Tibial Plateau Fracture Recovery

[Schmoopie]

Skiplct:

I've been really lucky pain wise. The first 24 hrs after the surgery was the worst, but I did not want to start on the morphine pump or Percocet. I know what those drugs can do to a body, and did not want to start using them. The worst, pain-wise, other than the first 24 hrs after the surgery, was when my dog ran into my leg. As for the bathroom supplies, I did investigate them, but did not have anyone to empty them. I use a walker around my house because in the past, my balance is not very good on cruces. I have been using crutches for going up and down the stairs. I am not driving as it was my right leg that was hit. When it happened, I drive home because I had to. The zimmer splint is a splint that keeps your leg straight, and supports it. I will be in the splint for at least 3 months. I am not heading back to work anytime soon. The dr. has me off for a few months, and work doesn't want me back trying to navigate with crutches, in the snow. They think I'm a liability if they want me back to work too soon. Work does have elevators for me to get to the 8th floor, where I work. I'm at a desk job, but when I do go back, it'll be a modified work schedule.

[peaton]

I'm glad to hear of your success! I am curious though of your symptoms, here is my story:

You can read my signature for details of my injury. Since surgery I was in PT for 3mo, doctor told me to give it a months rest due to the pain I was still having to see if it subsided, it hasn't. I have pain medial, front, mid-line that is anywhere from about a 2 - 8, it seems to vary. I also have a dull achy pain in the back of the knee mid-line. Also, I have pain and popping/clicking under the knee cap not a grind but a pop. I am stilling having pain on the lateral side where the plate/screws are and can the pain worse with shifting my weight while standing. My heel is still somewhat numb but not a debilitating numb. At times I also feel like my knee is hyper-extending. Does any of this sound familiar? I am pissed that it is the end of the year and I probably won't get in to see him until after the first of January in which case I have to start all over with my copays and deductibles. I tried to get them to do an MRI earlier on be he refused because he said even if he found anything he would do any surgery until at least a year had passed. I work on my feet as a waitress. I have gone back to work w/o his permission working on the slow days and not pushing myself too hard. We are however coming up on our money making time of snowmobiling and this will soon end!

Any thoughts would be appreciated!

Paige

Hi cbrou571,
I just had my right knee scoped Friday morning. It was a huge success!! I'm so glad I did it. The part of my meniscus that we thought was good was now torn to pieces from FWB and sticking out the front and back of the knee and apparently pushing on a nerve. I had been limping quite a bit and pain was about an 8 since Sept. The OS cut out 75% of the cartilage removed most of the scar tissue and shaved down the bone graph. Two hours after surgery my pain was a 1 or 2. I was 1 crutching it on Sat & Sun and started walking on Monday. If feels great today I returnted to work and am barely limping at all. I can finally strike my heel and feel like I'm truly walking again. What a relief!! Hope it goes well for you, hang in there!!

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

[dnabike]

Hi, I admire you for trying to skip the pain meds, but you should know there is a problem with that. If you are in a lot of pain it interferes with your bodies ability to heal and you don't want that. Pain meds where a big problem for me because you do get addicted to them. My pain management doctor switch me to a new drug called Nucynta which is as strong as Oxi but much much less addictive. That also helped my get off the Oxi because it is a narcotic with something extra that fools your brain. He claimed that in a two year study of the drug no one had become addicted. When I don't need it I only have the mildest symptoms.

If you are in too much pain you can't do the things you need to heal. So if you are not in that much pain skip the meds but if you are take them. Ask your doctor about Nucynta and if your insurance will not cover it ($430 for 120 pills) get your doctor to send a letter and if doesn't work take the other drug and buy 30-40 pills on your own to help you off the oxi etc.

Best of luck,

Jim

Skiplct:

I've been really lucky pain wise. The first 24 hrs after the surgery was the worst, but I did not want to start on the morphine pump or Percocet. I know what those drugs can do to a body, and did not want to start using them. The worst, pain-wise, other than the first 24 hrs after the surgery, was when my dog ran into my leg. As for the bathroom supplies, I did investigate them, but did not have anyone to empty them. I use a walker around my house because in the past, my balance is not very good on cruces. I have been using crutches for going up and down the stairs. I am not driving as it was my right leg that was hit. When it happened, I drive home because I had to. The zimmer splint is a splint that keeps your leg straight, and supports it. I will be in the splint for at least 3 months. I am not heading back to work anytime soon. The dr. has me off for a few months, and work doesn't want me back trying to navigate with crutches, in the snow. They think I'm a liability if they want me back to work too soon. Work does have elevators for me to get to the 8th floor, where I work. I'm at a desk job, but when I do go back, it'll be a modified work schedule.

[Schmoopie]

As I've said before, I've been very lucky pain wise. The worst, for me, was 24 hrs after surgery, and I relied on Tylenol 3's. i did not feel like I needed anything stronger. Once I was discharged, I went home with Tylenol 3's and Percocet. The Percocet was a "just in case", and has not been used. I stopped the Tylenol 3 after three days due to an upset stomach and it would not allow me to sleep. From the Tylenol 3, I went to just extra strength Tylenol. I'm 3 weeks from surgery, and am taking extra strength Tylenol, occasionally if my knee is bugging me. I am not in extreme pain, and have never been. I've been very lucky with the pain and have a good pain tolerance. My body and bones are healing fine. The only thing that's stopping me from doing my normal daily functions is my leg and the limitations this injury has put on me, not pain.

[Casper2012]

Peaton. I know what you mean about new deductibles and co pays going into the new year. I'm facing the same with knee replacement surgery being scheduled sometime in January. It really stinks but in my case the surgeon wants to be sure that my tibia is well healed. January will be 10 months since my break and surgery. If you need further surgery that will help it will be worth it. Good luck and happy holidays.

[peaton]

Thanks.....Happy Holidays to you and everyone else!

Peaton. I know what you mean about new deductibles and co pays going into the new year. I'm facing the same with knee replacement surgery being scheduled sometime in January. It really stinks but in my case the surgeon wants to be sure that my tibia is well healed. January will be 10 months since my break and surgery. If you need further surgery that will help it will be worth it. Good luck and happy holidays.

[cbrou571]

Casper why do you have to do a knee replacement? Just curious when they decide that is the best choice.
I'm 29 years old and suffered a type VI tibial plateau fracture with spiral. Waiting to have my hardware removed and knee scoped. Hoping that will help with the pain.
Good luck with the surgery in January and merry Xmas!

[Schmoopie]

Does anyone have any tips on how to sleep on your side with a zimmer splint? I've tried propping myself up with some pillows, but it never seems to work. Any suggestions?

[karpiel]

Does anyone have any tips on how to sleep on your side with a zimmer splint? I've tried propping myself up with some pillows, but it never seems to work. Any suggestions?

First thing I would do is ask why you aren't in a splint that offers some range of motion. My Brother and I had nearly the exact injury a month apart. He had free nationalized health care, I paid out the ass even with insurance for my treatment. He was externally fixated for 3 months, I woke up from the initial surgery in a CPM machine. Best way I found was on a couch/futon where I could prop my leg up on the back. For my first month or however long out I exclusively slept in a CPM machine while it was running. There's really no comfortable way of sleeping for a while. Either accept that this is a long haul and use the meds to pass out or man up and sleep in a "compromise" position.

Even now side sleeping results in pain the next morning. I got myself a $2000 mattress and a good heated blanket, makes a huge difference, seems expensive, but what would you spend on a car that you spend way less time in and has a much smaller impact on quality of life?


Were you issued under arm or forearm style crutches? I feel immobile on underarms, but with the forearms I bought I was, in all honesty, faster on flat ground than most people, could tackle stairs with no problem and they provide something to lean on while stationary.

[Schmoopie]

Karpiel: please don't take this the wrong way, but all I asked for was if anyone had suggestions for sleeping with a zimmer splint, nothing else. If I have questions for my doctors/ surgeons, ill ask the. I was just inquiring if anyone else with a similar injury in a zimmer splint has any suggestions for sleeping. I didn't join to debate anything about "free nationalized healthcare". And I don't need meds to "pass out or man up".

[Olligator]

Schmoopie, I didn't have a zimmer splint, but the key for me both with and without the brace is a pillow. You may need to experiment a little to see what works for you, but for me a thin pillow works best. With the brace on I found I needed to put the pillow between my knees and support my entire lower leg, especially the ankle. Letting the top foot dangle causes strain higher in my leg. Even when lying on my back I prefer to put a pillow next to my bad leg to keep it from turning too far out. I hope this is helpful to you and you can get comfortable.

[peaton]

Schmoopie...I agree a pillow works wonders between the legs if you are a side sleeper, like I am.

Good Luck.

Schmoopie, I didn't have a zimmer splint, but the key for me both with and without the brace is a pillow. You may need to experiment a little to see what works for you, but for me a thin pillow works best. With the brace on I found I needed to put the pillow between my knees and support my entire lower leg, especially the ankle. Letting the top foot dangle causes strain higher in my leg. Even when lying on my back I prefer to put a pillow next to my bad leg to keep it from turning too far out. I hope this is helpful to you and you can get comfortable.

[Schmoopie]

Olligator: Thank you so much! I've tried putting a pillow between my legs, but it hasn't been working. I'll try your suggestions.

Peaton: I am a side and any way but flat on my back sleeper.

[Casper2012]

Cbrou571. Im 57 My knee didn't recover from the injury and has collapsed one one side after some of the bone died. Hense I haven't been able to fully bear weight on it. I haven't found anyone else ont he forum who's had that happen but several who have some kind of knee issues and subsequent procedures to repair. I hope your recovery goes well.

[Casper2012]

Schmoopie. I too am a side sleeper and spent the entire time sleeping on my back while I was wearing an immobilizer brace and while wearing a brace that allowed knee range of motion. Even with pillows it hurt my leg on my side. Once I could sleep without the brace I began sleeping on my side using a pillow without a problem.. Like others said here you have to experiment. Good luck to you.

[Anna2]

Hi to all my fellow Tibial Plateau casualties!!

I've been a lurker on this site for the past few months and can't thank you all enough for sharing your experiences with this horrific injury.

I sustained my fractured Tibial Plateau VI approx 6 months ago, as a result of a very nasty kick to my knee, whilst riding alongside a friend and her horse. The kick was so hard, it exposed the bone marrow and due to the isolated location where it happened, it took emergency services over 3hours to reach me and get me to hospital.

I was operated on that day and the op took around 6 hours to perform. When I came round from the anaesthetic, I experienced THE most horrendous pain. I honestly wasn't aware pain like that existed. Absolutely excrutiating, despite being doped up to the eyeballs in morphine.

I spent 4 days in hospital, and as soon as I mastered the use of crutches, was off home! I quickly realised just how disabling this injury is and how the associated depression hits you like a ton of bricks. I've never felt so low in my entire life. I'm a very active 40 year old woman, who walked around 10 miles a day every day, rode and competed 3 horses and generally lived life to the full. To suddenly go from leading a very active lifestyle, to sitting on the couch or laying in bed for weeks on end was absolutely mind blowing. Not being able to do simple things like make a cup of tea and transport it back to the couch, not being able to take a shower unless somebody lifted me in and placed me on a disabled seat, not being able to dress my bottom half without assistance, not being able to take care of my beloved horses, not being able to sleep at night as so uncomfortable laying flat out on my back with leg locked straight and elevated etc etc......my whole life just fell apart.

I was in a Donjoy brace for approx 6 weeks and started partial weightbearing around the 5 week mark. I experienced the discolourment and foot pain many of you have described on here, but that did eventually subside after several weeks. I was full weight bearing at the 8 week stage but kept my crutches with me at all times as I slowly learned to try and walk again properly. Physio exercises were carried out religiously every day, as was use of a static exercise bike.

I followed my physio and consultants advice to the letter and fast forward 6 months, I'm thrilled to report I can walk up to 10 miles again per day, albeit with a slight limp, but very little discomfort

I've not attempted to ride again YET but will sometime soon

Downsides so far are, my consultant has warned me not to run again or do any concussive activities, as this would heighten my chances of getting arthritis in the joint.

Wishing each and every one of you a successful recovery and thanks again for sharing your experiences on this wonderful forum. It certainly helped me through the "dark days".

[karpiel]

Karpiel: please don't take this the wrong way, but all I asked for was if anyone had suggestions for sleeping with a zimmer splint, nothing else. If I have questions for my doctors/ surgeons, ill ask the. I was just inquiring if anyone else with a similar injury in a zimmer splint has any suggestions for sleeping. I didn't join to debate anything about "free nationalized healthcare". And I don't need meds to "pass out or man up".

Wasn't trying to start a debate of any kind, I apologize if it came off that way. I offered my opinion and advice based on my experience, what you take from is it up to you. My brother was a victim of sub par (lazy, if you will) treatment and has suffered long term from it.

[totaliboard]

@Anna-holy shit thats a fast recovery from what sounds like a pretty bad injury. congrats!

[cbrou571]

Casper- Thank you for your response. Sounds like a very strong person and have suffered through a lot with this injury. Keep smiling!

Anna2- I am amazed with your recovery time, it gives me hope that this one day will get better.
Thanks for sharing.

[Anna2]

cbrou571 - I'm glad this has given you hope During the "dark days" I honestly thought there was no way my knee would function properly ever again. I think the associated depression that everybody seems to get with this horrible injury really hinders progress.
If you can shake the negative thoughts off, and stay positive and focussed at all times, it certainly speeds recovery.

My consultant informed me that when he started to operate, "it was a complete mess in there". Apparently the tendon was off the bone and a type VI fracture meant it was pretty severe. I can't thank him enough for doing such a fantastic job piecing it all together again. He's a really lovely guy and I look forward to seeing him at the regular hospital check ups A good physio is also worth their weight in gold for providing the correct exercises at each stage of the healing process.

Provided your Xrays are looking good, it's a matter of gradually pushing yourself a little bit further each day.

One life...live it

[smilybeck]

Just a quick update:

11/8: TPF (hospitalised while waiting on swelling to reduce)
27/8: Surgery
31/8: Home after being cleared by pain, physio & surgeons
6/9: Returned to work
18-21/9: Sent home for a week (oops too soon )
10/10: Cleared for PWB
14/11: Cleared for FWB

It's now been approx 3 weeks since I've been walking unaided. Each week I'm getting better with my limp. Have been working on extensions / locking my knee when I climb stairs with the physio.

I'm walking to the train station to and from work which is up to 4 kms a day. Slowly...which is frustrating for me and anyone who walks with me.

[seanwieland]

Been a while since I've written. I'm 8 months post surgery, displaced type IV. I've been FWB since July, and just got the all clear from my OS. So I decided to ski a powder day at Snowbird this weekend. Bad move. I'm back on ice and Ibuprofen, feel like I've set myself back 3 months. And you could hardly even call what I was doing skiing - more like big traverses, and only 1/2 day at that. On the second morning I couldn't put enough weight on my leg to click into the binding. Did one run and called it a day.

I'm hoping the swelling will go down and this will be a short, temporary setback. But lying in my bed with my leg elevated on ice brought back memories, and instinctively reached for the laptop and brought up this forum. Would love to know when others were back on skis skiing like they were prior to surgery - a year? Tanner Hall did it, I can too!

[karpiel]

Been a while since I've written. I'm 8 months post surgery, displaced type IV. I've been FWB since July, and just got the all clear from my OS. So I decided to ski a powder day at Snowbird this weekend. Bad move. I'm back on ice and Ibuprofen, feel like I've set myself back 3 months. And you could hardly even call what I was doing skiing - more like big traverses, and only 1/2 day at that. On the second morning I couldn't put enough weight on my leg to click into the binding. Did one run and called it a day.

I'm hoping the swelling will go down and this will be a short, temporary setback. But lying in my bed with my leg elevated on ice brought back memories, and instinctively reached for the laptop and brought up this forum. Would love to know when others were back on skis skiing like they were prior to surgery - a year? Tanner Hall did it, I can too!

The funny thing I have experienced with this injury is that some days you feel like it never happened, others you take one step out of bed and can hardly walk. The best part is it seems to have nothing to do with recent activity level, it seriously feels like a roll of the dice.

I could go one day and quit after one run due to pain/discomfort and the very next day I would be out for hours, looking for things to jump off.

Best advice I can offer from personal experience is to just keep at it and know that some days will just suck.

[cbrou571]

Karpiel- I totally agree with you that this injury has a mind of its own. For example today out of no where I have way more pain behind my knee cap while walking, and I did nothing different. I think that is why people struggle so hard with this injury because the healing takes SO long and it is very unpredictable.

Schmoopie- I also had the same issue with pain while trying to lay on my side. I know you had said you tried a pillow, but have you used a body pillow? I found the body pillow helped me more than the standard sized pillow. Anyway just a thought..hope you have found some comfort with sleeping.

[justathought]

Hi All

I just found this thread. My fracture occurred on November 2. I had an external fixator for a week and an internal repair on Nov 9. I did not ask my surgeon the level of fracture--- but I knew if was bad when it happened -- never a good thing to hear a crack followed by a loud pop. I know that it was displaced and having now seen the post surgery x-ray, I have a plate two large screws and four or five pins.

Interestingly, my surgeon seemed to indicate that the hardware was permanent and would not come out until or unless I needed a knee replacement - which he predicts I will in about 10 years. I am aiming to be in the small group that does not need this -- but who knows. I seem to be a bit older than many of you at 58.

I am now 5 weeks post surgery. Still non-weight bearing. My flexion allowed was increased from 30 degrees to 90 degrees at the end of last week. Today, I am able to flex about 78 degrees -- increased from 50 degrees -- so progress is being made on that. PT at home twice a week and exercises done everyday.

OS tells me I will likely start to be partial weight bearing (25% to 50%) starting the second week of January. I am curious as to how that initial stps will be and how long it takes before you stop worrying about every twinge or click?

Luckily, I have had little pain. I had painkillers post surgery but downgraded to Tylenol within a week of surgery. At PT I make sure I have Tylenol - more is available, but thus far not needed.

Having read this I am embarrassed to say that my injury occurred while walking across a field - I stepped in a gopher hole which turned. After being an elite figure skating competitor for 15 years and an equestrian for 10... I never thought I would do something like this walking.....