Tibial Plateau Fracture Recovery

[daveh]

First off I want to say that it's been great to read this over the last 7 months...I have finally decided to join and contribute (or attempt to) with my story. Here it goes

I fractured my left tibial plateau and tibia back in early September. It was a freak accident while on the edge of a mosh pit at a concert, somebody basically chop blocked the side of my knee and that was that. I was left with a displaced tibial plateau fracture as well as about a 4 inch fracture down the tibia. I didn't however tear anything which the doc was very surprised by. Surgery didn't come until about a month later as I waited for my insurance to activate through Cobra.
Early October-surgery went well and my doc seemed extremely happy with the result. I now have a hockey stick shaped titanium plate that's approximately 6 inches in length along with 8 screws and a cadaver bone at the base of the tibial plateau. I was quite active prior to surgery, doing mainly power lifting 3x's a week and prior to that was doing a lot of boxing. I am 6' 2' and weighed approx 295 pounds at the time of the accident. I'm definitely carrying around some extra fat but by no means am I soft.
Here is my approx time line
4 wks-began pt for range of motion etc
6 wks-partial weight bearing with crutches
9-10 wks-starting to use a cane, managed to take my first full weight bearing steps (they were short and horrificly awkward steps)
12 wks-ditched the cane for good although I was clearly walking with a significant limp, stairs remained extremely challenging. I also stopped going to pt and hit the gym on my own

So here I am at 6 months post op and my stride is relatively normal or at least I can fake it well. I can do stairs with no hands however I am still using a little bit of momentum from my good leg. Going down stairs is somewhat controlled but not fully yet, so the second half of my down step is faster with the bad leg supporting my weight. My mornings continue to get better with less stiffness but I still go through a loosening up period each day. I live in the desert, so weather is rarely an issue but I do certainly feel more sore on cold wet days vs dry and warm ones.
I've been going to the gym 3 times a week and riding a bike as much as possible however I find that my leg is usually already tired from stabilizing while doing upper body exercises. I am currently doing modified deadlifts at about 155 lbs (was doing high 400's prior to injury) with a locked knee/slightly bent position. Leg presses are still extremely difficult (squats are not possible yet) but continue to improve each week. I can comfortably use an elliptical machine for about 20-25 minutes at a time however that definitely is pushing the envelope and I swell up a little after. Kneeling is doable although extremely painful on hard surfaces. I can squat down to a catcher position but it is also very painful. My range of motion is almost normal as I can nearly touch my heel to my butt and can get to about 0 degrees and straight. My left quad is still very week and the size of my thigh is noticeably smaller than my non injured leg...a big issue for me was the month I had to wait prior to surgery, my leg atrophied very badly. Leg extensions are extremely painful and bicycling in the air is definitely the most painful exercise that I have to do.

sorry for such a long post...anyway I just wanted to say thanks to everyone for posting their stories/progress. It's definitely nice to read that others are going through this with you. I hope to be near 85-90% by the end of this year but we'll see. The plan this summer is to do a lot of swimming.

Even though this was my first post, I've been reading this weekly since my accident. Best of luck with your recoveries!

[skiplct]

OK Margosh, I can hear that you are scared out of your wits and who can blame you; we have all been there, and back, several times. But I want to impress on you that you are still so very early in this process; I encourage you to try to relax and integrate into your thinking that this is a long process, there is very little that is a "done deal" at this early point in your recovery. For me, in the early PT, there was a difference between exercises that hurt with the "OK" kind of pain versus the "not OK" kind of pain. It's not a matter of degree of pain but the type of pain, if you know what I mean. As far as how much PT: I was in PT 3x/week starting at 3 weeks post-op for about 3.5 months. In retrospect, I think I wasted time and money in the sessions I did while still NWB. In fact the PTs practically told me: there isn't that much we can do for you before you're at least PWB. That "closed circuit" is so crucial to the proprioception. I wish now I had just done the NWB stuff they showed me at home and saved my visits for after PWB and FWB back in 2012. I just completed 12 sessions of PT post 2nd op (hardware removal) and am doing the PT at home now and at the gym for a fraction of the cost of doing going to a PT location. My impression of PT is that once they show you the exercises, i's cheaper to do at home on your own or at gym except for modalities you can't duplicate, like micro vas e-stim for nerve damage or whirlpool or massage and manipulation... Judging your ROM this soon after injury is premature. Feel free to private message me off line altho I'm old enough to be your great grandmother.... LOL....

[CHUTERMOM]

Hi everyone
I as well have been reading these posts for the past 10 months and have just decided to post my story as well. My gr 6 TPF was in May 2013. I suffered 3 main breaks and over 32 bone fractures. My surgeon said it was the worst he had seen. He has only seen this severity in front end car crashes and women with osteoporosis - neither of which apply to me. I was 47 yrs old at the time and fell from an 18" high foam block at a gymnastics club while on a field trip with our nursery school kids. A real fluke.

It is now 11 mos later, 4 surgeries and a lot of misery and pain and depression. On the plus side, everything has been covered by WSIB (workers comp) as I live in Ontario. Anything I have needed has been there - including amazing physio people. I still go every day for an hour and a half and swim therapy 2 nights per week. I want to offer that I am almost a year recovery - still not back to work, walk mostly unassisted now, every morning and night I am swollen and stiff, walk with a large limp, foot and ankle pain, still on low dosages of morphine and will have arthritis the rest of my life and will require knee surgery later in life. I have 2 large metal brackets that run down each side of my leg (from the knee down) and 12 screws.

To the people that say "it could have been worse".....it's true! My family is healthy and alive and that's all that matters, BUT, it sure has been a tough time. Some days are good but most days are awful and I am still wrestling with it all.

I am grateful for all that I have but I am sad and I think that is o.k. All of us are entitled to feel miserable from time to time.....only human nature......but I have hope that it will get better. Reading everyone's stories, recent and old, are informative, educational and interesting.

Good luck to us all!

[skiplct]

Chutermom, It is truly hard to imagine how you could do that much damage falling only 18"; if you view powdork's fall, he was in a back flip many feet up in the air.. You broke 32 bones in your leg? Or other bones too? DO be grateful for Canadian insurance; my Aug 2012 tpfx has practically bankrupted me; over $25k in unpaid medical bills and climbing... But his injury helps t put things like debt into perspective... My mother has a great refrigerator magnet (The source of all nuggets of wisdom, you know) that says, "If money could solve your problem, you don't have a problem." And yes the stories here are hugely interesting, informative, educational, inspiring and encouraging and comforting all at once. For newbies, I advise NOT to avoid this site but immerse yourself in it; it's the only thing that will make you feel less alone. I had my hardware out 3 months ago (Jan 14) and struggling hugely with whether I did the right or not. Many (most ) ortho surgeons advised against it ("What do you want to do that for?? Your up and functioning! Why would you take the risk of ending up worse off, and go through all that new pain and suffering", etc etc. But 1 or 2 said, "It's a gamble and a toss up. You might end up better off, you might end up worse off, and you might end up not much different." Right now I think I'm in the worse off domain but I can't bitch and complain because it's a choice and a gamble I decided to take with my eyes open. (Well, not literally. Probably closed during surgery.) So MUCH of this injury is the head game: what you tell yourself about how you are going to cope with the new limitations and how you are going to go about re-creating alife that isn't like the one you had before, but may be still crafted into something worthwhile, just in a different way than you are used to.

And yes people do say, "It could have been worse": I did mine in a bicycling accident. And no, I wasn't wearing a helmet. So... Yeah, coulda been worse.

[skiplct]

Note to all: When you are ready, try out this new craze called Aquajogging. I'm getting way into it. You wear a flotation belt that keeps your head above water, then you jog or run as fast or hard as you want in deep end of the pool (water must be deep enough that you can't touch bottom). You get a cardio workout, the feeling of running, and zero joint impact. Really cool. Of course you can't attempt this until surgery scars are completely closed and healed.

[CHUTERMOM]

Chutermom, It is truly hard to imagine how you could do that much damage falling only 18"; if you view powdork's fall, he was in a back flip many feet up in the air.. You broke 32 bones in your leg? Or other bones too? DO be grateful for Canadian insurance; my Aug 2012 tpfx has practically bankrupted me; over $25k in unpaid medical bills and climbing... But his injury helps t put things like debt into perspective... My mother has a great refrigerator magnet (The source of all nuggets of wisdom, you know) that says, "If money could solve your problem, you don't have a problem." And yes the stories here are hugely interesting, informative, educational, inspiring and encouraging and comforting all at once. For newbies, I advise NOT to avoid this site but immerse yourself in it; it's the only thing that will make you feel less alone. I had my hardware out 3 months ago (Jan 14) and struggling hugely with whether I did the right or not. Many (most ) ortho surgeons advised against it ("What do you want to do that for?? Your up and functioning! Why would you take the risk of ending up worse off, and go through all that new pain and suffering", etc etc. But 1 or 2 said, "It's a gamble and a toss up. You might end up better off, you might end up worse off, and you might end up not much different." Right now I think I'm in the worse off domain but I can't bitch and complain because it's a choice and a gamble I decided to take with my eyes open. (Well, not literally. Probably closed during surgery.) So MUCH of this injury is the head game: what you tell yourself about how you are going to cope with the new limitations and how you are going to go about re-creating alife that isn't like the one you had before, but may be still crafted into something worthwhile, just in a different way than you are used to.

And yes people do say, "It could have been worse": I did mine in a bicycling accident. And no, I wasn't wearing a helmet. So... Yeah, coulda been worse.

SKIPLCT-Yes! It is totally hard to believe the damage that was done. It was indeed 3 main breaks and over 32 bone factures. My hardward will never come out because it is literally holding my leg together plus a lot of man made bone (or whatever you call that stuff!) pieced in to glue it all. Maybe later when I have a knee replacement my hardware comes out?? Not exactly sure on that part. My surgeon told me; after my osteoporosis test came back negative) to go and buy a lotto ticket 'cause I had better odds at winning the lotto than this fluke of an injury. When I fell, I heard 3 cracks.......ewwww! I was told it the way in which I fell.....landed on the right hand side of he block and my foot rolled over to the right, twisted like, and then down I went.
And yes, totally grateful to be Canadian!!! No offense to anyone else in any other country! I as well am over $25,000 in recovery-medical equipment rentals, nurse visits, PSW visits, therapy etc. Totally grateful for workers comp! And skiplct you are so right about this injury being a head game! One minute I am all positive and ready to take on the world and the next minute I am down in the "crapper". I am blessed to have an amazing husband and 2 great sons who have been amazing! But if all told....they have a pretty cool mom and wife!!!
For everyone reading......it doesn't matter what grade level your injury is, or how many broken bones or how many surgeries.......the bottom line is that this type of injury is nasty and extremely difficult in recovery. I don't mean to scare off anyone new that is reading this...but it is true.
For sure this is true, but the one thing that does keep me pretty grounded, especially as a mom, is that I know that my kids aren't in the hospital dying of cancer, and my kids aren't being bullied and my kids don't have some kind of life threatening illness...........I will keep my injury a thousand times over if it meant my kids were never harmed or sick. Yes...it sucks....it hurts...it makes me cry sometimes....it pisses me off.....it takes forever to heal.....it makes me mad....but at the end of the day it is what it is and that is my new motto! I will probably never walk properly again but I am walking and even though it is slow I manage. Honestly, yesterday when I posted for the first time I can honestly say it was a "crapper" day and waking up today....is a better day. Perhaps because I finally vented on this forum....and thank you all......I don't know why it took me so long!!! And to you SKIPLCT for responding to me.....even though I have these 3 wonderful men in my life....they are not exactly "chatty patties" and I guess I hold a lot in.....was nice to vent and I encourage everyone else to do the same. I love that everyone talks a lot about the medical stuff and the physio and all that, but it is as nice to get into everyone's head and see how they are coping and managing emotionally as well. This injury is such a physical challenge to recover from I think we forget about our head space. Make it the best day you can....no matter what your limitations are. If you are in a hospital bed today...do a crossword, phone a friend you have not talked to in a long time...paint your nails! do something for yourself even though it seems silly and small...it helps!
I also lost my beloved dog to cancer last oct. while all this was going on....I just adopted another one...crazy me.....but it will encourage me to walk more, when I am able to actually walk her around the block If our stupid Canadian snow would ever leave! Saved a dog...will walk more.....it's a good day!

[groycan]

Hello,
I stumbled upon your thread to read what others are going through. On March 3, 2012 I was playing soccer with kids at work and hit from the right side causing me to come down and break my leg. I was 33 (with a 1 year old) and after a trip to the emergency room, they sent me home stating there was nothing they could do for me and that I had a tibial plateau fracture and to call an ortho clinic that Monday. I had surgery the following Tuesday and had 9 screws and a plate placed in my leg, missed two months of work and slowly returned per doctors instructions. My surgeon (like most) was cocky and confident and there were little red flags that started popping up. Four months from the surgery, I was still unable to lift my leg from a 90 degree position (think kicking motion) and my surgeon said "i hope that wasn't something that i did wrong.' Because it is a workmen's comp case, I didn't have a choice of surgeon. Regardless in August of 2012, I received a letter from workmen's comp stating that I was healed. I then went and got 4 other opinions, along with a lawyer. In December of 2012, I finally was permitted to switch doctors then my position was mysteriously eliminated in January of 2013. My new doctor performed surgery on my ACL and LCL in May 2013. I got a cadavers ACL and he shorten/tighten my LCL and removed my hardware. Still experiencing difficulties, I underwent my third surgery 5 weeks ago to give me a cadavers LCL. The only other surgery left to do would be an Osteotomy, which will be determined in the next six months. During the course of the two years, I have religiously gone to PT 3 times a week and see progress, but it seems that every time I move one step forward, I also move 2 steps backward. The one thing my doctor said was that an Osteotomy was going to be more painful then the other surgeries, so don't know if it is worth it. Just wish there was a light at the end of the tunnel and wish that I could run after my child and wish that they would go ahead and just replace my knee... Thanks for listening.

[Mr. David]

Hey Daisy, don't know if you'll see this a month out, but your disappointment with your original doc, and your lasting knee challenges, sound familiar. My 1st surgeon was by turns dishonest, defensive, distracted, a bit of a bully, and a real jerk (he snuck out the back and went home after the 5.5 hr surgery, while my wife, and my mom who had traveled to be there, waited for him outside the OR as directed by his staff). He also had a lousy approach to followup care.

While the doc kept bragging (literally) that everything looked great, major setbacks at 4-5 months' rehab eventually caused me to seek the opinion of other surgeons at respected ortho facilities; The other docs all pointed out the same debilitating defect on my xrays, more than one of them asking where the original work was done and being vocally critical of it, which is unusual in this field. Still, with all that grief, it's not clear that I'd have a strong malpractice case. Laws vary by state, but in many the standard of care isn't as tight as one might think, and there might be an extremely low standard of outcome before it's a compelling legal case. I say this because I've asked a good lawyer. That said, it costs nothing to consult with a good one, so if it's on your mind, ask someone who specializes in such cases.

I would get that question out of the way and really focus my energy on repair and healing (and PT - maintaining strength is huge). I was fortunate to find a terrific doc who repaired the biggest problems and got me functioning again. Going down stairs is still a bit painful but I work out vigorously on an Arc trainer (easier on the knee than an elliptical) and go for 4-8 mile hikes regularly. I was twice your age when going through the process, and your youth could give you some advantages in terms of procedural options, recovery and regeneration, etc...

On a separate note I'm not sure that your anger should be directed at your PTs. I think it is primarily their job to try to get you more functional & strong, from a neuromuscular standpoint, with the bones and joints you show up with, NOT to analyze, advise or speculate about some bony defect in your knee. They don't read xrays, or at least they really shouldn't, unless it's just for conversation's sake. If you don't like the PT you work with, maybe try a couple other clinics - their styles vary.

Stay positive, take care of yourself, and your problem-solving skills will grow as the process moves along.

Oh yeah, to answer your questions about the process: I had hardware removed, (2 plates, 12 screws) and a few months later an osteotomy with pelvic bone graft, and a subsequent ACL reconstruction. Occasionally some of those steps might be do-able during the same surgery (like if the osteotomy was on the femoral side), but it varies from case to case.

-Hardware removal on its own is minor (2 weeks, sometimes far less, on crutches, then told to do no running/jumping for a couple of months).
-The pain from the osteotomy was nowhere near the pain of the original fracture surgery (it's just a much more controlled procedure than the fracture stuff). The recovery time for some sort of osteotomy/graft is whatever your doc says it will be...(prob 2-3 months non-weight bearing, though my doc had me start standing on it (not walking, just standing) at 6 weeks.).
-ACL recovery is a walk in the park compared to what you've been though, and the web has pretty good descriptions of the process.

On the pain/inflammation front, I rented a game-ready ice machine for one of my recoveries and purchased, through insurance, a polar-care machine (radically cheaper) for the rest, and that cold & compression therapy was awesome in the weeks after surgery.

Best of luck

Just set up an account here, hoping for some positivity, support, and advice on recovery.

I fractured my tibial plateau while longboarding in May 2012; an external external fixator was surgically placed on my leg until the following surgery; one plate and five screws two weeks later in June 2012. I had been non-weight bearing for almost four months. I had been in physical therapy ever since the injury, about 2-3 times a week. I am still experiencing a lot of pain after walking around and my knee does not feel as stable as it used to.

Recently, I went to see a new surgeon, who is highly qualified in knee surgeries, and found out that my tibia was not placed correctly during the first surgery. I also found out that I no longer have an ACL. My surgeon who did the initial repair surgery did not tell me ANY of this information and acted as if everything was healing accordingly, even after watching my terrible limp. I am now being faced with upcoming surgeries; hardware removal (in order to get an MRI done), a bone graft to level out my tibia, and an ACL reconstruction. All of these must be done separately. It is shocking that none of my physical therapists, let alone my original surgeon, said anything about the issues I have been having with my knee. It took the new surgeon one look at my x-rays to know that something had not been done correctly during surgery.

I do not think that it is fair that I am in this position as a result of a poorly preformed repair surgery. I have already been to hell and back during my last recovery time as well as horrible hospital experiences. It makes me very anxious knowing that more surgery is necessary to get me back to normal again. All of this is a lot to take in as I am only 20 years old and almost halfway through college. I have been feeling extremely down lately, because I feel like I am putting an important part of my life on hold as a result of my injury.

I am wondering if anyone else has experienced anything similar to this? If anyone has received surgery for hardware removal, ACL reconstruction, and/or bone grafts and what the recovery looks like? I am also wondering if anyone believes this makes me a victim of a malpractice, as I am considering looking into hiring a lawyer regarding the initial surgery.

Thank you!

[Little Bike]

OMG... I can't believe I found this forum. I broke my tibial plateau on march 3rd. Had surgery on the 11th. I have just been laying here getting depressed and worried about my future. I didn't realize how many other people this has happened to. I am so worried about my recovery. I have a lot of posts to read on this thread.

\

Hi, we're just a couple of days off from each other! Class 5 TPF on 3/1 and surgery, one plate and 7 screws, on 3/7. I saw my os yesterday and got the OK to stop wearing the brace (getting a little more pain, I think it's from trying out sleeping on my side last night and this afternoon. I started out with my bad leg on top of a pillow between my knees - wasn't great but OK - then tried sleeping with the leg on the bottom side - I think I could feel the hardware being pushed on by the mattress, yuck, that didn't last long!) and start pt tomorrow. He wants me to work on my rom. I can't fully extend my leg yet (I thought I could until I had an X-ray yesterday, couldn't flatten my leg on the table - the brace fooled me : ) ).

Don't get yourself down about the poor outcome posts, there are a lot of positive outcome posts too.

If you haven't been doing so, get out of the house as much as possible. Really helps. I think too that this last appointment going so well and knowing I'm making enough progress to ditch the brace and start pt really helped my outlook (like you, I've done a lot of sitting and mulling over things).

[powdork]

\

Hi, we're just a couple of days off from each other! Class 5 TPF on 3/1 and surgery, one plate and 7 screws, on 3/7. I saw my os yesterday and got the OK to stop wearing the brace (getting a little more pain, I think it's from trying out sleeping on my side last night and this afternoon. I started out with my bad leg on top of a pillow between my knees - wasn't great but OK - then tried sleeping with the leg on the bottom side - I think I could feel the hardware being pushed on by the mattress, yuck, that didn't last long!) and start pt tomorrow. He wants me to work on my rom. I can't fully extend my leg yet (I thought I could until I had an X-ray yesterday, couldn't flatten my leg on the table - the brace fooled me : ) ).

Don't get yourself down about the poor outcome posts, there are a lot of positive outcome posts too.

If you haven't been doing so, get out of the house as much as possible. Really helps. I think too that this last appointment going so well and knowing I'm making enough progress to ditch the brace and start pt really helped my outlook (like you, I've done a lot of sitting and mulling over things).

the sleeping will get better. just having the ability to get on my side was a godsend, and about a week later the other side was doable. laying in bed stuck in one position unable to sleep was the worst for me. the painkillers didn't help, but seriously strong pot did.

and yes there are positive outcomes. i am exactly 2 months out from injury and a little less from surgery (plate, graft, 9 screws). yesterday i started with a short bike ride, my first that wasn't on a trainer. i even hit a few trails though i would say it was short of actual mountain biking. then i went climbing outside. then i had my first day back waiting tables, a 7 hour shift standing and walking. it was a good day.

it doesn't have to be the end of anything.

[Tcraig1992]

So i had a TPF and tore my meniscus (pretty epic skiing accident in some moguls) and am around 3.5 weeks out of surgery (plate and 7 screws). I'm not allowed to bend my knee for a few more weeks which is kind of annoying as it seems from the thread lots of others were bending early on. I am in good spirits because i know even though the road of recovery is long i can push through it. I have pain on my upper shin just south of my knee. How long will that last? Any advice or expert knowledge on this injury would be greatly appreciated! This forum has been a life saver, thanks to all who share their story.

I also went back to college a 5 days after surgery. Its a mountain college, makes crutches a little bit of a workout . Its a big time commitment and i cant rest and prop my leg as much as id like. Do you guys think this will slow the healing process?

[powdork]

I don't think it will slow it as much as sitting doing nothing would. Inactivity breeds inactivity.

[Little Bike]

So i had a TPF and tore my meniscus (pretty epic skiing accident in some moguls) and am around 3.5 weeks out of surgery (plate and 7 screws). I'm not allowed to bend my knee for a few more weeks which is kind of annoying as it seems from the thread lots of others were bending early on. I am in good spirits because i know even though the road of recovery is long i can push through it. I have pain on my upper shin just south of my knee. How long will that last? Any advice or expert knowledge on this injury would be greatly appreciated! This forum has been a life saver, thanks to all who share their story.

I also went back to college a 5 days after surgery. Its a mountain college, makes crutches a little bit of a workout . Its a big time commitment and i cant rest and prop my leg as much as id like. Do you guys think this will slow the healing process?

My brace was set so I couldn't bend much either for about that same amount of time. I had the shin pain too - if you look on your shin lower down and see a scab, the surgeon may have used a stabilizer attached to your shin.

Ooh boy. I remember when I broke my ankle back in the day in college - and of course the college was built on a hill. Luckily there was a tram you could call if you were disabled. However, I lived on the 3rd floor of my dorm and no elevators! I remember one day I couldn't get the tram. I stood there on my crutches staring at my dorm that was about 400 yards away…….sigh.

[BTinSF]

I'm really relieved to see this thread. Lots of reading to do

My injury (bike accident on my commute) is only about 4 days old. X-ray and CT show a lateral TPF with depression of about 3mm, and no apparent instability or deformation. Swelling is way down already, and next to no pain so far (I'm on crutches with a mostly straight rigid brace). My ortho is saying "no surgery". Will I regret this? I know I'm a lot better off than many folks who have posted so far, but should I be suspicious of a doctor who says 3mm is good enough?

[powdork]

If you're concerned seek out a second opinion (the internet doesn't count). But in general I would be more suspicious of a surgeon recommending surgery than one who is not.

[Skiobsessed]

I'm really relieved to see this thread. Lots of reading to do

My injury (bike accident on my commute) is only about 4 days old. X-ray and CT show a lateral TPF with depression of about 3mm, and no apparent instability or deformation. Swelling is way down already, and next to no pain so far (I'm on crutches with a mostly straight rigid brace). My ortho is saying "no surgery". Will I regret this? I know I'm a lot better off than many folks who have posted so far, but should I be suspicious of a doctor who says 3mm is good enough?

From what Ive heard most orthos use 5mm as the "line" like anything above 5mm they automatically recommend surgery and anything below 5mm is optional. Mine was right at that line around 5mm and I opted not to do the surgery after getting several OS opinions. I agree with powdork though you should def get a second opinion if you are worried so that you can feel secure in whatever choice you make. And I also agree that Id be more suspicious of a surgeon who IS recommending surgery than one who isnt. They have nothing to gain by telling you no surgery. Goodluck and hope it turns out well!!!

[BTinSF]

Thanks for the responses. Looking into a second opinion now.

The reason for my concern is that my doctor is part of my HMO.... his incentives are (at least theoretically) aligned with cost control, and it's not clear to me that they understand the level of running/cycling/skiing I want to get back to.

Thanks again! Loving these crutches right about now

[nycknee]

BTinSF - I too have a minimally displaced lateral TPF that is only around a 2mm depression. I skied on it for over an hour and then walked on it for three days before I had it looked at. I saw two OS (including a big time OS here in New York), and separately talked to two radiologists and all agreed that I didn't need surgery and that for a minor TPF, it's better to let it heal on it's own. So be grateful that it wasn't that bad and realize that surgery makes recovery longer and more difficult. Mine didn't hurt that much either and the swelling went down after 2 or 3 weeks. I also am in PT and have full range of motion (over 140) and can ride a bike, albeit with no resistance. I have been told that I will be skiing next year and that this will all be a bad memory.

I am currently on week 5 of 6 of NWB on crutches and can't wait for my follow up in a week and a half. Is there anyone out there who had a similar TPF (not displaced, no surgery, etc) who can tell me how soon they were able to walk and go full weight bearing after their 6 week follow up appointment?

[Lurking Lawyer]

Understanding that everyone's situation is different, my OS has set 3 months as the minimum for NWB. That seems awfully arbitrary.

[Ryan7878]

So I finally started PT. 5 weeks and 1 day after surgery. Flexion was at 78 and extension was 20 at end of PT. I am concerned that I can not extend unassisted. I seem to have no quadriceps left therefore there is no way I can make my leg extend without putting my other foot under it and using that leg extend. Is this normal?

[Mr. David]

BTinSF, if you are in SF and plan to go out of your HMO network, you might like Dr. Morshed over at UCSF. The guy is highly competent, down-to-earth and honest, and I didn't get the impression that he's one to "sell" surgery that isn't called for.

I'd guess you have this figured out already, but you'll get in fast with a trauma doc if you mention that you're dealing with a fresh fracture (as opposed to just asking for an appointment to get a 2nd opinion).

Best if luck!

Thanks for the responses. Looking into a second opinion now.

The reason for my concern is that my doctor is part of my HMO.... his incentives are (at least theoretically) aligned with cost control, and it's not clear to me that they understand the level of running/cycling/skiing I want to get back to.

Thanks again! Loving these crutches right about now

[Little Bike]

So I finally started PT. 5 weeks and 1 day after surgery. Flexion was at 78 and extension was 20 at end of PT. I am concerned that I can not extend unassisted. I seem to have no quadriceps left therefore there is no way I can make my leg extend without putting my other foot under it and using that leg extend. Is this normal?

Do your home exercises - you'll find that this will get better. I started pt a week ago (also 5 weeks post surgery) and was at less than 90 degrees flexion and my extension was about the same as yours. This week I'm about 110 extension and with a little persuasion, 0 flexion.

I can extend my leg laying down if I'm on a surface that allows my foot to slide. I had on tennis shoes at pt yesterday and had to use one foot to push the other down. I find it pretty difficult to extend my leg with my heel off the bed/table. Talk to your therapist with your concerns, perhaps ask for more work to do with your quads.

Keep plugging along!

[Skiobsessed]

Hey didnt lindsey vonn fracture her tibial plateau when she tore her acl ect last year? Does anyone know how depressed her fracture was? I dont think she had to have it fixed in surgery but not sure.. I always hear about the acl part of her injury but not about the tpf.. Just wondering..

[Margosh]

Hi everyone!
How to understand when it is time to walk? How did you start to walk? I'm now almost 12 weeks. I'm walking on crutches, but I'm using both of my feet now. So I'm partially wb. (50-60% i think. ) . When it is Time to use a cane? How lone does it take? From PWB to walking without a cane? My pt says that I can put already more weight, but I'm afraid to do something wrong..

[Margosh]

[QUOTE=Little Bike;4235624]
Ive started pt at week 8 after my surgery (before that my brace was strait).
I was at 67 degrees flexion. This week I'm about 110 -115
So like the others, I think it is very important to do your home exercises.