Tibial Plateau Fracture Recovery

[peaton]

I have a question for those of you who are about at the same stage of recovery as I am, or further along:

Date of Injury 5/23/12
Date of Surgery 5/30/12

I have completed 3 wks of PT and full weight bearing as of Sept.

I am still having a great deal of pain in the joint, stiffness, front part of shin area. I also have quit a bit of heat coming from the joint and shin area. At this point of the game, is this normal? It has not been officially diagnosed for any meniscal or ligamentous damage.

[scjohnson07]

1912berg- I get X-rays every follow up appt in the office to make sure.

[Casper2012]

Peaton. About 4-5 monts after my injury, several weeks into PT I too noticed that my knee was always really warm. My doctor said my synovial lining was inflamed with signs of osteomyelitis. He ruled out infection with tests also. X-ray was also bad, hence the hardware removal in prep for total knee replacement. You might want to see your ortho about it.

[Casper2012]

TheAshmani. Good luck with your X-ray, I hope it looks good. I'm now 5 days post op for the hardware removal and had hoped my leg would feel better by now but it still hurts a lot. I see the Ortho next Monday and hope all is well, just really paranoid about infection. I take it you're a Brit mate?

[peaton]

Casper...how did you feel physically? I have been having headaches, chills, nausea, tired and joint/shin pain with heat. Thanks for the info...not liking what I researched about this. I'll let you know what I find out.

Peaton. About 4-5 monts after my injury, several weeks into PT I too noticed that my knee was always really warm. My doctor said my synovial lining was inflamed with signs of osteomyelitis. He ruled out infection with tests also. X-ray was also bad, hence the hardware removal in prep for total knee replacement. You might want to see your ortho about it.

[Casper2012]

Peaton. I didn't have the chills or other symptoms you describe other than my knee was hot. Have you checked your temp to see if you have a fever? If you do I would get into your doctor. Could be unrelated or could be signs of an infection and you don't want to mess around with that. Best of luck and hope its nothing serious. Keep me posted.

[Righttibia]

H guys,

hope everyone recovering well..

its 11 weeks post surgery and on partial weight bear from last 4 weeks.

im having burnin kind of sensation on operated area when i put weight and getting pain below patelar occasionally,,,

scared to death as this saturday its 12 weeks and doctor said, he will start full weight bearning..

please advice

regards
jay

[Rockband]

Maker asked me a couple questions in a PM and I thought I'd repost here, just for general knowledge.

I'm over 4 years post-op.

Rehab was totally worthwhile and some kneecap pain still persists. The largest help for me is stretching and massaging the kneecap while the leg is locked. Whenever I start having recurring knee pain I will make sure to put in a few good stretch sessions.

I had a bike trainer for a while, using clipless pedals on only the bad leg really helps build up some supportive muscle.

Honestly, my final recovery has been aided greatly by jogging. I know this sounds stupid with the associated pounding but personally it's the most convenient path to exercise for me. I've been really careful with my technique (landing on the ball of the foot) and not pushing it (6ish months after surgery my first jog/walk was around the block), running on dirt, good shoes etc.
This is probably personal though, and I'd say find whatever leg workout you will do the most. I strongly believe the more consistency and repetition the better.

Keep up the hard work and painful workouts, it pays off in the end.
For a bit of inspiration, I did my first Xterra race in June and I've been competing/training in marathon's.

[global_dev]

2 weeks since FWB, after 1 week FWB was switching between 2 crutches, 1 crutch depending on the situation/location. This week has been only 1 crutch or none for the majority of the day.

Stairs are slow goings, but easily doable. I don't feel much pain unless i overexert the knee, which isn't hard to do when pushing the current "limits", especially as the joint loosens up in the AM. There have been 1 or 2 moments of excruciating pain when overdoing the "no-limp" no crutches walk, but feels great to be moving around again, albeit super slow.

Swelling at the knee is an everyday thing, my compression socks are only knee high, and i think thigh high might be more appropriate. Swimming feels great.

I need to get back to PT for a couple sessions and see what suggestions they have.

keep up the recovery all!

[toots1214]

Hi Folks,
From reading the numerous posts, it appears there are various forms of treatment (guess this depends on your surgeon and type of fracture). I fractured my plateau on 7/4/12 as a result of flying, falling off a makeshift stair. I had a pretty good depression and surgery completed on 7/9/12 resulting in 4 pins and a plate. Like everyone else, no weight bearing for six weeks. My great fortune resulted in loosing my balance on my crutches and falling backwards onto an object 2 weeks later. 9 screws and a plate in my right wrist. No more crutches and wheeelchair for the next period of recovery. Survived all that, the boredom and depression and I am now up and walking. My MD said no PT was needed but to get up and get moving but I am feeling like this is not enough. Leg stiffens if I sit too long and if I get up and start walking by the end of the day I can hardly stand on it from the pain. I have also developed these weird sensations in my foot and my knee. Almost like an electric shock. I have two questions: 1. Do you feel I should get some real PT? 2. Has anyone experienced these weird shocks?

[peaton]

You state "MD". Is he/she really just an MD that is treating you? If so, I would see a very good orthopedic surgeon for a second opinion in your area. Sounds fishy that you are no weight bearing for only 6wks with your type of injury, if not completely healed you'll regret it. You will need PT, most all of us are getting some form of it. Can't help too much with the sensation you are having.

Hi Folks,
From reading the numerous posts, it appears there are various forms of treatment (guess this depends on your surgeon and type of fracture). I fractured my plateau on 7/4/12 as a result of flying, falling off a makeshift stair. I had a pretty good depression and surgery completed on 7/9/12 resulting in 4 pins and a plate. Like everyone else, no weight bearing for six weeks. My great fortune resulted in loosing my balance on my crutches and falling backwards onto an object 2 weeks later. 9 screws and a plate in my right wrist. No more crutches and wheeelchair for the next period of recovery. Survived all that, the boredom and depression and I am now up and walking. My MD said no PT was needed but to get up and get moving but I am feeling like this is not enough. Leg stiffens if I sit too long and if I get up and start walking by the end of the day I can hardly stand on it from the pain. I have also developed these weird sensations in my foot and my knee. Almost like an electric shock. I have two questions: 1. Do you feel I should get some real PT? 2. Has anyone experienced these weird shocks?

[Casper2012]

Hi Peaton. Are you feeling any better?

[peaton]

Hi Casper...thanks, yes, part of my symptoms must have been some type of bug. I am still having some heat coming from the joint area along with pain and swelling as well as the pain in the shin area. I see the OS on the 9th of Oct. Pt thinks there is something else going on in the joint area. As I have not hit some of the goals set for me in 4wks of doing PT. I cannot go down stairs yet using the bad knee, haven't been able to return to work, or ride the horses, walk my dogs, along with other things. If I just walk on a flat surface and don't push things I am in pretty good shape. But as soon as I try walking on uneven ground, pushing a wheelbarrow full of horse poo I'm in trouble. I went shopping for the first time this past week for about 2hrs. My knee and foot have not recovered yet! I feel like I'm stuck in limbo right now and not progressing.

How are you feeling?

Hi Peaton. Are you feeling any better?

[imajypsee]

The weird "shocks" you're feeling are spasms and nerves "waking up" from the lack of use for all those weeks. Six weeks non weight bearing does seem short. As for the PT, my OS was the same as yours. He said I didn't need it. But you do need it to get your walking gait right and to work on the right muscles to regain strength properly. I had to ORDER my OS to write the order for PT so my insurance would pay for it.
The pain from walking is pretty normal (as is the stiffness). I was nine weeks non weight bearing (TPF on May 6th) and didn't ever use crutches; I had PT in the rehab facility (ROM and strengthening other leg), used a walker very briefly and then went to a cane. PT started July 16th or 17th and was walking pretty good in about two weeks, but I've only started really getting around halfway decent in the last several weeks. My OS had me in a Genutrain brace following nine week visit and i really needed it. Lately it's been used only when I go out to shop as most of the time I'm not on my feet for long periods (67 yrs old, so retired).
If you're walking around and you don't want to fight with you doctor, I can scan the exercise sheets that my PT gave me. I think there's a PM function on this board. Let me know.

Mary in FL

Hi Folks,
From reading the numerous posts, it appears there are various forms of treatment (guess this depends on your surgeon and type of fracture). I fractured my plateau on 7/4/12 as a result of flying, falling off a makeshift stair. I had a pretty good depression and surgery completed on 7/9/12 resulting in 4 pins and a plate. Like everyone else, no weight bearing for six weeks. My great fortune resulted in loosing my balance on my crutches and falling backwards onto an object 2 weeks later. 9 screws and a plate in my right wrist. No more crutches and wheeelchair for the next period of recovery. Survived all that, the boredom and depression and I am now up and walking. My MD said no PT was needed but to get up and get moving but I am feeling like this is not enough. Leg stiffens if I sit too long and if I get up and start walking by the end of the day I can hardly stand on it from the pain. I have also developed these weird sensations in my foot and my knee. Almost like an electric shock. I have two questions: 1. Do you feel I should get some real PT? 2. Has anyone experienced these weird shocks?

[Casper2012]

Peaton. I'm glad it was just a bug but sorry your progress has stalled. I never got to the point that I could walk without aid during my recovery. I used a cane for a few steps a day but it was very difficult. I see my Ortho Monday for X-rays and to have the staples removed from my incision. I've been feeling less pain each day but the knee hurts and my muscles feel like they've atrophied further. I have a lot of rebuilding to do. I'm curious to find out what condition my tibia is in now that the hardware is out. I've been putting no more than 25 lbs of weight on it as instructed. Ortho told me it will be 3-6 months for the knee replacement depending on how healed the bone is. I'm nervous about it but Im determined to walk again. It's amazing how long full recovery from this injury is. Maybe you need to give it more time. Seems like some people take 1-2 years to get back to normal or close to it. Maybe your Ortho can explain. Good luck to you and keep at it..

[Casper2012]

I know this injury can be discouraging and Ive been following a thread on knee guru.uk titled amputation after MRSA. The post was started by a 28 yr old woman in Sept. who fell by a pool suffering an open fracture of her patella. Following surgery she developed a severe case of MRSA and her leg was amputated from above the knee down a couples weeks ago. this woman is most inspiring and determined. If your feeling down i encourage you to read her story.

[leejem]

9 weeks today since break. Was going great guns until I fell over in my yard yesterday while walking with a single crutch. Landed on my bad knee and bent my leg up behind more than was comfortable. It hurt a lot.

I've got swelling above the knee, I think I stretched out the medial ligament. Couldn't weight bear at all yesterday.

Today the swelling and tenderness are still there but I can bend again and walk with a single crutch. So hopefully I haven't done any damage order my rehab back any.

[crystalteras]

So just an update on me...
TPF type 6 on may 26th, 2012
Surgery 13 screws, 2 plates June 1st, 2012
Been FWB for about 3-4 weeks now

I haven't had any of the foot pain that I hea everyone talking about. I do get horrible sharp AND dull pain in my patella and the inside of my knee where one of my incisions are. Other incision is fine. The pain is often so bad that I cannot walk and I've gotten back to taking strong pain killers on a REGULAR basis or I just can't walk and it kills me. I know this is the hard part where I just have to deal with the pain bc I have to power through but damn...this shit hurts like a mofo lol
I have numbness STILL on my shin between my two incisions and lately it's been itching. Weird feeling when your bone itches but u can't scratch bc it's numb and u can't feel it.
I also have been getting the really hot feelig in the same place which is normal I guess bc everything is working hard in that area so it just gets hot. I've been having a lot of swelling there too towards the end of the day. I am down to using just a cane now (which I duct taped pink zebra ) lol I have a pimp cane now bu most times around the house I don't use it at all unless I am in tons of pain.
I also go to the gym now about 4-5 times a week. And I just started school AnD I'm moving to a much larger house this next weekend so things are going okay now...WAY better than they were at least.

[gregrnel]

Haven't been around to do an update lately, I'm at 13 months from a type 6 (hi crystal ^^^) 16 screws, 2 plates and what I have to report is...it just gets better. I'm 41, so the road was a bit longer and less forgiving. There's always going to be pain and sometimes I still limp a bit, but overall I'm doing everything I used to. I bought some new skis and am ready to go out and do it. Heck, I may just go out and buy another Ducati next year, who knows......just hang in there, do your pt religiously, eat healthy and it will get better. Time heals!

[toots1214]

I should have been a little clearer, perhaps. My MD was an orthopedic surgeon. As a matter of fact he repaired my torn rotator cuff (I am an accident waiting for a place to happen LOL). Due to the wrist fracture lagging behind the TP fx I probably did seven weeks of no weight bearing. Then I did another 4 weeks of partial weight bearing using a walker. No easy feat considering I was still plenty sore from the wrist fracture but the ortho that repaired the wrist said it was okay to start on the walker. My surgeon is no slouch and highly recognized and one who believes to not baby yourself after an injury because the longer you avoid the use of your limb, the longer the recovery. However, I tend to agree with you that PT is probably not a bad idea. It certainly cannot hurt. So I will be calling him for a PT script. Knowing him as I do, he will have no problem with this.

What is weird about these odd sensations is that they occur when I cough, sneeze, laugh. Most of the sensations occur in my foot. I had bunion surgery on this foot last year and still have a screw in the foot. Perhaps the fact that I was off the foot for so long has a connection. I will ride it out for a while and see if it disappears. I think it is nerve related and it takes a long time for nerve recovery.

Every day I stretch that hamstring, quad and calf muscles. Hurts but I push myself through them. I also try to not walk with a limp, needless to say, it takes forever to get somewhere using this tactic LOL. Thanks for your input.

[/TGRVIDEO]

[marycapp]

Hi Everyone.

I am new to this thread. I am recovering from a tibial plateau fracture of my left leg. My surgery was on June 27, 2012. I'm 53 years old. So recovery is going slowly. I am also working with another leg that was damage badly about 3.5 years ago. So I'm having to bear most of my weight on a leg that is bad to begin with.

I am 13 1/2 weeks out from my surgery. I am doing physical therapy twice a week. Range of Motion, and very slight weight bearing.

I am having difficulty with large amounts of swelling after each physical therapy session. I have major problem with my ankle and achilies tendon. I am getting around on crutches finally ... was using walker and wheel chair up til about a week ago.

This week I am going to start water therapy. And hope to be able to do more weight bearing in the next couple of weeks.

Prior to this injury, i was exercising regularly to strenghten the muscles in my right leg. I was riding bicycle, daily, and doing cardio and weight training 5 times a week.

Last week I was finally able to on the recumbent bike go all the way around with the pedalling. and Friday I was able to do 500 complete pedals of the bike in 8 minutes. This is great progress for me.

I spent most of the summer in bed, doing what ever exercises the doctor asked me to do. I can bend my leg about 105 degrees. Hopefully the water therapy will help strenghten the leg enough to help to be able to get more range of motion.

Does anyone have any advice for me?

[gregrnel]

Hi Mary, welcome to the board. This is a great resource to utilize, read the whole thread, it truly is great therapy. My advice is to be absolutely crazy about your pt, eat right, and the swelling will eventually go away. I had swelling everywhere as well, in fact, more than a year later my shin still gets indented from a sock. My os told me I can expect this for perhaps another year. Recovery is long and slow, but you will improve with time and effort.

[marycapp]

Thanks for the response. I plan to be diligent with my PT. I will also read thru the whole thread... I am sure there is quite a bit of useful Information.

Thanks again.

[global_dev]

So just an update on me...
I haven't had any of the foot pain that I hea everyone talking about.

I am not having it either, some mild foot muscle fatigue, but nothing too bad.

I do get horrible sharp AND dull pain in my patella and the inside of my knee where one of my incisions are. Other incision is fine. The pain is often so bad that I cannot walk and I've gotten back to taking strong pain killers on a REGULAR basis or I just can't walk and it kills me. I know this is the hard part where I just have to deal with the pain bc I have to power through but damn...this shit hurts like a mofo lol

back make sure powering through is the right thing, i imagine sometimes it makes sense to rest.

I have numbness STILL on my shin between my two incisions and lately it's been itching. Weird feeling when your bone itches but u can't scratch bc it's numb and u can't feel it.
I also have been getting the really hot feelig in the same place which is normal I guess bc everything is working hard in that area so it just gets hot. I've been having a lot of swelling there too towards the end of the day.

same here, sounds normal

I am down to using just a cane now (which I duct taped pink zebra ) lol I have a pimp cane now bu most times around the house I don't use it at all unless I am in tons of pain.

i opted to forgo a cane, doesn't seem necessary for me right now, but there are moments here and there that I am glad to still carry around the crutch, even if i am not using it.

I also go to the gym now about 4-5 times a week.

that's awesome. hopefully you can keep up that schedule. i just went back to work full time as i started to feel better and with two small kids and as slow as i am it's hard to get there.

And I just started school AnD I'm moving to a much larger house this next weekend so things are going okay now...WAY better than they were at least.

nice

[/QUOTE]

Is that swelling mild or large around the knee?

[rockman54]

Mary
like you l have a few miles on me as well, apparently not a good thing with this type of break.Mine was March 20th of this year and although progress has been slow it is still progress.Cannot stress the pt part of this enough,walk cycle and do what ever you can to regain strength. The muscle wasting and nerve pain will get better in time.l did not try the water exercise but I hear it helps some.This is a catastrophic injury that not only effects you physically but emotionally as well,some days are tuff to motor through but a positive outlook goes a long way to help. L still have daily swelling as well as numbness in the foot and toes.Been told from my surgeon that this will get better,still waiting.
Unless you have gone through this yourself it is hard to believe the effects it has on your quality of life and ability to maintain some type of normalcy.Short story is keep on trucking keep on smiling and sooner or later things will get better,good luck.