Tibial Plateau Fracture Recovery

[soonerstacy]

So taking in all of your good advice from your posts. Started PT at home yest. just sets of leg lifts not much swelling no pain and mentally it helped alot! It's been 5 weeks since surgery OS appt this week hope he gives me more ROM only at 45 now. Hardest part has been emotional by far well that and the non showers :/

Deenah, I think at five weeks you should be more than able to get to 90 or more. I'm not sure what your situation is, but the day after surgery they had me at 85 and it wasn't a big deal. I'm four weeks past surgery and I'm about 110. The heel slide really helps me. If you take a towel and wrap the middle around your heel, just gently pull the ends of the towel and try to go further every day. If you don't get that ROM back now, you may never get it back! That's a bad situation you don't wanna be in. You should be able to take showers, just sit in the shower with a handheld sprayer, that's what I do. I go back in forth from sitting and standing occasionally with the help of a grab bar. If your doctor is the one telling you not to shower, I would seriously consider changing doctors!! Good luck and keep us posted.

[soonerstacy]

Hi Welcome to the site! (I am glad you found it, but sorry you had to) Did you fracture your tibial plateau - or your tibia? I think some of the recovery issues (and rehab) will be the same and some will be different...

Nope mine is also tibial plateau. That's how I found this thread. Although I didn't hurt it skiing....I had to "dismount" my horse very quickly and BAM! Not fun.

[SueBee]

Nope mine is also tibial plateau. That's how I found this thread. Although I didn't hurt it skiing....I had to "dismount" my horse very quickly and BAM! Not fun.

Wow - sounds like you are doing great!! I had to wait 3 days for my surgery an I thought I had it bad. We are all different but you have really good ROM for where you are at. I started with PT around 4 weeks post op- but not frequent until I started with the PWB. 6 or 7 weeks post op. that is when I got on a pool and practiced walking... I'd say keep doing what you are doing. Keep working on your ROM. Keep posting so we hear about your progress!

Good luck!
skiing Whistler TPFx 03/10
Surgery plate and 6 +? Screws (to be confirmed) 03/13
PWB 05/01
FWB AT 05/25

[SueBee]

the day after surgery they had me at 85 and it wasn't a big deal. I'm four weeks past surgery and I'm about 110. The heel slide really helps me. ...

That's weird - no immobilizer for you? I was immobilized for 2 weeks- many of us are and that is why the incremental improvement in ROM- you have to really work to get it back.

After immobilizing for 2 weeks, I was put in a brace that unlocked to 45 degrees for 2 weeks and then increased to 90 degrees- Which by then I had to work for a couple more weeks to get past 90 degrees.

Every recovery on this site is very different. The fact that you were at 85 degrees immediately after surgery is quite unique!

Best wishes,
Sue

[soonerstacy]

That's weird - no immobilizer for you? I was immobilized for 2 weeks- many of us are and that is why the incremental improvement in ROM- you have to really work to get it back.

After immobilizing for 2 weeks, I was put in a brace that unlocked to 45 degrees for 2 weeks and then increased to 90 degrees- Which by then I had to work for a couple more weeks to get past 90 degrees.

Every recovery on this site is very different. The fact that you were at 85 degrees immediately after surgery is quite unique!

Best wishes,
Sue

Well I do have an immobilizer but it can easily be taken off. He told me to wear it when I'm crutching around, but I can take it off when sitting or sleeping (hooray!). For leg lifts and another exercise I keep the immobilizer on. Most of them though I take it off. Maybe they pushed me so hard right after surgery because I'm young (27) and active. I did a lot of yoga and some running before the accident. Not sure if running will be in the cards for me though.... Yoga definitely will help. I wanna get back to 180 so I can get in child's pose. Correction, I WILL get back to 180! Must stay positive. Since I've made it to 4 weeks, I'm going to reward myself with a little trip to the pool today.

[Dgw3369]

I found this blog on tibia plateau soon after my injury. It's been very helpful with my recovery and questions I've had about this injury. I've enjoyed reading about everyone and where they are at in there recovery and how each person is doing. I wish everyone the best recovery with this terrible injury. Alright about me. I'm 35 yrs old and I broke my tibia plateau stage IV and spiral fractured my entire tibia on 3/19/12. I had surgery on 3/30/12 plate and screws installed like everyone else. This was my first surgery or ever breaking anything in my life(knock on wood). The pain was excruiating for the next 3 weeks. Nothing I took for the pain could relieve it, just slightly take the edge off. I was put into a Bledsoe brace the morning after surgery, the brace was unlocked and my os said I can immediately move the knee. I slowly over the next few weeks started to move the knee as I felt necessary(as the pain would allow). I started PT 4/19/12 after being ok by my os to start and the staples were removed. My initial range of motion was 15degrees extension and 89 degrees flexion. I've been working very hard on my extension as I've been reading its very important to get the leg straight. I do all my exercises at home everyday that I do at PT. But I'm not seeing much improvement in extension. My thigh and calf muscle atrophiated a lot initially. Sense PT my thigh has almost regained full size and feels very strong. Every appointment at PT I increase the weight for my exercises by a half pound. I'm now at 5 lbs. 5/24/12 last os visit he ok'd 20lbs PWB. That was tough to here cause 20 lbs is not much weight at all. I was expecting a little more. Like everyone else it's a long road to recovery. I've sense been going threw the motion of walking and putting my foot on the ground trying to only put 20lbs. I occasionally go a little more. I've been putting a lot of miles on these crutches and it feels great to almost walk again. When I do practice walking there's no pain and the leg feels really good. The knee is still stiff a little. One thing I have noticed that the knee does click as I bend it. Seems like it comes from the patella as it moves. I've been pain free sense the last 3 weeks. So it does get better and I was worried I would always feel pain. 5/30/12 I had my reassessment of my ROM at PT. 7 degrees extension 118degrees flexion and my flexion improves daily but my leg has seemed to stop at 7-10 degrees extension. Has anyone else had trouble with there extension. I try so hard to get it straight and it's worrying me I won't get there now. I continue to walk everyday a mile or so. The leg feels almost good as new each time i walk on it and PT twice a week with myself doing PT everyday at home. I go back to my os on 6/22/12 and he said he might give FWB. He said last time the bones healed well. I have my fingers crossed for that day. I can't wait to get back on the leg and walk without my temp legs(crutches) I would love to throw those things out.lol. More importantly I can't wait to get back to work and make money again and occupy my time. Best of luck to everyone here and Im glad to have found this forum. It has really helped reading what everyone has had to say.

[peaton]

Jumped from a 3' high stool from a standing position on May 23rd, I was taken to the ER in excruciating pain. X-rays revealed a fractured tibial plateau. One week later saw the OS, after reviewing x-rays and ct scan I have a bicondylar tibial plateau fracture w 1mm depression. Surgery was the following day, woke up in a full Donjoy ELS knee immobilizer at 0% ROM. I was told I will be in this for at least 9 days, until my check-up and NWB for 12 wks. I have not been taking any narcotics or pain relievers for 2 days and feeling pretty good.

Upon reading everyone's stories here I was taken back by the seriousness of this injury. I am not a professional athlete but would just like to be where I was prior to the injury and to enjoy my horses and malamutes again.

Good luck and thank you for telling your stories

[crobertscroberts]

4 Months post injury

Wow reading all these posts have been really helpful to know that I am not the only one struggling. I am so sorry to hear about all your stories, but it is wonderful to see how many strong and determined people are out there.
Injury Time line:
Feb 10-broke my tibula (plateau spiral fracture) and fibula
Feb 12-Surgery
Feb 17-went home from hospital
April 6-partial weight bearing on crutches
May 14-started using only one crutch

It has been along 4 months is all I can say...I broke my tibula and fibula skiing at Kicking Horse Mtn. in British Columbia and was sent by ambulance on a three hour ride to Calgary where I waited for surgery for two days based on swelling. I was in pretty rough condition in pain at the hospital and when i was sent home they put me on new pain meds that did not work at all, so ended up back in ER 4 days later due to pain. I had never experienced pain like this before and honestly did not know how to deal with it. Six weeks after the injury I saw my OS and he said the bone was healing really good but I was VERY stiff in the knee and he basically said if I didn’t start working on my ROM I would be back in the OR. I immediately started Physio and even though the it hurts like hell it is so worth every moment.
March 26, 2012 was when I started physio and I was at 35 degree flexation and 15 degrees extension, and June 4, 2012 I have made it to 140 degrees flexation and 8 degrees extension. It has been a lot of working going three days a week and about two hours a day total of exercises.
I would say the pain and the mental struggle are just as hard, I find myself getting really upset with how slow the progress is, and have a hard time seeing the light at the end of the tunnel. I still have a lot of knee pain and foot pain (nerve damage) which I pray will go away! The OS says that the foot issues could last up to a year and no one really has an answer for my knee pain as it comes with the injury. I would say this is the hardest thing I have had to go through, but the one good thing is that I see the world a lot different and hope to not take so many things such as walking for granted.

Good Luck and thank you for sharing all your stories

[Nurse Nina]

I am a week ahead of you with a similar fracture. I had surgery on the March 19th with a plate and 8 screws. I just started full weight bearing as tolerated almost two weeks ago. I am still using the darned crutches but can finally manage to get around with one crutch and a few steps without any in the last week. It is amazing how once I was able to bear full weight, along with PT strengthening exercises, how quickly i gained mobility. It still aches and swells up by mid day. I find pedaling the stationary bicycle before PT is really helpful and reduces swelling so I can get more flexion. I had 130 degrees flexion and just got down to zero extention last week. I thought I was at full extention for a few weeks but it turned out that was while on the bed. On a flat surface, i was more like 4-5 degrees. This morning was the first day I could actually see my knee cap appear. I get that clicking too. It comes from the weak quad muscles. My VMO was shut down according to my PT, so the tendons slip over the patella causing that clicking. As long as it doesn't cause pain, he said it is OK. I just need to work on those quads and hamstrings. My lower leg aches and I am sore along both sides of the tibial shaft where the spiral fracture was and it swells up if I walk a lot. The tendons apparently attach there and it is still very sensitive. The ankle and knee are also stiff and I can't seem to walk without hesitation. I started with flat foot partial weight bearing at 6 weeks post op. Try using your two crutches for some short steps to see how you do. If your bones are healing and you had a repair I don't know why only 20 lbs. My Pt says FFPW is about 35% weight bearing with two crutches. It depends on your weight and whether or not it was a high impact injury (mine was skiing) or a low distance fall. At 35 I assume it was high impact.?
I just started working on strength building now that I am at the 12 week mark. The step was tough, especially coming down and bending the right knee. I am not quite ready for that. If things go well over the next week or so, my PT tells me I may be able to give up the crutches by then. Much sooner than I had anticipated.
Thanks for participating in this forum. I have found it extremely helpful to help me get through this. I don't know where I'd be without everyone's input. Keep us posted.
Nurse Nina

[TheAshmani]

Hi guys, good to hear everyone is progressing because, yes it is emotional, depressing but there is light at the end of the tunnel and my overall recommendation is regular exercise and don't be scared to push yourself even though it hurts (and feels like your leg is going to snap). I was fortunate enough to have a very strict physio who changed my thoughts on pain! I am in week 10 (today in fact) since my operation (plate, 5 screws- 4 horizontal and 1 vertical). I came off my motorbike having slipped over some oil/petrol spillage. I am now full weight baring with crutches and practising 1 crutch in the house. I am still training every day in the gym when I can and each day making great progress. I have kept a diary of my training progress so if anyone would like to see it, let me know and I will post it.

Good luck with it guys, this week is my first week without my brace so should be interesting!

[itsdeenah]

So out of no where my leg swelled up huge yest. maybe overdid the crutches and letting it hang down too much at my desk. Did the pillow prop up Jenga style last night in the bed for elevation, then this morning I noticed a thick white thread sticking out of my incision? Gross!! so I pull on it alittle with tweezers and I feel the pain deep down ughhh sick. Is this a left over dissolveing stich that wants out? I've already pulled out 4 black shiny stitches that were easy but this one looks different. Any advise would be really appreciated

[crobertscroberts]

Timeline:
Feb 10-tibial plateau spiral fracture
Feb 12-Surgery
Feb 16-Released from hospital
April 9-Parital weight bearing
May 14-Walking with one crutch
June 3-starting to walk a bit with no crutch

It has been along recovery so far and I know I have a long time to go until things are back feeling good. On Feb 10, 2012 I was skiing at kickinghorse and caught an edge, twisted my knee while the ski did not release and from there all I remember is PAIN. I was taken by ambulance for three hours to Calgary where I had to wait a couple days for surgery due to the swelling. Surgery went well and 5 days later I was released from the hospital. I can remember the car ride home and feeling the pain after every tiny bump that was in the road. I had an ok couple days but the meds that I was sent home with did not help with the pain so I ended up back in the ER. Everything was okay but I just needed stronger pain killers. I have never felt pain like I have with this injury.
I started Physio 6 weeks after the accident and had a very stiff knee with a horrible ROM (35 degrees flexation 15 degrees extension). The OS said that if I didnt get my ROM going then i would be back in the OR and he would manually bend my leg. I was in physio three times a week up until last week and kept up with the exercises at home and now have a fairly good ROM (145/4) but still can not get to zero degrees, which makes walking difficult. Have any of you experienced numbing and tingling in your feet? apparently I have some nerve damage which really has effected my foot and made it quite uncomfortable.
I would have to say that the mental struggle is just as hard as the physical with this injury. It was very hard to be home for three months and have most of my independence taken away. It has been four months and I still feel quite a bit of pain in my knee and still taking pain killers and anti inflammatories. It is hard to see the light at the end of the tunnel some days because it has been such a long and slow recovery, however I would have to say as much as physio hurts it is the best thing to getting back to normal. I think the one good thing out of all of this is not to take things for granted because once you have been though a situation like we have it makes you realize what is important in life.

Hope all of you have a speedy recovery!!!

[Dgw3369]

Good to here from someone with a very similar injury(Nina) sounds like your doing a little better then me but soon I'll be there too. Yes I thought it was strange to only have 20 lbs weight bearing. It's not much at all once you put 20 on a scale and find out. But ive been walking with my crutches and my foot fully on the ground. Maybe putting a little more weight then I should but it feels good and I slowly increase the feel of more weight. I didn't just go all out at first. You have the clicking too. With mine I feel no pain just it's loud enough to hear and feels strange. Your PT explanation sounds correct. As my patella moves it comes from there(click). It must feel good to get to 0 extension. When I stretch my leg and can't get it fully straight it feels like I still need to stretch it. Almost a little unrest feeling with it. Can you feel where your spiral fracture runs down the tibia. I can feel a little canyon where mine runs down the tibia. As time goes on it gets less and less. There still discomfort on the lower part of the tibia only when I push on it. My knee cap just started to reveal itself and the rest of the knee is starting to look like the other one. Wasn't sure if that would ever look the same based on how swollen it was. I don't get any swelling on the ankle after walking and my ankle doesn't hurt. But I've been putting a shoe on that foot and resting it on the ground the day after surgery. It hurt a ton to do that but I think it helped me for the walking stage cause my foot got use to being used still. I've read that if you don't use your foot for some time the bones soften a little in the foot and that causes some of the pain. I hope you can give up your crutches as soon as your pt says you going to. I hope imsoon to follow. How I can't wait to give those up! I've put some miles on those things and so ready to feel my legs under me again. I can almost imagine walking again.

[Dgw3369]

Deenah I had a very similar white thread on the inside of my leg where they made a tiny incision. I pulled on it too and it Felt still attached but clearly it was some sort of suture. I left it alone for another week or so then I got the nerve to pull a little more at it and it came out. I'm assuming it was a dissolving stitch that worked its way out. Sounds to me it's the same thing you might have.

[peaton]

OK, so I have a quick question for those of you who have been through this and are further along than I.

I am exactly 1 week post-op. I am experiencing a prickly feeling in the bottom of my foot and numbness in my heal. My leg/ankle/foot/toes are still experiencing considerable swelling and bruising. Is this normal feeling? If you had this problem, does it go away or is it something I need to discuss with my OS?

[itsdeenah]

Deenah, I think at five weeks you should be more than able to get to 90 or more. I'm not sure what your situation is, but the day after surgery they had me at 85 and it wasn't a big deal. I'm four weeks past surgery and I'm about 110. The heel slide really helps me. If you take a towel and wrap the middle around your heel, just gently pull the ends of the towel and try to go further every day. If you don't get that ROM back now, you may never get it back! That's a bad situation you don't wanna be in. You should be able to take showers, just sit in the shower with a handheld sprayer, that's what I do. I go back in forth from sitting and standing occasionally with the help of a grab bar. If your doctor is the one telling you not to shower, I would seriously consider changing doctors!! Good luck and keep us posted.

I have a large bone graph to rebuild the entire top of my tibia as well as the tibial plateau and a plate for another fracture down the shaft. I sustained a permanent disability to the leg I get to walk at least but prob. not much more. Who knows though anything is possible right? I go back to the OS soon and hopefully more ROM and possible PT action. I just received a bathseat so that should help and I'll deff look into getting that grab bar too. Thanks again and I love reading everyone's positive progress..hopefully I'll be able to post some of mine soon too.

[itsdeenah]

Hi Peaton: I sometimes still have that as well and I'm 5 weeks post-op, I still have the numbness in my heal especially when it's resting on something even a pillow for a while and parts of my leg (more where the plate is - superficial nerve damage it should come back they said). My leg by evening is always huge swollen and still feels achy & sometimes that needle like pricking deep down in my knee (also a sign of healing). This week it was huge and 3 white threads are coming out of the incision (dissolveable stiches) so alot of changes all at once is hard Im still learning that the hard way...but this forum & everyone on it has already helped me so much. Keep posting and hope you have a better day - hang in there one day at a time.

OK, so I have a quick question for those of you who have been through this and are further along than I.

I am exactly 1 week post-op. I am experiencing a prickly feeling in the bottom of my foot and numbness in my heal. My leg/ankle/foot/toes are still experiencing considerable swelling and bruising. Is this normal feeling? If you had this problem, does it go away or is it something I need to discuss with my OS?

[crobertscroberts]

OK, so I have a quick question for those of you who have been through this and are further along than I.

I am exactly 1 week post-op. I am experiencing a prickly feeling in the bottom of my foot and numbness in my heal. My leg/ankle/foot/toes are still experiencing considerable swelling and bruising. Is this normal feeling? If you had this problem, does it go away or is it something I need to discuss with my OS?

I am 4 months post op and I have been experiencing the same issues with my foot. The OS and Physio say that it is most likely nerve damage from the break or surgery. For me I have tingling and pain on the outside part on the bottom of my foot, and I cant really feel my baby toe. Sometimes my foot hurts more than where the break occured. The physiotherapist told me that nerves can take up to a year to heal, so it may be awhile until your foot feels back to normal. Another reason for foot issues is due the foot not being in use (weight bearing and mobility). Hope this information helps!

[peaton]

Thanks for the info, although it wasn't what I was hoping to hear. Hopefully it will be a temporary issue, as my job (when I'm able to return to it) requires me to be on my feet and walking 100% of the time.

[crobertscroberts]

Just wanted to know do any of you still experience knee pain four months after your injury? I have quite a strong achy pain under my knee cap that is almost constantly in pain, and it gets worse in the morning and at night.
I am taking an anti inflamatory and a tramacet a day which helps a bit with the pain, but trying to stay mentally strong when in pain for four months is super tough.

[lgillingham]

I'm now at 12 weeks post surgery and I'm feeling like I am progressing. I had surgery on march 7 and was told I could walk after 6 weeks. My surgeon didn't limit my walking in any way. He said the bone was healed and I could walk. So walk I did.
I decided I was going to walk the rock and roll marathon in sd. I know that may seem crazy given our common situation but marathoners understand pain and pushing better than most. What I learned is that walking long distances hurt no more than being at work all day. I also felt like my knee felt better when I walked...less clampy feeling. My foot, as some have mentioned, has been the most painful part. After six weeks of walking and training I did complete the marathon walking all 26.2 miles.....some with a cane but most on my own two feet. And i made the cut off of seven hours with thirty minutes to spare. It really can be done. During my training...each week I noticed less pain in the knee area and less swelling as well. I wore compression socks which made a big difference. And post the marathon, I was sore and blistered a bit but my knee was ok. I'm still walking with a limp because of the foot pain. I'm not sure if that's nerve damage as someone said. My surgeon said that the swelling and foot pain can last a year. That is depressing. Plus no running still. The newspaper and news stations in sd had fun reporting my race....I guess they liked the human interest side of it. I'll am curious to know if I'll ever be able to truly run a marathon again.

[itsdeenah]

Wow! Congrats on the marathon that's so amazing and inspiring!! I was supposed to run in the Warrior Dash in July but that's deff not happening this year. But thanks to your post I look forward to getting back at some point down the road. Great hearing your progress---Keep posting

I'm now at 12 weeks post surgery and I'm feeling like I am progressing. I had surgery on march 7 and was told I could walk after 6 weeks. My surgeon didn't limit my walking in any way. He said the bone was healed and I could walk. So walk I did.
I decided I was going to walk the rock and roll marathon in sd. I know that may seem crazy given our common situation but marathoners understand pain and pushing better than most. What I learned is that walking long distances hurt no more than being at work all day. I also felt like my knee felt better when I walked...less clampy feeling. My foot, as some have mentioned, has been the most painful part. After six weeks of walking and training I did complete the marathon walking all 26.2 miles.....some with a cane but most on my own two feet. And i made the cut off of seven hours with thirty minutes to spare. It really can be done. During my training...each week I noticed less pain in the knee area and less swelling as well. I wore compression socks which made a big difference. And post the marathon, I was sore and blistered a bit but my knee was ok. I'm still walking with a limp because of the foot pain. I'm not sure if that's nerve damage as someone said. My surgeon said that the swelling and foot pain can last a year. That is depressing. Plus no running still. The newspaper and news stations in sd had fun reporting my race....I guess they liked the human interest side of it. I'll am curious to know if I'll ever be able to truly run a marathon again.

[ZGHighlands]

Hello to All!

I have been away for several weeks, and it is good to come back and read about everyone's progress. I am at 13 weeks post accident/operation today. I am happy to report that I am back at work and continuing to make progress with my recovery.

I was cleared to return to work at 8 1/2weeks....the return required several levels of performance tests and evaluations to ensure that I could do the worst case scenario tasks which require the use of my affected leg. It is amazing how tasks that I have taken for granted all of my life, now require concentration to complete. It was a huge boost to my morale to be working again.

Additionally, I have been back on my road bike (NO MTB...yet) and doing 30 to 40 mile rides....albeit mostly flat. I intend to begin climbing rides this coming week! I totally attribute my recovery to the work of my PT.....she has been great!

My leg is certainly not 100%, but it is getting a little bit better everyday. My knee still feels a bit stiff and pain seems to be a roaming annoyance. The most recent pain seems to emanate from where they pushed the plate through the muscle tissue. Before that, it was different points where tendons attach to the lower leg. My PT coached me to push through this pain and within a few days I was adding more weight to rebuild muscle.

Recovery has been a journey through depression and pain. Staying positive is crucial!

Thanks to everyone for sharing your stories and advice...it has been a big part of my recovery and often and much needed morale boost. Best wishes to all!

Travis

[seanwieland]

Lgillingham and ZGHighlands - Thank you for giving me inspiration! I am at 7.5 weeks right now post-op, recently migrated to one crutch, although sometimes drop back to two crutches after a heavy PT session. I can load my knee with 120 lbs before any pain, up from about 70 lbs only a week ago. My question for you - when did you go to full weight bearing, no cane? And tell us what exercises you were doing for PT that gave you such great outcomes? I'm happy with the PT I'm doing now, and I believe I am making great progress, but any advice from someone that is only 5-6 weeks ahead of me would be very helpful!

Thank you, and congrats on your great progress!

[ZGHighlands]

Lgillingham and ZGHighlands - Thank you for giving me inspiration! I am at 7.5 weeks right now post-op, recently migrated to one crutch, although sometimes drop back to two crutches after a heavy PT session. I can load my knee with 120 lbs before any pain, up from about 70 lbs only a week ago. My question for you - when did you go to full weight bearing, no cane? And tell us what exercises you were doing for PT that gave you such great outcomes? I'm happy with the PT I'm doing now, and I believe I am making great progress, but any advice from someone that is only 5-6 weeks ahead of me would be very helpful!

Thank you, and congrats on your great progress!

Hey Sean,

I'd say that for your stage of recovery, pool walking is great. Chest deep and progressing to shallower. Other than that, anything that helps strengthen your supporting muscles so that when you do start walking, you can do it without a limp. Stuff like leg raises, clams, hamstring curls with the thera bands, calf raises, foot and ankle rotations were all good. Also, I had my road bike on my indoor trainer, so I could spin for 30-45 minutes a day.

I'm guessing your doing a lot of the same stuff so keep up the work! It's all worth it!

Good luck and keep us posted on your recovery!

Travis