Tibial Plateau Fracture Recovery

[97r82]

Amy
In my 50 years on this earth I have been thru a lot of tough times but this one is in the top three. Most of my friends have been in contact since my injury. Their advise if you want to work without pain the have the hardware removed when it makes sense to do so. I think most doctors wait at least a year unless the body rejects the metal? Sooner or later it became an issue with all the guys who work a rigorous schedule like mine and yours. Lost time from work along with unexplained pains is very common. I plan on making this decision after working at least one year since I have no desire to go under the knife again unless it makes my life much better.
This week feels like my progress has stalled but I guess I need to expect that from time to time. I am walking with two crutches with some foot pain and kneecap is painful. Taking a few more pain pills to deal with it but slowly getting better. Sounds like you have your head straight on how you want to proceed. Don't rush into it you will be fine.

thanks
jesse

[framerboy]

I recently fractured my tibial plateau a month ago snowboarding and in my boredom of recovery i stumbled upon this site. It is nice to hear from others that are going through the same thing even if some of them are depressing.
I had surgery just over four weeks ago. A plate and nine screws later, I have a brand new knee. I am coming up on week 5 and am looking forward to starting my physio next week. It is hard to go from an active lifestyle of outdoor sports and construction (my occupation), to sitting in a recliner for a month and watching your leg waste away! Not to mention the rest of my body. I have lost 20 lbs since my surgery. Did anyone else have this? If so, how long did it take to gain it all back?
I have 6 more weeks until I have the go-ahead to start walking. Until then it's crutches and the t.v. remote for me I suppose.
I look forward to reading more posts on peoples recoveries.

[Mallen65]

Framerboy, get use to your recliner and the remote, they will be your companions for awhile. Ask your Dr. If you can do some isometrics while you are in your recliner, that will start the muscle building while your non weight bearing. I too lost about 20 pounds at first which is pretty common if your taking any pain meds on a regular basis and the fact your body is still under stress and shock. I did gain some of the weight back after I got off all the meds so hang in there that part will get better. I was lucky enough to receive an iPad from all of my coworkers and it was a life saver. The bordom and the depression is something real and don't ignore it, you must find a way to stay positive because things will and do get better it just takes time. Stay in touch with friends and family and accept help when it's offered even though you don't want everyone fussing over you and doing things for you. This is a serious injury and it takes a lot of time to get over it, your life as you knew it is on hold and it is important to do everything you can physically and mentally to get through it. Hang in there and refer to this site often, it really helps to know your not alone with this, there are a lot of us going through the same thing!

[97r82]

Framerboy
Hang in there this is a long boring ordeal. I am at 13 weeks since my accident (2 plate and 22 screws) and I am just now putting half my weight on the bad leg with two crutches. Pay attention to your doctor and find a good therapist. PT has done more for my recovery (mental as well as physical). Do what you can to keep a positive attitude. Call up some old friends, watch all the movies you missed last year, surf the net do something to take your mind off the leg. Its like watching grass grow. Hang in there and buy some new batteries for your remote and a couple of big pillows to prop your leg up.
thanks
jesse

[Moonstruck]

This is my first post. My accident was due to a horseback riding injury. I have been riding all of my life and am an avid hunter/jumper equestian who is active in show jumping. I am 49 years old and am able to ride about 3-4 times a week. I work full time and am a mother to a 15 year old son, so my riding in not my highest priority.

I had a very bad accident on 10/30/12. I had just mounted my horse and was going for a typical trail ride before ring work. I was about to go in the heavy part of the woods when a loose 140 lb Rhodesian Ridgeback ran out in front of me to chase a deer. My horse spooked and took off, which in turn caused the dog to chase us towards the woods. I was falling off of the horse to the right when the lights went out. I knew that we were headed for the woods and trees ( I live in NC where we have a lot of trees) and knew I was going to hit a tree. I was knocked out at this point. The next thing I recall is EMT's putting me in neck braces carrying me out on a stretcher. After trying to relive the events of the accident, we believe that I was drug by the horse for a period of time (right leg) as the stirrup and leather were found next to me. My horse was then chased all over the property by this loose dog, until she was finally caught. She suffered some cuts as we were caught up in a grouping of for a while with the dog barking.

I was taken to a trauma center where my injuries includes, hear trauma (I was wearing a helmet), a collapsed lung, 8 broken ribs, two broken vertebrae, and a shattered tibia plateau. I spent 7 days in the hospital the first time, and had sugeries for the collapse lung, had blood and platelet transfusions to prepare me for the first leg surgery. I had an external fixator put into my leg with screws in my lower tibia and upper femur. This stayed in place for about a week. I have my tibia plateau surgery on 11/14/12. I had plates on both sides of the tibia and plate at the top of the tibia and 11 screws. My bone was shattered and there was nothing to set so I have cadeaver bone packed into my leg. I started PT in a CPM machine about 4 days following surgery. My situation has been so difficult because my broken ribs have caused me so much pain, that my PT was a slow start. It has now been about 9 weeks since the surgery and the CPM is gone and I am in PT. I am so frustrated becuase I can only get to about 90 degrees and it is painful to go any further. My Dr has already said that he may have to go in an "clean up" scar tissue that he thinks has limited my ROM. I am still in a wheel chair and have actually now aggrevated my "good knee" due to the twisting of getting up and down and in and out and had an MRI on the good new yesterday. Results are pending.

I am glad to have found this website to be able to communicate with people who have suffered a similar injury. I can now understand how terrible this injury can be. I am trying to stay positive but it sure has been hard!

[Simplicity]

Wanted to provide an update, injured 4/9/2011. Got 8 screws in, and didn't walk until mid July. I did PT until the end of December. Upon approval of my physical therapist, I did some skiing this past weekend. I was only able to make it a few runs on easy terrain before my knee got very sore and I called it a day. I don't think anything is fundamentally wrong, I just think that skiing probably introduces some odd forces on the knee that I was unable to strengthen in PT, and atrophied when I didn't walk for 3 months. With the approval of my physical therapist, I will try skiing again in a few weeks and see if I can make it a little bit longer. Did anyone else experience similar soreness? And how many days did it last?

[sudyshewo]

Mooonstruck! Thats terrifying--but you're alive, which sounds lucky. My great grandpa was a terrific horse trainer in ww1. He was college educated and everything. I must tell you he was the first person in the county to get a tractor and never looked back. He said he never had to stop what he was doing and go take a nap wating on a stubborn tractor. He loved the future so much he opened a gas station on the corner of the farm. We still have the shed. Now we all want to go back to a simpler time, in some ways. Not when it comes to medicine though. another twenty years maybe they will inject some auto forming plastic in there that will grow you instantly, and you could walk out, but for now make a pot of soup (which will be exhausting) then... get cozy with your library card, remembering crones innovate. Your hips are intact! Grapefruit juice will increase the longevity of your narcotics by 20%.

[hev]

Moonstruck! wow. That is quite a story. Glad you are here to tell it. I am now about 20 months since my injury and am now feeling 95% in my day to day activities and about 85% while skiing. Some guidelines on my experience from the injury. I am 32 and in good shape overall.

1-month post opp =90 in the CPM. No weight bearing
7-month post opp = walking with cane or single crutch
9-month post opp = walking with significant gate
18-month post opp = skiing
3-year post opp goal - walking with no gate

[Moonstruck]

Thank for the encouragement! I know it is going to take a long time. In the meantime, I am reviving my lost art career. I have already sold 3 graphite drawings and am showing more. I had wanted to go to art school but ended up going thru Engineering school and have been working in IT for 27 years. This has been a chance for me to have the time to do something I always wanted to do and didnt have the chance.

I did have a setback today. I had an MRI on my "good knee" as it has been causing me pain. My Dr called me to explain why I was having pan and delivered the following news:

- Chipped kneecap
- partial ACL tear
- Meniscus tear
- leg was hyper-extended
- fractured tibia
- Arthritis

So, I will having surgery on my "good knee" in about 4 weeks. My Dr is going to examine my "bad knee" in 3 weeks and wants me to have RM of 120 degrees. This morning PT measured me at 94 degrees. I am getting a little better each time, but not enough to my Dr's satifaction. So, I will have surgery on the "good knee" and possibly the "bad knee" at the same Operation... The tibia plateau fracture and my other 11 broken bones had all of the focus. Funny how that can happen. So, now I think I have met my broken bone quoto for life - 14!! (I broke my nose and in college).

Thanks for the encouraging words...it is nice to have the opportunity to have a forum to discuss this and share stories!

Moonstruck! wow. That is quite a story. Glad you are here to tell it. I am now about 20 months since my injury and am now feeling 95% in my day to day activities and about 85% while skiing. Some guidelines on my experience from the injury. I am 32 and in good shape overall.

1-month post opp =90 in the CPM. No weight bearing
7-month post opp = walking with cane or single crutch
9-month post opp = walking with significant gate
18-month post opp = skiing
3-year post opp goal - walking with no gate

[dogkneed]

I googled recovery of tibial plateau surgery and found this thread. My husband told me to look for something like this since I have been feeling depressed the last few days. My six week check up is on fri. I was not feeling like I am where I should be in my recovery, but after reading some posts I am feeling better. Seems like everyone has there own rate of recovery and different docs are doing different things. My story:
Thanksgiving 2011. My dog and another dog ran into my leg at the dog park.
Went to Er next day and was told I needed surgery. Thought they were trippin.
Following Monday got second opinion and was told again I needed surgery. Cried my eyes out. I am 38 with a full time job, a 6 yr old and a night class twice a week. Could not believe I would be off my feet for weeks to come.
Dec 6th had surgery. Dec 9th came home. Stopped taking the Percocet the next morning. Been doing Pt 3 times a week since Dec 14th. BEEN DOING Cpm since first night in the hosp. Been 50% weight bearing since 4 week follow up. Got to 85 for ROM. Cant seem to bend my knee as much as doc and therapist want me too. Frustrated. Now trying to walk without assistance. It is so scary and frustrating. I get sick of hearing that the fear is all in my head and that I can bear this weight. That is why I wanted to post. I needed to know I am not alone and not the only one going crazy!!

[dogkneed]

Moonstruck. So sorry to hear about your accident. I was cringing the whole time I was reading your post. I hope you have a speedy recovery and stay positive regarding your future hurdles. I know easier said then done...bless your heart though.

[97r82]

Moonstruck
I thought I had a bad accident. You have been thru too much. I just had the one bad leg to deal with after the bruises healed on my good leg. The boredom is the killer. The pain is manageable. Hang in there. Keep a good attitude and follow the docs orders. Find a good PT. Make sure they do hands on to work out all the knotted up muscles. Some PT never touch their patients. You need both the exercise and hands on. Each day my leg feels slightly better. My accident was Oct 7th 2011. Still on crutches but getting there. Keep us informed and just remember that a broken tibia alone is a very serious event. Seems to heal slower than most bones.
thanks
jesse

[framerboy]

thanks for the encouraging words madden65 and jesse. The mental part of this injury is becoming more a factor as the weeks go on that's for sure. The first month wasn't so bad. The holidays brought alot of family and friends by, but now everyone is back to their normal schedules except for me. To make things worse right now we are experiencing blizzard conditions, so i am really under house arrest and so are my friends. Oh well, at least I am not working in this weather.
I had my first physio appointment this week and my physio says my ROM is pretty good. The bike was no problem and felt good to get some circulation going to my "non-existent" leg. Feels good to have something to do for your recovery that is in your control.
Anyway, I gotta get to my busy schedule here (who am I kidding).

[Moonstruck]

Thanks for the encouragement! I appreciate all of the feedback I am getting. I go to the Dr tomorrow for the quartizone shots in my "good knee" ...so I hope it feels better. My next fear is surgery on the good knee and bad knee simultaneously, and being back to bed rest. Oh well, I just want to get it over with and get on with life, and eventually get back in the saddle again!

[Moonstruck]

I just had an appointment with my Dr and he said that my fracture was a Schatzker scale 6 which I understand is the worst grade!

[framerboy]

Thanks for the encouragement! I appreciate all of the feedback I am getting. I go to the Dr tomorrow for the quartizone shots in my "good knee" ...so I hope it feels better. My next fear is surgery on the good knee and bad knee simultaneously, and being back to bed rest. Oh well, I just want to get it over with and get on with life, and eventually get back in the saddle again!

Moonstruck, I just finished reading your first post on this site. What an injury! That's aweful, but it is good to hear that you are doing ok, all factors considered. I crushed my tibial plateau 6 weeks ago by over-shooting a jump while snowboarding. Landed perfectly, just too much impact on my tibia. After reading about your injury, mine feels inadequate. I wish you all the best in your recovery. After reading this post I now have that aerosmith song stuck in my head "back in the saddle again".

[Ryanrene]

moonstruck..
I too just recently (12.10.11) fractured my tibia into 12 pieces after jumping from my horse...Not nearly as bad as your accident...my horse reared and I lost both my stirups and decided to dismount. I landed perfectly on my feet but as soon as I did I saw my left knee buckle to the left and I collapsed and had my reins in my hand and my horse spun me. As a result I too have a type VI (6) tibial plateau fracture and 2 spiral fractures down my tibia. Apparently the plateau was broken off on both sides and another piece was shattered into 8 pieces. My leg swelled so badly that I too needed an external fixator but had that on for 2.5 weeks before surgery. I have 2 plates on both sides of the tibia and 12 screws as well as some bone graft shoved in.

So today I am 3.5 weeks since my second surgery but 6 weeks since the accident. It's been a long, depressing, painful time and by the looks of things it's not getting any better any time soon. I was not given an CPM machine and infact my OS has put me in a brace locked at 30 degress. I have an appointment next week for xrays and if the bones are healing maybe I can start some PT but the OS has warned me that I will not be even toe touching for 3 months. I am very afraid that my knee is going to be stiff as most people on here have been using their knee way more than me and still say their knees are getting locked up at 90. To make matters worse I seem to have developed some foot drop. My ankle is very stiff and I am having problems flexing and pointing even with help.

Like many people on this thread, I looked for anyone in my situation just to feel like I am not alone. I have a 3 yo and a 6yo and a full time job and have been on my butt for 6 weeks. I am on crutches, thank goodness, but still reliant on vicodin for pain. I seem to be getting burning and shooting pains in my foot and leg. I am hoping thats a good sign. If anyone has any suggestions or similar foot drop issues, please help. I took a long look at my leg today without the ace and brace and it looks like my arm, which made me want to cry.

[hev]

Some thoughts of encouragement.

Everything up to the point prior to walking on one-crutch is pretty hard and not fun. Definitely depressing.I tried to make it a point to give myself little projects to do that made my life easier around the apartment. I setup an Aeron chair so I could roll to fridge, my desk, and the couch. Get a kindle for sure.

Once you get to one crutch, you are home free but it is much harder work. It's actually extension that is the hard part. I rigged a board, with two cam belts and locked my leg into that torture trap for like 6 months. It hurt big time. Your flexion will come back even if you aren't in the CPM right away I think...sounds like to much hardware in the mix to do that now.

Ryanere from breaking my foot I know that swelling in the foot is hard to deal with. If you don't have an ice-machine get one ASAP (you may want a couple with your injuries). They are far superior to ice-packs. Keep your foot in it as much as possible. You may want to get some elastic bands and work your foot a little on your own.

[97r82]

Ryanrene
I just now went to one crutch today. Tibea plateau fractured and tibia spit full length. Happened Oct 7,2011. Just now putting most of my weight on the leg. PT is important. Ask you doctor to send you to a good one. They had me do a lot of leg lifts plus using a strap to keep stretching my ankle (Dogleash at home). This will prevent foot drop or correct it. PT guys know what you can do without slowing the healing process. Ask the doc about ultrasonic bone stimulator (Smith Nephews brand). Supposed to help speed bone growth. Main thiing you have to battle is depression. Read if you enjoy books. Movies, Crackle.com is free. catch up on your knitting or something. Call your old friends and family? Don't be afraid to ask them for help (they usually want to do something). This injury has a very slow recovery (I went 11 weeks without touching down on the foot) Very hard task to accomplish. i used a walker instead of crutches makes it easier to swing your bad leg. Also used a wheelchair. With the little ones around crutches are dangerous. Someone on this board summed it up pretty good with this quote (sucks to be me right now). Keep us up to date. This is a great site. not many people have this type of broken leg so we know where you are at.
thanks
jesse

[Ryanrene]

thanks hev and 97r82...I've read this entire thread and everyone's various stories and injuries and recoveries and from that I try to maintain my motivation. this injury has been life altering to say the least. I have family and friends helping me and giving me support but at the end of the day, it's just me adapting to life as it is now. Each day I find more challenges: today is how in the world do i take steri strips off when it feels like I am ripping my skin off?? I had 26 staples after surgery and 4 giant holes in my leg from the ex fix. I look like I've been shot! My main focus is to strengthen my foot and ankle. I stretch and use the elastic bands but its so darn slow! I just dont know how it got so stiff in the first place..I mean I didn't break that part! sigh. And how long is it going to take before your foot doesnt' turn purple after you have it down on the ground? I imagine when I can start using it again...I am just grateful to have someone to talk to about this injury...

[Mallen65]

My accident was 8/28/11 and when I look back I didn't think my life would ever be the same. I am approaching my 5th month and I am starting to realize my life will not be the same. I look at things in the before and after kind of way. There are so many little things I did before that I will not do after. I look at it as starting fresh with the second chance I have. It has changed my life personally and professionally. My wife and kids say I am different in the way I deal with things and the way I conduct my everyday life. Things I thought were important are not, things that bothered me don't, I appreciate things more, i.e. my family, my job and just all the little things I never took the time for. I am determined to keep up with my recovery and get as strong and healthy as I can but my new motto is "don't sweat the small stuff". I know all this may sound sappy but going through this injury and everything that goes along with it has changed my life for the better. To everyone on this site, new and old I could not have made it through without your sharing your experiences and advice. I have turned the corner, I know I will be ok and I will move on and enjoy my life to the fullest. I just will stay on flat ground and not take so many chances, I am getting to old for that. I wish everyone a fast and healthy recovery and stay positive because things will get better, they may not be the same but they will get better.

[dogkneed]

ryanrene. Sorry to here about your accident. I only had 4 screws and a plate, so my injury was not half as bad as yours. But i used a walker and a wheelchair during my recovery. Cannot stand crutches personally. I am at 6 weeks and was instructed to lose the walker. So onward and upward. The purple foot/leg thing is normal. I just asked my doc about it and he said it will go away as you use your bad leg more. That means when you start walking. I wish you the best of luck. Keep your head up. And its ok to go lock yourself in your room and cry it out. Its ok to take naps and to ask people for help. This will pass it just requires some patience.

[liamy]

Im not sure what to do, so I thought I'd come here. The only place that I can find anyone who can relate to what I'm going through.
Here's a tiny bit of background......I fell on 6/20 and ended up with a grade 6 TPF and spiral shaft fracture. I had surgery 3 days later and ended up with alot of bone graft, a 12 inch plate running the length of my tibia and 14 screws. I was NWB for 12 weeks and spent about two months transitioning from two crutches to one crutch to a cane and finally to nothing but a limp. I feel like I've had two big obstacles, besides the knee. Foot and ankle pain and getting to full extension. Which leads to to my problem....
The past week, my OS and my PT have told me that in all likelihood, I will not get any more extension. I'm stuck at about -5 degrees. I'm on week 6 of using a JAS splint, three times a day for 30-45 min each time. Before the splint I did nothing but lay prone on the bed with my leg extended over the edge so gravity could pull it straight. Now that I'm told it's probably permanent, I wonder why more wasn't done to fix it!! I talked to my PT today about it, and he thinks that the entire time prior to the brace, my knee was not ready for anything but the prone/bed stretch. It was too painful and too inflammed. He didn't want to passively push it straight because the femur would come into full contact with the damaged plateau. I don't know if he's right or not. When I ask if there's anything I should do in addition to the brace he says no.
Both the OS and PT agree that having a contracture of -5 (which I know isn't terrible, but it's enough to make an impact), will affect my ability to walk and stand comfortably and therefore, will limit my ability to return to my job!!! (I work 12-hour shifts on my feet for most of it).
Sooooo.......my fellow TPF'ers.......Do you have full extension? How did you get it? Did your PT "push" you into it? Do you think my PT didn't push me hard enough?
Thanks.....amy

[Mallen65]

Amy, I was told in the hospital that I had to keep my leg as extended as I could at all times. It was very painful and every time I wasn't doing it they would get on me and made sure I did it. When the surgeon came to see me he made sure he told my wife to make sure I keep at it when I got home. After two weeks on the couch, I graduated to my recliner and I used a medicine ball as a foot stool, resting the heel of the foot on the ball. It was painful but I started 10 minutes on 10 minutes off until I was doing it on a regular basis. Slowly my leg got to full extension. My issue was flexing, it took me over 4 months to get past 100%. I am not sure if it's too late for you but try he medicine ball and see if that makes a difference. Good luck and I hope things get better for you.

[sudyshewo]

... I feel like I've had two big obstacles, besides the knee. Foot and ankle pain and getting to full extension. Which leads to to my problem....
The past week, my OS and my PT have told me that in all likelihood, I will not get any more extension. I'm stuck at about -5 degrees. I'm on week 6 of using a JAS splint, three times a day for 30-45 min each time. Before the splint I did nothing but lay prone on the bed with my leg extended over the edge so gravity could pull it straight. Now that I'm told it's probably permanent, I wonder why more wasn't done to fix it!! I talked to my PT today about it, and he thinks that the entire time prior to the brace, my knee was not ready for anything but the prone/bed stretch. It was too painful and too inflammed. He didn't want to passively push it straight because the femur would come into full contact with the damaged plateau. I don't know if he's right or not. When I ask if there's anything I should do in addition to the brace he says no.
Both the OS and PT agree that having a contracture of -5 (which I know isn't terrible, but it's enough to make an impact), will affect my ability to walk and stand comfortably and therefore, will limit my ability to return to my job!!! (I work 12-hour shifts on my feet for most of it).
Sooooo.......my fellow TPF'ers.......Do you have full extension? How did you get it? Did your PT "push" you into it? Do you think my PT didn't push me hard enough?
Thanks.....amy

Amy, I don't know what to say about facing limitations -- some things don't regenerate, and it sounds like you don't have a meniscuis? That seems impossible, but if the femur and the tp touch that would be the case.

Only 20% of ppl escape this injury without soft tissue damage and meniscuis tears and I thank God for my luck in the numbers. I don't think you should just force push all at once you should SWIM and kick and even use resistance foam floats in the water, then it becomes about muscle and tendon strength. You can strengthen those forces and they can do magic at 'sanding' in a good range of motion the bone putty and graft material, but you have to strenghten those soft structures and it takes time. I don't get a PT I just go down and pretend I'm a bird or do what I need to do and am able to do to keep going forward. Pain can make a person grouchy, but you will just have to work smarter, and you can do it. I bought a bunch of neoprene "waist wraps" at the chineese goods bodega down the street and I wrap my calves and foot in those--they don't swell, and I don't get runyards in that foot anymore after 4 mos the circulation from clearing all that fluid has cmy ice toes. My one calf went from 17" to 14", the other from 17" to 15"--and my shoulders were strong before but the flexibility is way down they are muscle bound for sure. You work at a hospital.

When I was in the hospital I noticed they hired and kept on tons of disabled people. One of my aides wad deaf, she had hearing aids that didn't work as well as ears, but they looked at her as a good example of patients to see empathy and imperfect usefulness at work. If you approach it with that attitude about your contributions, I think you can positivly expect your boss will follow suit, if he or she dosen't, someone important at the hospital will, and they will help you. YOUR ATTITUDE IS KEY THOUGH. Also, I was looking for assistive devices I could prop or hang off myself easily to do the necessary hand work of assembling pizzas... look at this lighweight muppet wrangling device, its even inexpensive, you can get FAST with assists --and limps get faster too--I'm counting on it! If it hurts to much, change your position, get help if you need it, but don't stop.

http://www.allegromedical.com/crutch...t-p558454.html