Tibial Plateau Fracture Recovery

[CarlB]

I sustained a TPF in March 2017 at Snowbird. It was, according to my doctor, a 6.5! I had an external fixator applied at the Intermountain hospital. A week later I flew back to Boston and had to wait another two weeks for surgery because it took that long for the swelling to go down. I had to purchase an entire row on Delta. It was the flight from hell.

My doctor was the head of orthopedic trauma surgery at Beth Israel Hospital. He installed two plates and 20 screws during a 2.5 hour operation. Unfortunately I had some complications that made my recovery a bit of a nightmare. The long and the short of it is that I sustained two infections afterwards plus a blood clot. This slowed my recovery significantly. The first infection almost caused them to take one of the two plates out. My doctor said that he really didn't want to do that because my bone would not heal straight and would adversely affect me going forward. But the infection was bad enough to consider it. Fortunately the infectious disease team at the hospital got it under control. I took several weeks of two types of intravenous antibiotics. I had a pic line in my arm to administer them at home once a day. After that I took antibiotics in pill form for another 6 months! The blood clot was controlled with three months of a very expensive drug. In all I spent 17 nights in the hospital between Utah and Boston.

After about ten weeks I was able to put half weight on my leg. I began physical therapy and worked my butt off for 5 months to get my leg strength back. By the fall I was hiking moderate hills and feeling encouraged. But my leg kept swelling badly every day with significant edema on the inside portion of my leg. But I still thought I was on track to ski during the 17/18 season. I had both plates removed in late November 2017 because of the swelling which I felt was due to irritation from the plates. But because a lot of bone had grown over the plates, the surgery was more complex than anticipated. The recovery was also much longer than I had been led to believe. My goal of skiing that season was put on the shelf. It never happened.

During 2018 I continued to work out regularly to build up the muscles. This all led to me being able to ski during this season. Admittedly I'm not back to where I was before the accident. My knee gets sore and my strength is not 100% yet. But I've been told that it could take 3 full years to recover fully. I'm hopeful that I will get there. I did take another trip back to Utah this year and skied Atla and Snowbird for 6 straight days. I can't hit the steeps quite like I used to yet but I did do them. The first three days where better than the last three. My leg got progressively sore.

I was told by some that I may not be able to ski again but I never believed it. I didn't want to. So I worked as hard as possible to get my strength back and prove them wrong. I'm 60 years old and have been skiing for 45 years. I plan on skiing for at least another 20!

My message is to never give up! Think positive and take PT seriously.

[t-the-east]

Damn. Good story CarlB! I know the flight from hell, one of the worst feelings.

Timely bump too, just got back from my 2 week follow up, surgeon is happy that everything is aligning properly and looking good. Stitches are out and I got my first look at my new hardware -


5 more weeks til my next appointment. No weight bearing or knee movement at all until then. Guess I’ll have time to catch up on that office work I keep putting off...

[t-the-east]

Update bump - just back from my final surgeons appointment yesterday after 4 loooong months since surgery. Been doing PT 3 times a week for the past month, plus all the exercises at home. Fully cleared to bike, hike, and ski. Doctor was very pleased with the final xrays and my progress.

I wasn’t full weight bearing til about 11-12 weeks. Off crutches now but using a cane for rough terrain. Been using the bike trainer for about a month, can’t wait to get back on some (mellow) trails. And back in the woods for some hikes.

Doc says I could take the hardware out in 6 months if i want, but only if it’s really bothering me. Then I’d be a month recovery. Tough decision.


Long story short, tibial plateau fracture, type 5 on their weird scale of 1-6, “major trauma” says the surgeons and doctors. Overall, not a fun experience, but I’m at the tail end and it feels damn good.

It’s absolutely insane how your entire life can change in a second. 41 years young, lots more time to explore.

[Goniff]

Update bump - just back from my final surgeons appointment yesterday after 4 loooong months since surgery. Been doing PT 3 times a week for the past month, plus all the exercises at home. Fully cleared to bike, hike, and ski. Doctor was very pleased with the final xrays and my progress.

I wasn’t full weight bearing til about 11-12 weeks. Off crutches now but using a cane for rough terrain. Been using the bike trainer for about a month, can’t wait to get back on some (mellow) trails. And back in the woods for some hikes.

Doc says I could take the hardware out in 6 months if i want, but only if it’s really bothering me. Then I’d be a month recovery. Tough decision.


Long story short, tibial plateau fracture, type 5 on their weird scale of 1-6, “major trauma” says the surgeons and doctors. Overall, not a fun experience, but I’m at the tail end and it feels damn good.

It’s absolutely insane how your entire life can change in a second. 41 years young, lots more time to explore.

Cheers to the next 41 years. Live it up.

[t-the-east]

Cheers to the next 41 years. Live it up.

Thanks Goniff! Maybe we can even take a few runs next time your in my neck of the woods again!

[Doremite]

T, glad to hear things are progressing. Keep up the great PT efforts.
Where do you typically ski in the east?

[t-the-east]

T, glad to hear things are progressing. Keep up the great PT efforts.
Where do you typically ski in the east?

Thanks man! I live right outside of Lake Placid, NY so Whiteface is about 15 minutes from my house. Usually there at least a few times a week, we’ll see how this season works out. Occasional trips down to Gore as well since my pass works there also.

[grinch]

Didnt know you were on the injured list. Great youre back on the go. Saw this "skills with Phil" yesterday and thought it might be you showing him your zone. Guess not but looks pretty good there


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[t-the-east]

Didnt know you were on the injured list. Great youre back on the go. Saw this "skills with Phil" yesterday and thought it might be you showing him your zone. Guess not but looks pretty good there


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I’ve never seen that vid, but know those trails well! The Whiteface gondola served biking can get intense to say the least!

[dreadrocksean]

Update bump - just back from my final surgeons appointment yesterday after 4 loooong months since surgery. Been doing PT 3 times a week for the past month, plus all the exercises at home. Fully cleared to bike, hike, and ski. Doctor was very pleased with the final xrays and my progress.

I wasn’t full weight bearing til about 11-12 weeks. Off crutches now but using a cane for rough terrain. Been using the bike trainer for about a month, can’t wait to get back on some (mellow) trails. And back in the woods for some hikes.

Man I envy you. Mine was a non displaced 2 weeks ago. but suddenly yesterday the outside of my knee started to hurt whenever i tried to laterally raise it, from a lying or standing position. Bent or straight. Im worried.

[t-the-east]

6 months to the day since my accident. What a ride it’s been. Just “graduated” from pt. Passed all the strength tests and my walking looks pretty damn close to normal now if I really concentrate on it, they even threw in a free t-shirt.
I’ve managed to do a few short hikes in the 2-3 mile range. I’m not fast, but it feels good to get out. Been on a few short bike rides too, but I have a problem with trying to jump off of things. Looking to maybe get a road bike to keep myself in check.
Still a decent amount of swelling if I’m on my feet all day, and with swelling comes a bit of pain. I’m Reading it could take up to a year for that to fully subside.
Still very seriously thinking of getting the hardware removed. It’ll be a step back for a little bit, but I can feel the plate every now and then, I imagine it’ll get worse once winter sets in.
Last week I bought my ski season pass for the year, so I’m either getting much better or a complete idiot. Only time will tell.
Just updating this for those that are unfortunate enough to go through the same thing. Timeframes and references will help during the recovery. It’s a total mind fuck. Stressed my marriage and my business quite a bit, but it’s nearing normalcy now, whatever that is.
My best advice-don’t fracture your tibial plateau. It’s made me reevaluate a lot of things in my life, some for the better and some not. Maybe I’ll give another update once I try and start skiing again this winter, or if I work up the nerve to have the hardware removed. Carry on.

[mlinky]

I have spent a year thinking that my recovery was soooooo slow, then I read this thread and find that I'm doing okay.

Background, I got a displaced tbf the stupid way, I had been on my horse for an hour, at a show, it was about 100 degrees...I dismounted, got dizzy, and fell over backwards with my leg folded up under me. I still have to correct people who think the horse tossed me. No, it was dehydration. The horse was as surprised as I was.

Took 2 weeks to find a surgeon who did the repairs. Got a plate and 9 screws. Totally NWB for 3 months and at a rehab facility the whole time. Really, I had fairly minimal pain during the whole thing. Did a lot of PT, and extra homework. It is the only time in my life that I've ever been called compliant. The only thing remaining is some mild pain after exercise, my hamstrings seem to have some issues, and I have some feelings of instability. I'm getting the hardware out next week, and can't wait.

Started riding again about 6 months ago. My doctor cleared me before my trainer did, but I'm grateful to be able to bend my leg enough to get into the saddle. All in all, not a bad outcome so far.

[airedoc1]

This thread looks like about the greatest collection of TPF patients on the internet! I am two weeks post op from ORIF for lateral TPF after motorcycle versus tree episode, tree always wins. As everyone on here notes, the swelling is one of the greatest challenges in recovery and rehab. I am using an ice machine and elevation, just started using a compression sock up to the bottom of the knee, which seems to really improve the ankle swelling. My biggest question is about the use of nsaids for this purpose. I am a pain physician myself and there has long been controversy about using nsaids after fracture, most ortho surgeon are now saying after two weeks there is no negative effects on bone healing. I have adequate pain control with tylenol, so my question for everyone is have nsaids helped your swelling go down? I mean to a noticeable degree, beyond the traditional methods of elevation/ice. I am very interested in the experience of people here who been through this.

[HAB]

Grade VI TPF after tomahawking myself down a cliff band on skis in April of this year. Ibuprofen helped considerably with the swelling after surgery.

[MiddleOfNight]

Had my second surgery Thursday. My break is distal from the plateau, and the first surgery failed 'unionize' the two parts of the tibia (?).

Old hardware out, a lot more new better bigger hardware in with more bolts and screws. Sigh.

I'm avoiding ibuprofen. My surgeons say there's still debate on whether or not it hinders bone growth or repair - we can agree it's not worth the risk.

To control swelling I'm using a game-ready ice/compression machine (https://gameready.com) .. fully recommend. all-day elevation and gameready, swelling hasn't been bad. This is the third surgery I've used it for. Game changer. It's $300/2weeks I think.

they even threw in a free t-shirt.

Congrats on graduation!

[12snap]

I have adequate pain control with tylenol, so my question for everyone is have nsaids helped your swelling go down? I mean to a noticeable degree, beyond the traditional methods of elevation/ice. I am very interested in the experience of people here who been through this.

I've had numerous surgeries on multiple body parts. For my last two, removing hardware from my hip and repairing a torn labrum in my shoulder, I've found that CBD oil has worked magic at reducing swelling and helping with the pain. Personally, I took 100 mg at bedtime and 100 mg in the morning for the first 5 days or so and then tapered down to 25 mg daily. NSAIDS definitely helped with the swelling but I try to avoid them as much as possible. I've taken a lot of them over the years and I'm concerned about their long term side effects. I'm jealous that you say you're getting adequate pain control with Tylenol. That stuff did absolutely nothing for me.

[powdork]

6 months to the day since my accident. What a ride it’s been. Just “graduated” from pt. Passed all the strength tests and my walking looks pretty damn close to normal now if I really concentrate on it, they even threw in a free t-shirt.
I’ve managed to do a few short hikes in the 2-3 mile range. I’m not fast, but it feels good to get out. Been on a few short bike rides too, but I have a problem with trying to jump off of things. Looking to maybe get a road bike to keep myself in check.
Still a decent amount of swelling if I’m on my feet all day, and with swelling comes a bit of pain. I’m Reading it could take up to a year for that to fully subside.
Still very seriously thinking of getting the hardware removed. It’ll be a step back for a little bit, but I can feel the plate every now and then, I imagine it’ll get worse once winter sets in.
Last week I bought my ski season pass for the year, so I’m either getting much better or a complete idiot. Only time will tell.
Just updating this for those that are unfortunate enough to go through the same thing. Timeframes and references will help during the recovery. It’s a total mind fuck. Stressed my marriage and my business quite a bit, but it’s nearing normalcy now, whatever that is.
My best advice-don’t fracture your tibial plateau. It’s made me reevaluate a lot of things in my life, some for the better and some not. Maybe I’ll give another update once I try and start skiing again this winter, or if I work up the nerve to have the hardware removed. Carry on.

I'm pretty sure you read the end of my story in the knee replacement thread but it bears repeating here since my original injury was tibia plateau back in Feb 2014. If the doc says you're likely to need a knee replacement down the line when arthritis sets in keep in mind they're gonna want to take the hardware out as a separate surgery then before the TKR.
Also keep in mind that 5.5 years after my original surgery the pain got to where I had a TKR scheduled for 10/30. My hardware was removed on July 31. The end of September things started to feel better. October 2nd I took my last ibuprofen (after 1200-1800mg daily since 2/2014). On the 17th, I officially canceled the surgery. Now I'm running down hills with a heavy pack and no pain.
Needless to say, my advice is to get the hardware out.

[Richard Strokes]

I fractured tibial plateau 5/21 (stupid lady with 3 dui’s no insurance and no money hit and ran on me, I was ridding home from work). The doctors for some reason chose not do surgery. It seems it took to long for the doc to get me to a specialist and by that time it had started to heal. They did nothing and decided to wait.Once the fracture healed I was still having pain and weakness. I now just had mcl and acl reconstruction in hopes of stabilizing my knee and holding my knee in a place where the fracture will not effect it. Back on crutches but am hoping for a fast recovery.

Some time we should all sit on my porch and predict the storms coming in with our knees

Cheers

[Richard Strokes]