Tibial Plateau Fracture Recovery

[rod9301]

Hard to believe I’m jealous of your first steps Ben in only 4 weeks!

Got my staples out 3 days ago and my brace opened to 90. Feels great to have something else to work on getting my range motion back. Dr told me probably 8 more weeks non weight bearing but the bone seems to be healing on schedule. He said I could probably start doing no resistance spinning on a stationary bike at 5 weeks post op, that will be a good day!

Splat using the CBD quite a bit now, not only on my achy parts that are compensating for my bum knee, but it’s helping me with the process of getting my ROM back.

Have a tens/ems unit I bought a few years ago, been using it every day to fire muscles in my leg. Not sure if it’s helping keep any muscle mass, but it definitely seems to help with the swelling in my lower leg as I believe it helps with moving blood around better. Also doing endless leg lifts and crunches but look forward to being able to start PT.

Ems really works. It will build muscle mass faster than weights. But you need to use pretty high intensities.
For quads, i sit in a chair and i have to tie my ankles to the chair legs to withstand the forces, otherwise my legs just shoot up.

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[BenSkisTrees]

Been using NMES on my quad and recently along my lateral tibia to help with my ankle flexion. Having just as much trouble bending my ankle that I am with my knee. I've been using some CBD cream on my knee (800mg CBD, 40mg THC) and can't really notice any effects other than a pleasant cooling sensation from the menthol. Going to keep using it since I bought it, but it doesn't really penetrate deep down to where my pain is. Edibles, on the other hand, have been working great (50mg CBD, 5mg THC).

I read a study where they immobilized people's legs for 5 days and used NMES on half of the group. The group that had electrical stimulation maintained more muscle mass, but still lost strength the same as the control group. I think maintaining mass will make regaining strength faster though.

[TahoeBC]

I’ll have to say I’m impressed with the EMS results, I’m actually building back muscle mass and tone, girlfriend even noticed the improvement yesterday. Spend a couple hours a day working the quads, hamstrings and calf’s with it.

As far a CBD goes in my experience, I have had no noticeable effects taking it internally, with the exception of edibles and I’m not sure how much can be attributed to the high taking my mind off the pain, but cbd by itself internally does nothing for me.
On the other hand I’ve hand great results with CBD creams, but it kinda depends on the pain, I find they either work nearly immediately or they provide little relief. Cbd creams are not all created equal, Splats Cbd cream is very good and I’ve been using it multiple times a day, mostly on my other sore parts but also on the medial non surgery side of me knee and underneath as I work on range of motion. Still waiting for my surgical scar to be scab free before using it more extensively.

I can get to my 90 degree limit with zero issues now but have some more work to get to zero.

Next week I see my surgeon, hope I’ll be cleared for no resistance training on my bike which I have set up on the trainer already, that will be a big day for me when that happens.

One thing that’s been an enormous help for me was I ordered a zero gravity chair just before surgery, has heat and a massage feature. Was not cheap but it’s been key to helping stay comfortable and keep the leg elevated.


I also purchased a couple wedge pillows to help me with more options to try and stay more comfortable in bed, the one I got to elevate my legs is useful for laying on the floor also


I was using a roller for awhile as kind of a poor mans CPM machine to work on range of motion using the bottom of my foot and the back of my heal to move my knee from zero to 90 rocking back and forth. Developed a pretty sore bruise on the back of my heal though as my foot is still pretty sensitive and swells up by the end of the day especially the more time I spend not elevated. Anyway gave that up, but was nice when I could do it.

[TahoeBC]

So at 5 weeks post op I got my brace fully opened and given the ok for no resistance spinning on the bike trainer, within a few days I had worked up t to o 1 1/2 hours a day spinning. That was getting boring so I figured if I was careful I could do no resistance spinning on my ebike letting my good leg and the assist do all the work. Doing 30 some miles most days now, knee feels so much better after every ride. Hopefully at my orthopedic surgeon appointment next Thursday he’ll start letting me bear weight on the TPF leg, feels like I’m ready to walk again.

[splat]

What fucked me up after my acl/meniscus surgery was riding my bike and unconsciously jumping off my bike onto that repaired leg, ripping my meniscus open again and shredding it hard. Happy healing dude. You sound like you're doing well. Don't do what I did.

[mf07d1]

Hey guys, I found this thread about 4 weeks after my injury. I suffered a severe tibial plateau while skiing and had an EX-fix(4/1/21) on for 2 weeks before having ORIF(4/15/21) with 2 large plates and 14+ screws. They also removed several inches of "dead bone" but didn't really explain to me how that will affect me in the long run. I am extremely down and discouraged as I am a ski boot fitter and my life revolves around the outdoors. I'm glad to have found this thread both for knowledge and encouragement but it is also a bit daunting seeing how long this will be lasting. The surgeon said this is one of the worst he has seen and described my leg as being "in close to 50 pieces" aka my leg was shattered. I have successfully been able to straighten my leg and start some very minimal range of motion exercises at home, I see my PT for the first time early next week. I cannot say I have read the entire thread but don't see a lot of talk about misalignment. I know it's early but my leg is visibly crooked and it's really a mind fuck trying to imagine how it will ever work properly again. The docs say everything in the x-rays look straight but that is only partially reassuring as every time I look down my knee and foot don't line up. I have a follow up next week and hope to have some good news on my staples being removed. Thanks to everyone that has posted encouraging status updates on this thread, I will be doing my best to stay positive and put in work with the PT to get some of my life back. Will post pics when able

[TahoeBC]

Search for a private Facebook page called “tibia plateau fracture recovery” you will need to request to join the group. It’s very active with members from around the world with all kinds of TPF breaks. You will probably get more answers to your questions there.

Maybe this link will work
https://m.facebook.com/#!/groups/tpf...&source=result

Good luck, my break was not nearly as bad as yours. I worked hard at recovery, walked for the first time today 10 weeks post surgery l, 11 weeks since I broke it.

[Marsupial Rex]

Hi Maker,

You sounds very knowledgeable so... I'm gonna pick your brain. I think I have exactly what you describe as malalignment; that's exactly what it feels like: that my knee isn't "lined up right". I have a big hard bony knob-- the outer edge of the plateau I guess-- on lateral side which feels like a constant pressure forcing my leg inward. Very similar quad atrophy to what you describe but I thought leg lifts (maybe w/ankle weights) were the answer. I had all hardware removed 1/14 in the belief that the hard knob was the plate but the plate's gone and the hard knob is still there, meaning that it must be the edge of the plateau that has shifted out of alignment. So... Now what? What can I do besides leg lifts to strengthen the quad, and once misalignment has occurred, is it too late to correct it? I am not crazy about my surgeon but am "stuck" within him for now because no surgeon will touch this within 3-6 months of another surgeon's work. PN of the peroneal nerve seems to be getting worse since hardware removal, not better. What is an osteotomy? Send private reply message if you don't want to bore everyone with details.

Skipict, you haven't posted since 2014 or so, but I'm hoping that you will see this and let us all know what the long-term situation was with your injury, and especially the neuropathy. To what extent did the neuropathy ultimately resolve?

[cspringsposer]

Guess I get to join the TPF club along with a few others. Looks like I have a TPF, tib/fib, torn LCL, MCL and Patella ligament, ruptured quad tendon and the icing on the cake is the compartment syndrome and faciotomy. I just had a long talk with the surgeon and it sounds like the recovery from the TPF (and pain from the skin graft) are going to be the toughest things moving forward.

Still in the hospital but hope to get home in a couple of days. Very eager to start any PT and exercises possible and plan to read through this thread to learn what works. Along with the PT docs I know I will have, I am very fortunate to have a neice that is a PT doc. Very hopeful I can hit the PT hard and hope to get on skis by December. It might not be realistic, but I am the type that needs goals to keep me motivated.

[cat in january]

That sounds real bad, but your attitude sounds great. Stay within the bounds of your pt practice you have a lot of things to heal. Doctors are going to give a conservative outlook postop, it’s a long road. How the recovery goes I found was different for folks. Given you have an athletic tilt (making an assumption here), you will likely progress faster and farther than the doctors prognosis

[cspringsposer]

Thanks brother. Like everyone else here, definitely consider myself athletic. I have previously recovered from a number of "sports" injuries and haven't let them slow me down much, but this is an intimidating one. Reading about all of you successfully recovering and getting back on skis gives me a ton of hope!

[MiddleOfNight]

Vibes, csprings. How are things coming, 6 weeks out?
I didn't have all that damage, but I still have the nail/screws in my tibia to this day. I'm back skiing and lifting and cycling and rolling and all the things. And your attitude is was better than mine.
Hope things are going well.

[cspringsposer]

Thanks brother. I'm 8 weeks out from the injury. Still total non-weight bearing but the pain and swelling is much better. The first three weeks were crazy tough with pain and swelling, but once that got under control it is just the stir craziness from being stuck inside getting to me now.

I haven't been cleared to start PT yet, but thanks to a few mags that had this injury before me, I was able to get a plan together and start rehab at home (leg lifts and stretches mainly). It still blows my mind that I almost lost my leg from a crash that didn't seem too horrible. Compartment syndrome is a bitch!

If anyone else here ends up with a TPF or compartment syndrome, definitely send me a message and I will try to pass on the tips I have learned the past few months. The surgeon doesn't agree, but fingers crossed I will be back on skis by the end of the year. I don't expect I will be skiing any gnar, but just getting on the mountain will feel great!

[Elkhound Odin]

Glad you’re on the road to successful recovery. That was a nasty mess of an injury.
If it makes you feel any better I managed to meet my goal skiing 8 weeks after surgery on my arm. Riding the mtn bike now.
I’m sure you be on the slopes before Xmas.


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[powdork]

So almost three years ago I had the hardwear removed from my leg (prettty much identical to cspringsposers above). For some reason, the hardwear arrived in the mail today out of the blue.

In case you’re wondering what it looks like

[spanky]

So almost three years ago I had the hardwear removed from my leg (prettty much identical to cspringsposers above). For some reason, the hardwear arrived in the mail today out of the blue.

In case you’re wondering what it looks like

What was the reason for the removal? I’ve had mine in for a little over three years and am contemplating pursuing a removal. I get pain in my shin at any attempt to run. The area around the hardware definitely aches with the weather. Lastly, I think one of the pins protrudes out on the inside of tibia (I had a lateral/Type II tpf) and causes irritation around my pes anserine. This results in pes anserine bursitis symptoms.

Since I’ve had both a patella tendon autograft ACL reconstruction (2014) and an ORIF TPF/MCL repair (2019), I figure I’m a candidate for a knee replacement at some point in the future. It is my understanding that hardware removal is required prior to knee replacement. So, why not sooner rather than later?

[powdork]

I got a replacement knee. Usually it requires a separate surgery to remove the hardwear then let that heal and then do the replacement. In my case the knee felt so good after hardwear removal I cancelled the knee replacement, but ended up getting it done a year later.

[t-the-east]

Interested in the hardware removal as well. For similar reasons as Spanky. I’m 3 years in, 2 plates and 11 screws left in my knee. I had 3 screws removed as soon as I could, I could feel them sticking into my muscles. I read so many reports of people feeling so much better after the hardware is removed. I do everything pretty much the same as I did before the accident, except I’m a bit more cautious now. And running really is the only thing that really sucks. Skiing, biking, hiking etc are all back to about 90% of what I was before.
Powdork, what was the recovery time like for the hardware removal?

[powdork]

Interested in the hardware removal as well. For similar reasons as Spanky. I’m 3 years in, 2 plates and 11 screws left in my knee. I had 3 screws removed as soon as I could, I could feel them sticking into my muscles. I read so many reports of people feeling so much better after the hardware is removed. I do everything pretty much the same as I did before the accident, except I’m a bit more cautious now. And running really is the only thing that really sucks. Skiing, biking, hiking etc are all back to about 90% of what I was before.
Powdork, what was the recovery time like for the hardware removal?

It's like 2 weeks. Your knee can do everything the same right away but you just have to let the incision heal.

[cspringsposer]

It's like 2 weeks. Your knee can do everything the same right away but you just have to let the incision heal.

Obviously I am still very early in my recovery, but I have every intention of getting this metal out as soon as I can.

Glad to hear most have healed and are back doing the things they did before the injury. My bones are healing but am still dealing with the effects of the compartment syndrome. It was just a bad break having that on top of the leg, knee and ligament damage.

I'm still sticking with my goal to be on skis by December, but I suspect I will ski fairly cautiously the first season back. Glad you got back out there so quickly EHO!

I very much appreciate the encouraging words from everyone! There are some dark days with this type of injury but the encouragement and advice of those that had the injury before me was incredibly helpful!

[MyNameIsAugustWest]

Just seeing this csprings...

Positive vibes to you. I was lucky when I suffered a TPFx...it was a clean break and not a compression. Only required 2 screws and no plate. Had the hardware removed 10 months after the injury (similar symptoms as Spanky) but my recovery was quite a bit longer. I skied on Sunday, 10/14/2012 and had the hardware removed on Monday, 10/15/2012. Couldn't get on skis until after Christmas. My surgeon warned me that the hardware removal would have a longer recovery than the hardware installation and he was right.

Bottom line, don't have it removed unless it's really bothering you.

[cspringsposer]

Just seeing this csprings...

Positive vibes to you. I was lucky when I suffered a TPFx...it was a clean break and not a compression. Only required 2 screws and no plate. Had the hardware removed 10 months after the injury (similar symptoms as Spanky) but my recovery was quite a bit longer. I skied on Sunday, 10/14/2012 and had the hardware removed on Monday, 10/15/2012. Couldn't get on skis until after Christmas. My surgeon warned me that the hardware removal would have a longer recovery than the hardware installation and he was right.

Bottom line, don't have it removed unless it's really bothering you.

Thanks brother! Definitely good to hear others experiences to help make an informed decision. I am only 3 months out from the injury, but the metal is fairly uncomfortable. Maybe the body will adapt and it won't ache the way it does now? Either way, I am still a long ways away from that decision and really just need to focus on strengthening the leg and rehabing the ligaments.

[MashedPotatoes]

Checking in, I can't even believe this club would have me as a member

Got my TPF on 2.23.22 skiing at Heavenly (so a little over 3 months ago). I popped off the cat track and my right ski came down directly on a rock which ate my knee. I was crushing it just owning the mountain that day and then I got crushed and the mountain reminded me who owns who.. I will remember to keep this all in mind when skiing in the future. My injury was avoidable, I failed to scout my landing and paid dearly for it.

Anyway, my TPF is a minimally displaced medial TPF with oblique extension posteriorly. I was lucky to avoid surgery and hardware. 10 weeks to FWB which sucked major balls. This was my first major injury and I had no idea it was gonna be such a PITA. Crutches oh how i hate them..

It was cathartic to read through this thread and realize I was not the only one with a chronic swollen purple foot that was peeling for awhile. I should have read through it earlier but didn't get around to it till recently. I was also lucky to have my wife and teenage kids looking after me and was able to work from home the entire time I was off the leg. ROM is good too, so very lucky really - especially compared to many in this thread who had more severe injuries and longer periods of NWB or trouble with their HW. Really puts things in perspective to read peoples stories ands very heartening to read about so many successful recoveries.

Mistakes I made
1 - first two weeks I was unaware of the calcium/vitamin D supplements one should take for this
2 - not getting velcro ice gel packs sooner (so much easier)
3 - no trainer bike, I just waited till FWB and am now finally back to the elliptical machine but this probably would have helped to have the bike going
4 - thinking there was a lot I could do to be proactive during the NWB phase (there isn't other than ROM, just don't slip or fall and just be patient and let the bone heal, the real PT comes with WB phase)

I can walk now but it still hurts a bit after 3 weeks and my limp is fading but it's hard to completely erase so far. I think a few more weeks/months and I should be pretty good I hope. The other thing that seems quite sensitive that will maybe take longer to resolve is pain behind the kneecap when fully extended/locked with weight bearing. There are just some zones in the knee with flex/torque/weight that don't seem ready to go yet but it's getting better day by day.

I've been really humbled by the experience and hope to never go through something like this again. Beware of bikes, cars, horses, dogs, ladders and skis people!!

[liamy]

Hi everyone. I’m Amy. I haven’t been to this forum for about 10 years. My mom broke her hip this morning and it led me to reminisce about my fracture.
It was a grade 6 with a spiral fracture 3/4 the length of my tibia. I’m not a skier but this was the only forum I found back then. My posts start on page 6.
It’s been a LONG road.
I had my hardware removed at 1yr post op. I worked as an ICU nurse, on my feet for my 12hr shifts. I didn’t return to light duty work for 11mo. Then was the hardware removal and I was back in a week.
I’ve had so many ups and downs. It’s been quite the ride!
I’m currently in a down. About to finally do it and make an appointment with my old ortho. I’m sure it’s my meniscus. Last time I saw him, he was pleased with my X-rays. That was 7-8 years ago.

Work hard, friends. PT is brutal. Get your leg to 0deg extension. This was a huge challenge for me. I wish I would’ve fired my PT earlier and pushed harder. Hindsight…

Anyways…good luck you all!!! ❤️

[liamy]

FYI: my pic cracks me up. I didn’t know that would show up. That was the first time I had made to to and from pool PT with my cane. It was also my birthday! It was a good day.