Tibial Plateau Fracture Recovery

[peaton]

I am new to this forum and found it like others doing research on fractured tibial plateau's. I am a 47 year old female that is overweight, but do walk, hike and horseback ride. I am also a waitress/bartender. Well I was...looks like I'll be taking a well needed vacation even though I'm not going to a tropical island. No really, this is scary stuff on here, but informative. I just broke mine on Wednesday the 23rd of May. Went to the ER was seen by a physician's assistant (joke) had xrays taken and sent home with vicodin for pain and told to call a specialist in the a.m. Very painful injury, I have had 2 c-sections in my life and they don't even compare. Well upon calling a specialist in our area was told I couldn't get in for over a week. I didn't take that lying down and made several other calls to other specialists. So I now have one 3 hours out of state to see a very reputable doctor. I'm sure I have lots of soft tissue damage as I had a prior knee injury a year ago in a horse related accident. I had a partial tear of my MCL and was babying a meniscus tear. When I fell off the stool, I felt my knee kick inside with a loud pop. Pretty sure my ACL and possibly LCL are now ruptured as well. I posted an xray image hoping some of you may see what I don't. I go to the surgeon on Tuesday, I will keep you updated on my story.

http://smg.photobucket.com/albums/v1...au%20Fracture/

[TPFxPilot]

My advice is get off the drugs asap (if you are not off already), they mess with your head.

Absolutely this! I was on the pain drugs twice - once post-injury for a few days, and again post-op for about 6 days (I had two weeks between injury and surgury). Both times I was on them my brain went into a bizarre anxiety mode - my mind would be racing, I had trouble concentrating on anything going on around me, and I definitely had serious trouble sleeping. Both times, as soon as I stopped taking the meds, it all went away.

[TPFxPilot]

Quick update on my status:

I had another OS appointment on 5/16, and he cleared me to eliminate the immobilizing brace completely and officially start working on range of motion with a prescript for PT 3x/week over the next 6 weeks. I was a little nervous for the first couple days without the brace, but overall it was great to move that knee again! I had about 80 degrees flexion right out of the box, which I have since increased to 112. I was a couple degrees short of full extension, but I'm now at zero.

The OS is very conservative and wants me to stay NWB until 6/27, at which time he'll approve 100% weight bearing assuming there are no major setbacks in the meantime. I'm actually ok with that...My employer doesn't want me back to flight duty until a month past FWB anyway, so PWB doesn't do me much good in terms of getting back to work beyond what I'm already doing now. Kills my goal of walking by Father's Day, but that may have been a little ambitious anyway!

[SueBee]

I have an update too!
I have been cleared for FWB. I am using one crutch as of today. I cant tell you how great it is to carry things with my spare hand!! I walked a fair amount today and i finally experienced the achy foot. And I am driving (standard) as of today too. FREEDOM! Pushing some weight -"don't go crazy" according to the doc. I am over 100degrees flexion. Doc wants me to be at 120 when he sees me next in 4 weeks - I am aiming for more like 2weeks.

I want to attach a before picture I took of the CT scan but I do not have access. Any suggestions? (Anyway you guys have seen your own and don't need to see mine. I just think its cool)

TPFx 03/10/12
Plate and 4 screws 03/13/12
PWB 05/01/13
Okayed to FWB 05/26/12 (not there yet)

[SueBee]

Before and after pics.

[TPFxPilot]

Congratulations on moving up to FWB, SueBee! And it sounds like you're making some pretty good progress on ROM now, too. Keep up the good work!

BTW, you've been selling yourself short - looking at your x-ray, I count at least 6 screws, and I'd be willing to bet you may have as many as 8 (2 more hiding behind your upper one)!

[SueBee]

Congratulations on moving up to FWB, SueBee! And it sounds like you're making some pretty good progress on ROM now, too. Keep up the good work!

BTW, you've been selling yourself short - looking at your x-ray, I count at least 6 screws, and I'd be willing to bet you may have as many as 8 (2 more hiding behind your upper one)!

Thanks!! I am trying to focus on the improvements. It has been a good weekend. Big congrats on your progress too! Knowing what I now know, I perhaps could have been working on ROM earlier. I was tentative. However I should probably not second guess what felt right at the time.

I am going to call the docs office and ask about number of screws on Monday. At some point he said 4 screws... But maybe that was outside the OR before the surgery. I'm not sure. I count 5 or 6 but thought I must be looking at it wrong and that the top ones were part of the 'plate'. I don't actually spend much time with the OS and I have to have my questions written down or they go out if my head when I'm there.

Thank you TPFx pilot and everyone for sharing your experience here. The tips and advice, the wins and the setbacks. It really helps.

[TPFxPilot]

Thanks!! I am trying to focus on the improvements. It has been a good weekend. Big congrats on your progress too! Knowing what I now know, I perhaps could have been working on ROM earlier. I was tentative. However I should probably not second guess what felt right at the time.

Thanks to you too! I am doing my best to keep all of the positives in mind, as well...we've all made huge strides compared to the first couple days after injury or surgery!

Certainly don't second guess anything...that won't do anything after the fact but cause needless worrying. As many others have mentioned on this site, you have to listen to your body; it will often tell you what's right or wrong - sometimes in a whisper, sometimes in a pretty loud shout! A short time ago, I was very worried about my ROM because I was immobilized; just two weeks later, I'm amazed how steadily I'm making improvements. Anyway, one thing I've definitely learned through this community is that TP fractures and recoveries are like fingerprints - no two are the same, and everyone's recovery process is different because there are too many variables involved. The important thing is to take solace in the improvements you gain, and let them fuel your drive to continue progressing, regardless of the overall pace.

I am going to call the docs office and ask about number of screws on Monday. At some point he said 4 screws... But maybe that was outside the OR before the surgery. I'm not sure. I count 5 or 6 but thought I must be looking at it wrong and that the top ones were part of the 'plate'.

Nope, the top ones are also screws through the upper portion of the tibia, "the plateau". The plate itself is often an L- or T-shape, but the "front" view you have sort of hides the arm of the L because it's attached to the side of your knee. I'll try to post mine in front & side views in a separate post, so you can see what I mean.

I don't actually spend much time with the OS and I have to have my questions written down or they go out if my head when I'm there.

I'm right there with you on that one - in the flurry of activity at the appointment, it's easy to forget something you wanted to ask, especially as new questions arise during the appointment. And one of my big frustrations at first was the limited time the OS had to spend with me, but at the same time I recognized that some of my questions didn't need to be answered by the OS. Anyway, I write all my questions down too, as I think of them. Then the night before the appointment, I reorganize the questions into "general" questions that I believe a Physicians Assistant can answer, and then the "big" questions that I definitely want the OS to answer directly. Seems to help things flow smoothly at the appointments.

[TPFxPilot]

SueBee -

Hopefully the images above help illustrate a "3D" picture of what I was trying to describe. The front view on the left shows the screws with the plate on the inside of my knee; the side view on the right makes it more evident that the top screws go through the knee and really aren't part of the plate.

Also, for anyone who isn't aware, you should be able to request copies of all of your x-rays, CT scans, etc; they belong to you as part of your medical records. I have copies of all of my images on a CD provided by the hospital, but I did have to ask for them.

[SueBee]

SueBee -

Hopefully the images above help illustrate a "3D" picture of what I was trying to describe. The front view on the left shows the screws with the plate on the inside of my knee; the side view on the right makes it more evident that the top screws go through the knee and really aren't part of the plate.

Also, for anyone who isn't aware, you should be able to request copies of all of your x-rays, CT scans, etc; they belong to you as part of your medical records. I have copies of all of my images on a CD provided by the hospital, but I did have to ask for them.

That's great! Thank you TPFx pilot. I took pictures of the X-rays and the CT scan with my phone. I do have a side view of the screws but it is fuzzy and I can't really see what's going on at the top. I will ask for copies on a CD. I will post again when I know the magic number. :-D

Good luck to all in their recoveries!

~Sue

[SueBee]

...Anyway, one thing I've definitely learned through this community is that TP fractures and recoveries are like fingerprints - no two are the same, and everyone's recovery process is different because there are too many variables involved. The important thing is to take solace in the improvements you gain, and let them fuel your drive to continue progressing, regardless of the overall pace.

TRUE THAT!

[Nurse Nina]

I thought it was time for an update. I saw my OS at 9 weeks postop and was progressed to full weight bearing as tolerated and to progress to getting rid of the cruthes within 4-6 weeks of PT. The best part was being cleared to drive since it was my right leg. The only issue is parking. How long does it take to get a temporary handicap space? Is it worth applying for it?

The two PT sessions I had so far were tough. The thigh and shin muscles are weak and some are so tight, he had to deep massage them and run a metal plate across the quads just above my knee to break up the tension. They don't think I have any scar tissue but it is supposed to help with being able to stretch them. I get this clicking when I walk as the tendon slides over the patella. It doesn't hurt but feels weird. I still need to work on range and strengthening my quads. There is a lag when I do the leg lifts. My Achille's tendon is also very tight. The first few steps out of bed in the morning are rough, but the stretching helps.

In the last week, I quickly progressed to walking with one crutch for short periods of time but the leg and ankle swells up quite a bit by the end of the day, despite the compression stocking. Other than that, I feel like I have made a lot of progress in just one week. My calf muscles have come back to near normal size in the morning. The knee is still swollen though, by about 3 cm, but overall, I am pleased with the progress. I see the OS again in one month and hope to walk in without crutches and with a near normal gait by then.
Nurse Nina

[Painful]

Ugh!!! Feel like Im never going to walk again!!!!!!! Hate this!!! Yes I am having a bad day!!!!

[itsdeenah]

Had surgery 1 month ago Tibia Plateau fracture and Tibia Shaft fracture & cartilage tear. They used bone graphs to rebuild plateau and a plate to repair the shaft fracture and temp. stitched the cartilage. I've been in the mobilizer style thigh to ankle from sugery and last Monday he turned the dial 45 degrees. It deff felt good to bend my knee but no weight bearing until end of July. Seems like this is taking forever! I start with toe touches them sitting in chair putting my foot down then standing by the end of Aug. The surgeon didn't sugar coat it no running or jumping, etc. ever. No full range of motion but hopefully walking without assistance by end of Sept. I had no idea the extent of this injury, hardest part by far is the waiting but trying to stay positive everyday and play out the waiting game. Anyone else have experience with the bone graphs? Really glad I found this site it's been uplifting to see how positive and helpful everyone is to eachother

[gregrnel]

Ugh!!! Feel like Im never going to walk again!!!!!!! Hate this!!! Yes I am having a bad day!!!!

I know the feeling (type 6, Sept. 3, 2011, 16 screws), it does get better, keep working at it and you will improve and the pain will subside, really!

[Nurse Nina]

Me too! Yesterday's PT eas just too much. I had to take my Tramadol along with the salsalate to get through the day. I just want walk and do things like a normal person.

[seanwieland]

Six week post-op visit with the OS today. Good News! OK for PWB to 50%, and to increase gradually as long as there is no pain. The main fracture is no longer visible in the X-Ray, but the depression is, but making progress. My ROM is 0 to about 120 degrees. Still have some swelling, but "below average" for this stage. So today was a good day - a glimpse of light at the end of the tunnel. I start "formal" PT this week. I say "formal" because I have been working this knee for several hours per day in total (at least). I'm always either putting it in a bridge to push hyper extension, or raised and bending it and holding it there, or doing the heal slide back and forth. The harder I work it, the more it hurts, but that's OK, because I'm making progress. So I'm interested in hearing what the PT suggest I do that I'm not doing already. I also rode my trainer for 30 minutes today with minimal resistance, the first time I was able to bend my knee enough to do so. So between the weight bearing, spinning, extension, and flexion, it's sore right now. But I'm icing it down and I'm going to do it all over again tomorrow, and the next day, and the next day, until I drop one crutch, then go to a cane, and then walk! Next time I see the OS I expect to be walking (@ 12 weeks)!

My Story:
4/9/12: TPF type IV with compression while skiing (last run of the last day of the season)
4/18/12: Surgery, plate with 8 screws
5/30/12: PWB 50%
??? : FWB
November, 2012: Opening day at squaw!

[itsdeenah]

Until you are broken you don't know what you are made of...Courage doesn't always Roar sometimes it's the quiet voice inside saying "I will try again tomorrow"
Have a blessed day everyone <3
Stay Strong!!

[soonerstacy]

I fractured my tibia in April, had surgery in May almost a month later due to insurance (long story). I see the dr at 2 weeks, 6 weeks, and 12 weeks post op. Its been almost 4 weeks since surgery. He didn't exactly clear me for swimming, yet. But I would really love to get in the water and start doing some therapy. I haven't actually gone to a physical therapist since I was in the hospital. They gave me exercises to do at home. I can bend my knee a little past 90 degrees. At 6 weeks I start early weight bearing. Is that when most of you started going to physical therapy appointments? From what I gather that's the plan.
Oh and I had a grade 3 split compression fracture with multiple depressed fragments. I've got a 4 inch metal plate and 8 screws.....still hard to believe.

[seanwieland]

I fractured my tibia in April, had surgery in May almost a month later due to insurance (long story). I see the dr at 2 weeks, 6 weeks, and 12 weeks post op. Its been almost 4 weeks since surgery. He didn't exactly clear me for swimming, yet. But I would really love to get in the water and start doing some therapy. I haven't actually gone to a physical therapist since I was in the hospital. They gave me exercises to do at home. I can bend my knee a little past 90 degrees. At 6 weeks I start early weight bearing. Is that when most of you started going to physical therapy appointments? From what I gather that's the plan.
Oh and I had a grade 3 split compression fracture with multiple depressed fragments. I've got a 4 inch metal plate and 8 screws.....still hard to believe.

Yup - just had my first PT appointment today at 44 days post-op. At four weeks post-op you are doing pretty good, but try to go as far as you can with ROM before PT starts. Straightening is the tough one - spend an hour a day working on ROM. Today I was at 2 degrees and 120 (see if you can beat that in 2 weeks!). My guess is at 4 weeks your incision should be healed enough to get in the pool. Good luck!

[soonerstacy]

Yup - just had my first PT appointment today at 44 days post-op. At four weeks post-op you are doing pretty good, but try to go as far as you can with ROM before PT starts. Straightening is the tough one - spend an hour a day working on ROM. Today I was at 2 degrees and 120 (see if you can beat that in 2 weeks!). My guess is at 4 weeks your incision should be healed enough to get in the pool. Good luck!

Thanks that is really helpful! Its hard for me to tell exactly how many degrees I am because I don't have anything to measure with. But I'm going to work on ROM really hard this week! I have noticed if I'm standing for a while my other foot turns red with white spots. Its really quite gross looking, just wondering if this is normal. You could describe it as mottled. It doesn't hurt really.

[SueBee]

... I saw my OS at 9 weeks postop and was progressed to full weight bearing as tolerated and to progress to getting rid of the cruthes within 4-6 weeks of PT. The best part was being cleared to drive since it was my right leg.....

In the last week, I quickly progressed.....I see the OS again in one month and hope to walk in without crutches and with a near normal gait by then.
Nurse Nina

This is GREAT progress. Sounds like you and I are sync with timing and recovery. I also started driving after i was cleared for weight bearing a week ago - what freedom! And we both have the same goals too.

I have been able to walk with no crutches carefully in short bursts almost immediately after the doc cleared me for FWB as tolerated. I am usually tired after physio - but the pain has not been bad - no pills - and the ice works miracles. I have massive ice packs that wrap around my knee. My physio also has this pressurized ice cuff that I say on as long as possible after the session. I am still working on ROM - at 104 today. Extension is probably zero. Physio has me on the squat rack and leg raises with muscle stim. And I enjoyed walking in a pool a while ago- want to get back there.

I look forward to hearing more of your progress.

Good luck!
-Sue

[SueBee]

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...

I fractured my tibia in April, had surgery in May almost a month later due to insurance (long story). I see the dr at 2 weeks, 6 weeks, and 12 weeks post op. Its been almost 4 weeks since surgery. He didn't exactly clear me for swimming, yet. But I would really love to get in the water and start doing some therapy. I haven't actually gone to a physical therapist since I was in the hospital. They gave me exercises to do at home. I can bend my knee a little past 90 degrees. At 6 weeks I start early weight bearing. Is that when most of you started going to physical therapy appointments? From what I gather that's the plan.
Oh and I had a grade 3 split compression fracture with multiple depressed fragments. I've got a 4 inch metal plate and 8 screws...

[itsdeenah]

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 :/

[SueBee]

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 :/

Hi Deenah! Good for you to keep it moving. I am about 10 weeks post op and I the emotional pain does get better. Ask your friends directly for specific help. It was good for me and that was one of the early gifts was the friends who did show up. Also have you looked into a shower bench? In my area, red cross loans out this kind of equipment by donation.

Thanks for posting!