Tibial Plateau Fracture Recovery

[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]

[mc6029]

Update after almost 5 years:
I had been doing well for over 3 years after the removal of my hardware, but in the last 6 months, I was getting gradually worse, from the start, when getting up from sitting for a while, I would limp for the first step or 2, then I would be fine, now, I limp for about a minute, and the discomfort never goes away.
Went to see my doctor, as I've also been having hip problems in the last while, x-rays were taken, and my doctor told me that the knee area trouble was due to metal particle debris in the area. My doctor referred me to a clinic where they will inject the area with cortisone.
Has any one else here had this, or even hear about something like this?
Thanks,
Denis

[bry]

I am sorry to hear. Never heard of that but I'm surprised there isn't a procedure to consider where they scope and try and clean it up as best possible?

Cortisone as the only remedy is tough to keep doing for the long term I would imagine. If it returns after time, again.

Sent from my Pixel 4 XL using Tapatalk

[mc6029]

My GP who referred me to the clinic said this was not something that surgery would fix. I realize now I should have asked more questions, but I was a little stunned about the other part of the diagnosis that I would need hip replacement surgery in the future.
I will ask more questions at the clinic on Thursday, when I'm scheduled for the injection.

Denis

[splat]

Cortisone is not a cure-all but will provide tempory relief for a while. Google is your friend.

https://www.google.com/search?rlz=1C...V7_CF0Q4dUDCAs


The knee cartilage of a patient with OA thins over time (upper panel: prior to treatment;
lower panel: 2 years later, with corticosteroid injections to the knee every 3 months).
Repeated corticosteroid injections to the joint may speed cartilage degeneration.
Credit Timothy E. McAlindon, M.D., M.P.H., of Tufts Medical Center, Boston.

The knee bone's connected to the hip bone. Rolfers have a move to help with hip pain/degeneration that is awesome.
I also learned from my rolfer that if you sleep on your stomach with one leg cocked, as in knee raised upward, this has a long term degenerative effect on the hip.

[enginenerd]

Hi guys.

I did a TPF, ACL & miniscus 6-7 years ago skiing. The fracture I got lucky and it broke a chunk off that was shaped such that it was wedged in place. No screws. Just straight leg brace for a long time.


The acl though, didn't tear but instead ripped the chunk of bone out that it attaches to. Later, they did a little surgery to grind off some scar tissue and strap this in place to heal, and they trimmed up miniscus.

Anyways, the issue has been pain all along. It's totally functional, but I can't stand more then a few hours without it starting to throb. I can't straighten it out all the way with weight on it or it will sometimes pop and hurt quite a bit. Definitely no running is possible.

I finally got back on snow this year after a lot of time on the peloton, but even that is like take 800ibu / some tylenol and a 5mg edible and a beer or two to go ski 3 hours groomers and then pay with 5/10 pain the next morning. Been hoping just toughing it out would settle it down

I've had it mri'd, scoped, 3 different surgeons, they all say it's fine.

Anybody else with a similar outcome? What did you end up doing? I keep wondering if I should be pushing them harder to go back in look at miniscus more or just a knee replacement or what. My mom is 70 with double knee replacements and better mobility then me lol. :/

[splat]

My girlfriend did a spiral tib/fib fracture with seven fractures in her tibia plateau, plus a depression and a meniscus tear while skiing almost a year ago when she was 63 years old. Docs said she was the fastest healer they might have ever seen, as she was back doing Zumba at six months, as well as hiking and riding bike while sticking with her PT. I posted photos of the ugly scar she got in surgery that stretched well over half her calf. I don't remember how many screws and plates she got but it was considerable in both the tib/fib and tpf. This happened just as I was finishing the formulation on my CBD cream with DMSO to help my demolished shoulder. She started using my cream the day she came home from the hospital and attributes much of her stupendous success to it. So, I know I'm sounding like the ultimate schill here, but some of y'all here might want to give it a try. There's a thread right above this one I started a year ago where I discuss my own healing as well as hers over the last year. It's https://www.tetongravity.com/forums/...tive-CBD-Cream and the website for the cream is www.cbdnowcream.com . My shoulder and her knee and leg are like new again and we're old fucks. Might help some of you younger people, too. Just sayin, plenty of testimonials in the thread.

[HelenTPF]

I was going to read the whole thread but was on page 7, then clicked to the very end and saw there were 74ish pages, so no. So helpful though to read people’s experiences at different stages of recovery.

I fractured my tibial plateau after an awkward fall while bouldering at the climbing gym. Was shocked this could happen falling onto the soft mats. I had outpatient(!) surgery 3 days later and have 2 plates, 9 screws and a bone graft. I may have a PCL tear which may or may not need surgery depending on how strengthening goes (I think I will opt for it, though more recovery time isn’t a nice thought). Waiting for MRI appointment to confirm.

I was non weight bearing for 12 weeks, then doctor had me full weight bearing but it took me a few weeks to be able to do that without any support. Was using both crutches, then one crutch, then a cane. Started PT 2x/week about 3 weeks after surgery, even though doctor said not to worry about it until I was FWB. I’m so glad I ignored him bc PT kept the muscles from completely disappearing (I was alarmed at the amount of atrophy after just 2 weeks.. couldn’t even get my quad muscles to activate) and also once it was possible to, started working on ROM. I was stuck almost straight with a slight bend and now I’m at 140 degrees flexion (my normal range is more than this and I want to get it all back). I’m at about 0 degrees extension now (my normal range is hyperextension.. I’m normally very bendy!). Muscles still weak but I have to admit I’ve been lazy about the PT home exercises. I recently started doing yoga and Pilates (can’t do all the moves), and started using an exercise bike (but can’t stand on it bc of pain). I just returned to the climbing gym yesterday and was able to get on easy routes but normal climbing won’t be for awhile. My knee still hurts in certain positions and with resistance (when doing exercises) and feels stiff when I wake up or don’t move it for awhile. I can also feel an ache at the side that I think might be from the hardware (I can kind of see it sticking out). My skin on my shin around where all the hardware and incisions are is still tender (does this ever go away?).

I’d like to get the hardware out and am wondering if anyone here is in Canada and if doctors tend to dissuade you from doing it if not absolutely necessary (since it’s on the public dollar)? From what I’ve read on here, it sounds like removal is a good idea to get as close to normal as possible. Right now, I can’t even imagine my knee feeling back to normal or close, even though I can walk. Still can’t jump or run as there is pain, or do anything too onerous. I’m normally an active person so my current state is not what I’d be content living with. Also, how long is full recovery time after removal? I’m reading people can go without crutches after a week but haven’t read much about full recovery timeframe. Final question is if I do need ligament repair, would they just remove the hardware during that time if I request it? Thanks!

[Anjylkat]

I used Dr. Christopher's Bone and Tissue healing balm, massage oil and capsules I bought on Amazon that were posted on a blog for a woman who had wrote about her TPF surgery and recovery. All three products cost less than half of the CBD now cream. I am a smoker and smoking can greatly inhibit bone growth/healing, so I was a bit concerned as I tried initially to quit but with so much time of doing absolutely nothing during my 8 weeks NWB, I smoked within a week after surgery but by my 8 week check with my ortho surgeon, the bones were healed wonderfully and doc was pleased. I attribute the healing to my doing what I was supposed to do, having excellent surgeons and Dr. Christopher's B and T stuff. The massage oil stinks to high heaven and the pills have a gross after taste, but I applied the balm or oil regularly.

[Orthoski]

One of the limits of gauging your recovery based on others' experiences online is that a tibial plateau fracture refers to a fracture at a specific anatomic location, but not necessarily a specific injury. What I mean by that is that each person's fracture is different. By the sound of it, if you needed two plates and bone graft you had both comminution (a shattering of the bone) and a significant joint line compression that left a sink hole below when the joint line was tamped back up. This is likely a more severe injuries than many.

Along this line, in the long run it can be hard to separate symptoms that stem from the severity of the injury from symptoms directly related to the hardware. Hardware pain can come in many forms, and there's a lot of unpredictability in removing it - pain that someone says is right over the plate when something pushes there is more likely to improve after removal than a more diffuse, deep ache. Sure, the heightened stiffness of the metal plates relative to the bone can, for some people, cause issues, but the majority of patients leave the plate in place. The skin around the tibial plateau is not always the most forgiving, and if you have two plates one may be posteriorly in the back of the knee where a surgeon isn't excited to chase it. Hence the risk/reward to considering hardware removal - the harder it is to remove and the less forgiving the skin, the less a surgeon rushes to do it. On the other hand, the possibility of benefit alongside the psychological benefit of having it out also matters. Talk with an experienced surgeon and weigh the risk/reward to your specific situation. Also, given the potential for continued improvement alongside the desire to allow the bones to heal, surgeons often wait a full year before considering removal forgoing extenuating circumstances.

Best of luck healing.