Thread: tibia pilon fracture

last day at alta i took a nice fall and had a pretty bad pilon fracture (joint surface to the end of the tibia), the doctor was blown away at how it occured in my skiboot! After surg the following day i ended up with 7 screws and a plate in my tibia) its now been 5.5 weeks and the pain is mostly gone, though i can still feel my ankle swell when its not elevated for extended periods. I am still non-weight bearing for another 2.5 weeks. I was just wondering if anyone else has had ankle/tibia fractures of this nature? and what sort of recovery time/therepy i am looking at?
thanks

I also have a Tibial Pilon (Plafond) fracture. Surgery was on May 10th. On tues July 13 it will be 9 weeks post op and I will start weight bearing in a boot air cast. Not sure how much weight I will be able to apply because my other leg still is non-weight bearing for 4-5 more weeks. My Tibial Plafond was broke in 6 pieces and I have one plate with 10 screws. I have been working getting some Range of motion (ROM) the last couple weeks. I would say I'm about 50% for ROM. I would also be interested in hearing others experiences with these type of injuries and what type and time frame for physio and recovery. I believe in my case the ROM will almost get to 100% but I have major cartilage damage so I'm not too optimistic for my ankle joint having no pain.
Any comment and advice would be welcome!

sorry to hear about ure ankle man....i am roughly 11+ weeks in, i certainly know how u feel, my ankle is feeling better, but a long way off from 100% for sure....but i am fully weight bearing with a walking boot and can sorta walk normal in it although i still use one crutch quite alot of the time it makes it feel better....some days are better than others though, if i am pretty optimistic about getting back to 100% in the coming few months! i am probally like 75% rom by this point! its sorta strange because the parts that hurt the most are no where near where i injured it (achilies, calf, and lateral side of my foot and ankle! my advice to u is not get too down on yourself because it hurts, but in the coming weeks it will start to feel better and every morning it will feel just a little bit better than it did the day before, also get in the pool and do lots of swimming and get on a bike asap! tough it out bro!
sorry for the very disjointed and sub par response, but its late

Wondering how you guys are all progressing? I had a tibial pilon fracture in early Dec 2011. Was NWB for 8 weeks, and ramped up to FWB by 12-16 weeks. I've been doing the elliptical and stationary bike as soon as I could bear weight and have just about maxed on that. Tried running a few weeks ago. I could go for half a mile (and probably could have gone longer) but I definitely have a limp/awkward gait and have discomfort. My ROW is great and in talking to my surgeon it seems like one thing holding me back now is the hardware (plate and 9 pins). I have a pressure point at the top of the plate that is generating bone growth and the bottom of the plate seems to be restricting the ROW. Curious as to how your recovery has been going? Are you planning to have the hardware removed? Has anyone already done this? If so, what is the recovery time on that? My surgeon mentioned in passing that it would be 2 weeks for the incision to heal and another 2-4 weeks (4-6 total) for the pin/screw holes to fill in and heal.

Any info you have is much appreciated!!

Thanks!

I broke my tibia plateau and surgery Aug. 2, 2012. Healing is going along pretty well, but I only have about 50% ROM in the knee. My biggest problem is swelling in my foot and ankle. If I sit up for awhile, it turns purple and swells up. I have to lay down and elevate my foot for a good while until the swelling subsides. It seems like it is the same thing each day, with no improvement. I am worried that this situation may last for months! Anyone else experience this, and did it improve with time? THANKS!

A rock climbing wreck resulted in a bad pilon fracture (9 or 10 breaks to my tib-fib (mainly tibia) 2 breaks to my sternum and concussion. 3 surgeries, one plate, lots of screws and 7.5 months later I still have quite a bit of pain and significantly reduced ROM. I'm climbing again but not yet leading because of some sort of weird vertigo (severe spinning) that happens every once in a while. Hiking is painful especially downhill. Most of you seem to have had ski wrecks so I guess I'll (hopefully) hear about the ankle recovery. When (if every) have you recovered ROM and are able to hike or play hard without severe pain? BTW, swelling is still an issue although seems to be improving.

Areed - sounds like you had an absolutely horrible injury and I'm glad to hear you're back hiking/climbing. There's some reassurance to be had in that you're able to be active after only 7.5 months and you're able to engage in the activities that you enjoy (albeit I'm sure not yet at the same level as before). Furthermore, unlike many orthopedic injuries, symptoms after a pilon fracture have been shown to continue to improve over a longer time period (2.4 years on average in one study) than many other orthopedic injuries. Thus, bear in mind that any quoted statistics from research studies start falling apart when they apply to an individual like you because it doesn't matter how everyone else does - it matters how YOU do.

The tough part, however, as you probably already know, is that pilon fractures are among the most difficult of orthopedic injuries. There are two often-quoted studies that followed patients longitudinally after an injury like yours, both in the premier orthopedic journal (Journal of Bone and Joint Surgery). They found that returning to recreational activities, esp. if they involve running, can be tough, but you've already outdone that statistic with the recreational activities important to you. Thus, when you read the snippets below, I cannot stress enough that with your determined mindset and with what you've already managed to do, I would absolutely be positive. Furthermore, a lot of people do fine - it's just not the same class as a "standard" ankle fracture that most people refer to when they say, "I broke my ankle." Best of luck!

Study #1
J Bone Joint Surg Am. 2003 Oct;85-A(10):1893-900.
Outcomes: 35% of the patients reported substantial ankle stiffness; 29%, persistent swelling; and 33%, ongoing pain. Of sixty-five participants who had been employed before the injury, twenty-eight (43%) were not employed at the time of follow-up; nineteen (68%) of the twenty-eight reported that the pilon fracture prevented them from working.

Study #2
J Bone Joint Surg Am. 2003 Feb;85-A(2):287-95.
Outcomes: The degree of osteoarthrosis was grade 0 in three ankles, grade 1 in six, grade 2 in twenty, and grade 3 in six. The majority of patients had some limitation with regard to recreational activities, with an inability to run being the most common complaint (twenty-seven of the thirty-one patients). Fourteen patients changed jobs because of the ankle injury. Fifteen ankles were rated by the patient as excellent; ten, as good; seven, as fair; and one, as poor. Nine patients with previously recorded ankle scores had better scores after the longer follow-up interval. The patients perceived that their condition had improved for an average of 2.4 years after the injury.