Tibial Plateau Fracture Recovery

[Mayaresearchmom]

Oh, how hard do the circle parts of the brace push on ur knee? Mine press super hard.. I know its supposed to apply pressure but not sure if mine fits right... Another thing I wish I knew!!!!!

Ski,
Whoever out your brace together may have done so incorrectly. Mine did the same thing. The straps had been put on the wrong way, and caused the strap guides to bruise my leg. The straps on my DonJoy brand brace go from under the guide up through the slot, across the guide, and down through the slot on the other side of the guide. When done correctly, the Velcro on the back of the strap attaches to the Velcro on the guide to hold the strap in place. There should also be a piece of foam to cushion the back side of the hinge where it sits on the leg.

[Libbyf1]

I've read various bits of this discussion without much intention of posting, just seeing how people have coped.
I definitely think it's helps reading about it (I did my TPF in France and nothing was really explained to me). It has also helped to see a light at the end of the tunnel, even if it's quite far away!
I had a 20mm depressed fracture from an unlucky fall 2 hours into the ski holiday. 1 plate and 4 screws.
Was really down for first couple weeks but got a lot better.
I'm now exactly 6 weeks post op and ROM, pain and swelling had massively improved, with hope to start weight bearing tomorrow after my check up x ray.
I had a physio see me everyday at the hospital to get the movement going, and I've been to mine once a week after that. Make sure you do the boring home exercises they advise!

Unfortunately I had a fall down the stairs yesterday, bad knee bent under. Which hurt, a lot!
I'm hoping I've done no serious damage, but a lot of swelling has returned and ROM reduced. Feel like I did about 4 weeks ago so hopes of weight bearing have probably been dashed!

[Skiobsessed]

Mayaresearchmom, thanks! Thats good to know Im not the only one having brace trouble!! I hate how it always falls down!
Also, I feel like maybe in trying to keep it up, I had the circle parts pressing too hard on my knee cuz ever since I wore it and started bending with it on my knee got really swollen again.. My swelling had pretty much gone away but now its back. Maybe its from bending more? Or maybe from the brace? Or a combo?

[SkiTurtle]

I just go the OK to go to 50% weight bearing and transition into full weight bearing as fast as I can tolerate (and my physical therapist allows). I am so relieved and the feeling of putting my foot down is thrilling. I still get a lot of swelling from any activity, but optimism has finally overcome depression.
7 weeks post injury, and I have new hope of skiing gentle groomers in May at the Basin. Woohoo!

I wanted to pass on the good news for anyone like me that got really depressed post surgery when first researching TPF surgery and what the future holds.

[Skiobsessed]

SkiTurtle, CONGRATS on getting to put your foot down!!!! I cannot wait untill Im allowed! It has been 4 weeks for me so far of no weight baring and I just hate it! I have my first session of PT tomorrow so I am excited about that, but I still keep thinking about how long it will be before I can walk and more than that resume some real althetics!! I see my leg shrinking and it freaks me out. My calf muscle from the good leg compared to the other is a HUGE difference.. It freaks me out that all my muscles are getting soft. And yeah I have been very depressed since this injury, all the things I have read and heard about what the future holds.. Wondering how long it will tale to get my full strength back, how long will my legs will be "even" again and most of all will my knee ever really be the same as it was.. Will I be able to ski super aggresive the way I used to, will I still be able to land stuff.. Etc etc etc.. There is so much time just laying around doing nothing, no cardio no activities all I do is think and worry.. So it is great to hear some good news from someone and be reminded there are things to look forward to, little steps.. But hopefully it all turns out ok and by next ski season this will just seem like a bad nightmare

[SkiTurtle]

Yeah, I've seen a lot of atrophy since surgery. The PT told me to flex my quad to help extend my leg and my response was "what quad?"

There are lots of levels of TP fracture and I am super thankful that despite my level of bone depression and the number of screws and plate put in, that I am in the range of folks that should come back around to normal with a lot of work. I am certainly planning to put in a lot of work and my PT keeps reminding me that patience is just as important. Tough to learn patience when so much of my recreational life centers around athletics, but I am trying. Good luck.

[Skiobsessed]

Yeah, I've seen a lot of atrophy since surgery. The PT told me to flex my quad to help extend my leg and my response was "what quad?"

There are lots of levels of TP fracture and I am super thankful that despite my level of bone depression and the number of screws and plate put in, that I am in the range of folks that should come back around to normal with a lot of work. I am certainly planning to put in a lot of work and my PT keeps reminding me that patience is just as important. Tough to learn patience when so much of my recreational life centers around athletics, but I am trying. Good luck.

Thanks! Sounds like we are in much the same boat. I am horrible at being patient and the biggest majority of my life has always been centered around athletics!!!! I have never had to just sit around for so long before and its really hard watching all my muscles dissappear and be unable to do much about it! Its been one month exactly for me today and the thought of non-weight baring for 2 more is just insane to me. But on the other hand I am super thankful that my fracture wasnt worse than it was!
I had my first PT appt today and she told me the same thing, try to flex/fire your quad and said "what quad? Its gone!" I ended up getting it going a little but I felt like I was sitting there with my brain telling my quad to flex and just nothin happened.....
For my first ROM I was able to get 4 degrees straight and 101 degrees bent..she said that was pretty good for someone who had been in an immobilizer for a month. Im just happy that I now have some "excersises" I can do at home and start work on increasing ROM etc.. She also told me I could so arm weights laying down and things like that to keep from going nuts. She said there isnt much we can do about the quad until Im allowed to walk.. I just hate sittin here watching it waste away. But I am SURE I will get it back. As soon as Im allowed to walk etc, my number one priority is to get my leg strength back so that its even with the "good leg".. Its just a lot of waaaiiittttiiinnngggggg

[Skiobsessed]

Hey how many of you are allowed to sleep without ur brace or immobilizer? I got the ok today that I could sleep without it, but Im kinda scared..lol. How long do most of you keep sleeping with it on? Im just afraid Im gonna move wrong in my sleep and possibly do more damage or something? Am I being overly cautious?

[Margosh]

Hi, I'm a 31 year old female, with normal health and normal activity like tennis, yoga, hike and ect. My tibial plateau fracture happend on 31 Jan 2014. i was Running a Sprint ans somehow twistend my leg and fell down on my knee. I really do not know how it happened but it happened. On 1 February I had my tpf. Right leg 1 plate 7 screws put in. After 3 days I went home. First 1,5 weeks I was taking meds. I'm wearing only a brace. After 4 weeks I ve seen my OS but he didn't tell me anything about bending a knee and I had no pt yet and I'm NWB. I'll have next week an appointment and after that he told me that he'll allow PT and for 2 weeks I'll need to bend my knee and after that he will allow PWB.
It's a pity that I've found this forum only now, after almost 6 weeks after my Tpf. Pls let me know is it normal that I didn't have had my PT yet???
I'm walking with a crutches... Not for a long time but 30 min I can walk. My knee is swelling but after a night it ok again. I'm taking my brace off if I'm having a bath or a shower.. Also I have a question is it normal that the leg is getting purple after 15 min walking on crutches?
Also I have a question to people who has like me the right leg TPF. When did you start to drive a car?

[SkiTurtle]

I'm without my brace all the time right now at 7 weeks post surgery. Except for a sprain of my MCL, my ligaments made it through the injury intact. If you have other ligament damage, the answer is probably different. My surgeon said that the brace is mainly a reminder that you are hurt, and a red flag to others in public to steer clear. Sleeping was so much more comfortable once I took it off.

[Skiobsessed]

I'm without my brace all the time right now at 7 weeks post surgery. Except for a sprain of my MCL, my ligaments made it through the injury intact. If you have other ligament damage, the answer is probably different. My surgeon said that the brace is mainly a reminder that you are hurt, and a red flag to others in public to steer clear. Sleeping was so much more comfortable once I took it off.

Awesome! I went ahead and slept without mine for the first time last night. I propped my whole leg up on a pillow tho because someone told me they had done that the first few nights without a brave and it was helpful, they said to make sure if I used a pillow under my leg tho to have it go longways so its under my heel, not just my knee, so that it wouldnt hinder getting my full extention back.. Anyway I tried that but woke up halfway thru the night because my heel was hurting so bad!! Im guessing that was because my heel had not really had any type of pressure on it for this first month during my time in the immobilizer.. I always had a pillow under just me knee with the immobilizer so my heel barely touched the surface. I thought it was weird that my heel was hurting that bad tho!!! I ended up taking the pillow out and its been fine since then.. Did that ever happend to anyone?

BTW, most of the excersises I was given at pt yesterday are straight leg things, like leg raises, and flexing the quad sitting down, propping heel up on a rolled towel and sitting in that stretch to get full extension back etc.. But the only two I got for bending were putting a towel around my foot and pulling knee in towards butt untill it stops, then hold there and let back out..and also sitting on the edge of bed with leg hanging off and raising to to straight then back down etc..
Did you or anything do any other stuff that helped you get ROM back quicker? I can only bend to 100 degrees right now so I really wanna improve that!! I will be doing the things they told me 3 times per day, but let me know if there is anything else that helps? Thanks!

[Mayaresearchmom]

Skiobsessed,
I got the go-ahead to sleep without my brace at 4 weeks. But was non weight bearing for 12 weeks. To answer your question about knee swelling........ As you start PT, you can expect it to stay swollen a lot of the time. Ice and elevation helps! When I asked my OS how long to expect the swelling, he said at least a year. I ended up buying gel ice packs from my PT, which are great because they cover the whole knee and conform to the shape of the knee.

[Skiobsessed]

Skiobsessed,
I got the go-ahead to sleep without my brace at 4 weeks. But was non weight bearing for 12 weeks. To answer your question about knee swelling........ As you start PT, you can expect it to stay swollen a lot of the time. Ice and elevation helps! When I asked my OS how long to expect the swelling, he said at least a year. I ended up buying gel ice packs from my PT, which are great because they cover the whole knee and conform to the shape of the knee.

Cool yeah I am at 4 weeks now and last night was my first night without the brace, but I am still non weight baring as well..prob for 8 more I cant wait to walk again!!!!!!!!!! I cannot believe its been this long without walking and Im only 1/3 of the way there... But at least Im starting to bend now so everything is heading in the right direction!
Thanks for info about swelling, now that I know to expect it and that its normal its cool. I got those gel ice packs too and I love em
Now if only I could get the back of my heel to quit hurting when I lay with my leg straight for too long, I spoke with my OS today tho and apparently that is normal too

[Julialynnb]

Had my tpf surgery on dec 27th one plate 7 screws , just got to 80 degrees rom ( massive scar tissue has been a challenge) I was sent to pt 2 weeks after surgery and have been 3 times a week since , I am cleared for weight bearing as tolerated and finally learning to put small amounts of pressure on the leg . My problem is my foot pain from the swelling and circulation issues. I saw a previous post about a leg turning purple , mine does the same , entire leg right into my foot with my foot turning very dark and scary ugly. My ortho and pt say all is ok , just prop it up over my heart and leave it that way until normal color comes back. I am 45 yr old female and not in the best of shape , I was in a car accident on dec 10 , I was home before surgery for 17 days . I am hopeful for a full recovery , just a slow one ! I enjoy reading all your posts , positive or not , my state of mind is my own , I love information and you all have been the best source of that !

[Skiobsessed]

How long does is usually take to get ROM back? Like how many degrees do you guys typically gain per week? Also, what happens when you start bending to the side as well as just straight back and forth, like how people sit "indian style" and things like that?? I know Im getting ahead of myself just kinda wondering a typical time span of how long its going to feel so "stuck"

[Mayaresearchmom]

Cool yeah I am at 4 weeks now and last night was my first night without the brace, but I am still non weight baring as well..prob for 8 more I cant wait to walk again!!!!!!!!!! I cannot believe its been this long without walking and Im only 1/3 of the way there... But at least Im starting to bend now so everything is heading in the right direction!
Thanks for info about swelling, now that I know to expect it and that its normal its cool. I got those gel ice packs too and I love em
Now if only I could get the back of my heel to quit hurting when I lay with my leg straight for too long, I spoke with my OS today tho and apparently that is normal too

Yeah, the heel pain thing is normal. I was thinking they had missed a fracture in my heel or ankle for a while. Doc told me it was just muscle atrophy from being in the "toe touch weight bearing position" Got better at about twelve weeks when I started weight bearing. As for wanting to speed up the healing process and increasing ROM, take the advice of your PT and don't push it. I pushed mine, thinking if a little was good, more would be better. It's not........ Just had cat scan last week that showed varus deformity of tibia secondary to the loss of bone heigth in the plateau. In other words, the plateau was pushed down into the tibia again causing the knee to bend outward to the side putting all my weight on the medial plateau rather than being evenly distributed across the knee. (original injury was 6mm depression across the entire plateau with multiple fractures through it, type V fracture). 6 months out now, the bone has healed, but I am basically walking on my buttressing plate and screws, because the bone collapsed. Looks like total knee for me in the very near future. Believe me when I say that the next time I will definitely follow the PT's instructions.

[Skiobsessed]

Thanks so much for sharing that advice!!!! I need to be reminded not to push it!! I have follows the exact instructions so far and not done too much because I am scared of messing anything up... But then I also get freaked out that its never gonna get back to normal if I dont bent it more!
Did they tell you what exactly caused yours to collapes again??

[Mayaresearchmom]

Thanks so much for sharing that advice!!!! I need to be reminded not to push it!! I have follows the exact instructions so far and not done too much because I am scared of messing anything up... But then I also get freaked out that its never gonna get back to normal if I dont bent it more!
Did they tell you what exactly caused yours to collapes again??

Took the pics down because I realized I forgot to take my personal info off them. Will repost later with the addition of another pre-op that actually shows the top of the plateau. Even though it just looks like the bone broke off in two large chunks, the top view looks like a jigsaw puzzle with multiple fractures through the plateau. Doc thinks it was just to many pieces for it to stay in place, plus there was osteopenia which further weakened the bone, and I overworked it in PT (enough to cause patellar tendonitis)

[Skiobsessed]

Could you tell when it collapsed? What does it feel like to walk with the bone compressed like that, can u?

[Mayaresearchmom]

Could you tell when it collapsed? What does it feel like to walk with the bone compressed like that, can u?

Just an overall feeling of the joint being unstable as I started weight bearing. I kept telling my doc, and my PT that it felt like the knee was just going to bend backwards when I was working in PT to stand on the leg with all the weight on it. As for walking on it, once I was told to lay off therapy because of the patellar tendonitis, it's gotten less painful, but still with all the pressure on the medial side of plateau. I'm doing good to walk about 100 yards with a cane before I have to stop.

[Skiobsessed]

Wow that kinda freaks me out since mine is healing with the lateral side still compressed. My OS didnt think it would be a problem but Im worried if its going to feel different or if Im gonna be able to tell that plateau is caved where it is.. He didnt say anything about it feeling unstable, he told me it would feel the same as it used to but that having the dip in the joint would put me at a higher risk of arthritis, but he say the surgery itself would also increase the risk of arthritis... So basically we decided the benefits were not worth the risks because the benefit of fixing it was going to be so minimal.... But now I always worry about having that little dip down section in my joint. I still have 6 weeks till Im allowed to weight bare so I have no idea what its going to feel like but I hope he was right.. Im super worried about it feeling less stable

[tam0558]

It's great to see so much progress being made. I am 9 weeks post op and walking with a cane. It was tough learning to trust that leg again, but I'm doing it. I only wear my brace out in public or when I'm walking on uneven surfaces. Like others, that leg stays purple, almost blue. I'm told that's normal too. I see my OS on Friday and hope to start driving at that time. Most days, I feel like my recovery is going great. However, I am struggling with flexion. I'm only flexing to about 80 degrees. My PT is "ok" with it, but she definitely wants quicker progress. Over the past few weeks, I've gained about 15 degrees per week. We'll see if that trend continues.

[Margosh]

That is very scary for me, and of course foe you too.. My tpf is scala 6 but it's only 1 plate and 7 screws..
Today my doc did allow me to work on my rom with pt. The first pt in a couple of days. I'm a little bit worry, and the brace now is in 60gr flexion .. I was asking about the purple leg and doc was checking pulse all over my leg and told that it is normal, the color will come after I'll have some mussels again. 60 -70 flex is not a problem, but I was trying to bend more and I can not do it
Plan is: next 2weeks -working on ROM.
If ROM will be good, I can start 25% wb for 2weeks, 50% next 2weeks, and 75 next 2 weeks, and before 100% he want to see my new x ray.

[Little Bike]

I was rolling a motorcycle up a ramp into the back of my van by myself….and…..dropped the bike, tried to save it, ended up with a tpf. I'd never even heard of this kind of fracture before then. Broken on 3/1, surgery on 3/7. Doctors said it was a nasty one - 2 fractures, many pieces and a 5 mm depression. Saw the x-rays, but didn't get a chance to count the screws.. but there are a lot.

I just found this forum and thread - it's going to be very nice to be able to get advice/support from others who have been through this.

So, non-weight bearing for 3 months (10 weeks and 2 days to go - not that I'm counting or anything!) I'm hoping to be back on a street bike (motorcycle) maybe a month after that and maybe my dirt bike a few months after? Maybe with a knee braces to help with the jolts?

To add in some spice to my day my left shoulder is getting increasingly sore from the wheelchair (I went over the bars on my bike in early November and am still recovering from a shoulder injury). I need to talk to my doctor next time to make sure I don't end up with a worse rotator cuff problem.

Got my staples out today, brace adjusted to 30 degrees of motion (ouchie), steristrips and given my first real set of pt exercises.

Sorry this is so long, it's just really nice to be able to vent a bit to people who have "been there, done that" or are still "doing that!"

[SkiTurtle]

So, non-weight bearing for 3 months (10 weeks and 2 days to go - not that I'm counting or anything!) I'm hoping to be back on a street bike (motorcycle) maybe a month after that and maybe my dirt bike a few months after? Maybe with a knee braces to help with the jolts?

I'm not sure about the "dirt bike in 2 months" part after you are weight bearing. I am pushing the envelope hard right now and I hope to get on skis again before the season end. Approximately 2 months after being allowed to be weight bearing. But I fully don't expect to ski hard. Maybe one or two groomers with no jolts and at relaxed speeds.

My surgeon is very sports oriented and deals with athletes all the time. He is fully on board with doing everything to get me back to form quickly for sports. However, he is also cautioning me against any impact activities for at least 4-6 months after being weight bearing. That means no hard skiing, no road running (maybe not even trail - I'll have to ask), etc. My familiarity with motocross is that it is like dropping 10 foot cliffs over and over again. Definitely on the list of impact sports.

As my doctor and my physical therapist say multiple times during each visit - "this injury sucks, be patient." Good luck!