($60 per month). After I stripped most of the parts off, leaving the basic chair and single leg platform in the elevated position, I could navigate the kitchen and living room areas where I spent 90% of the time while awake. Another important rental was a bath bench to sit on while bathing ($20/month). Considering the convenience, they were both smart investments to help get through the daily routine.

[scjohnson07]

Roller chair is a great idea! Yes the compression sock is phenomenal! I have an immobilizer on so the sock is great. Unfortunately I have to be PWB and have decent ROM before they do my surgery (meniscus and acl) due to my leg having such bad atrophy which I'm sure the PT will be painful. I have no range of motion and my leg looks like a skeleton so they didn't want to do surgery on it like that.

[Skigramma]

How pathetic have I become. A week and a half ago i was a full time nurse working 12 hour shifts. I surgery later here I sit on the recliner, home alone, the recliner has lost power and it is tilted up and back, I can't move, I dare not tilt forward in case the chair tilts over and I can't get my leg comfortable, oh and I have to go to the potty. So I am stuck until someone comes home. So yes here I am mourning my loss of independence. Hope everyone is having a better day

Heather - I was in the same boat in Feb this year, TBP ORIF - I was in wheelchair, sore bum on the recliner, sore bum on the bed my daughter moved down to the living room, feeling like a beached whale when I lay down on the bed and needed to get up to try to get to the bathroom! It was frightening, being so helpless. Was on major pain meds for 4 weeks....Good news....it will get better. I read so many posts during those first few weeks...tv on 24/7. I felt like it would never end. It does get better, slow - like a turtle, far too slow for me but it is what it is. My ski friends came to visit, but I think my injury scared them. It's now 5 months...I am walking although I have to concentrate on normal gait and I have to watch uneven terrain, working on stairs properly, physio 2x/week, going to my camp. I still have some discomfort, foot issues (hypermobility and some temp nerve damage) after being NWB for 11 wks, foot muscles atrophy too! Huh.:/ Keep the foot moving, get that knee moving if possible and OS allows, ice ice ice elevate. My leg was black from foot to upper thigh, and swelling was horrid. Being an active person, I feel your pathetic ... I felt that too. My mantra...It is what it is...and keep moving forward. Take care