Tibial Plateau Fracture Tibia Plateau fracture not healing

AZTeri

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I'm new here and looking around but in a brief glance, I didn't see this as a topic. I had a bike accident on June 5 and fractured my tibia plateau. I've been total non-weight bearing since then. There are multiple small cracks in the head of the tibia along with a larger fracture. Because I was already anticipating a TKR the doctor advised against repairing the fracture with plates/pins/rods, which would mean a second surgery to remove those before a TKR at a later date (three surgeries in other words). He recommended letting the fractures heal as much as possible then proceeding with the TKR. I've been having physical therapy in an attempt to get to a 90* range of motion and weight-bearing before surgery will be scheduled. I'm currently at approximately 30* but have only been working on ROM for the past 3 weeks or so. Once I reach 45*, I think he will have me starting to put some weight on it, but I'm not sure, as it's slow going and I'm sure a lot depends on the larger fracture. The small cracks are healing nicely, but the larger fracture still has a long way to go. He is anticipating surgery sometime in November or December.

Is there anyone here who has experience with something similar? I have a feeling my recovery time will be much, much longer, and more difficult than what is considered "normal".
 
Hi and Welcome!

I‘m sorry to hear about your accident and that you have to wait so long for surgery. We do have another member whose wife had a tibial plateau fracture, @VolFan0927

Here’s the recovery thread for you to look at:

 
Hi @AZTeri

My wife is about 24 weeks post op commuted tibial plateau fracture. She had surgery and is working on rehab now. Her knee flexion (ROM) has been slow to come back, but slowly getting there at 117. It took her 12 weeks before she could weight bear. She has some bone issues and muscle atrophy, and although she is cleared to full weight bear now she is slowly transitioning from walker to cane and hopefully no assist. Would be happy to try and answer questions. Big thing here is patience, and recovery I am finding is taking longer than knee replacements. Some of the time of recovery will depend on type of fracture, how active you were before the accident, type and approach to rehab, etc.
 
VolFan0927 - Thanks, I just got a chance to visit again. I was very active before my accident, in fact, it was in the middle of a 30-mile bike ride when I fell off and fractured it. I'm at week 8. I have about 30* flex now, the doctor wants me at 90 and walking before surgery.

One weird question - did she have problems with her foot? Part of my issue is I had foot surgery on that foot (right, the damaged tibia is right) and it's numb feeling. I exercise it as much as I can, doing the exercises my PT gave me for it and my quads and glutes as well, doing all of them about 4-5 times a day as I sit in my recliner. I am more mobile now with my walker partly because I can move my right leg now without a lot of pain. In fact, I'm down to only 2 Extra Strength Tylenol at night. The other thing I've noticed with my foot, besides the swelling I still am getting, is the skin is really tight and sloughing off. One of the visiting nurses suggested an Epsom salt bath to try to ease up some of the issues, but besides getting rid of the dead skin (not objecting to that at all!), it really doesn't seem to be doing much else.

I just came off of a home health visit and will be changing to a different PT next week. I'm interested to see what my OS says on Friday when I see him again. I'm hoping the X-rays are more encouraging.
 
I am healing from a tibia plateau fracture, after which I'll be having a total knee replacement. I'm pretty strong, I was in the midst of a 30-mile bike ride when I fell and broke my leg. I'm back to working out at the gym to strengthen my upper body, prior to my accident I worked out 3x a week with a trainer. My question has to do with my non-injured leg. I'm doing as much as I can with my walker, but I have noticed it is really getting weak. Since I just recently went back to working out with my trainer, he's thinking of ways I can strengthen that leg since I am still non-weight bearing. I'm up to 50°, but won't be able to start bearing weight until I reach 70°, which the doctor would like to see in 4 weeks. What can I do now to strengthen my good leg? I know the stronger I am, the faster and easier the recovery, and considering I've already been at this since June 5 and surgery probably won't happen until late November/December, the thought that I will be pretty immobile for another 6-9 months is rather discouraging. I have some ankle weights and plan to look at the YouTube videos that are referenced, but I'm looking for personal experience as well. Thank you.
 
I did front straight leg lifts (sitting back on a yoga mat, elbows propping my upper body) separately, isolating the quads while holding in my core to stabilize my middle (& protect my lower back). I also did side lying, inner leg lifts, & "mule kicks" on the mat. All no impact. You could use ankle weights with these exercises but you take a chance at tweaking your back if your form is off.
You can also look up chair exercises where you can isolate each leg and get a really good burn as well.
 
I'm in total agreement with Gingerbread. The straight leg raises with an appropriately sized ankle weight does well. You can also just do quad sets (tightening your quad) throughout the day. That keeps the quad firing well. The quad it the key to the knee!
 
I found this set - 10 Must-Do Pre-Hab Exercises Before Knee or Hip Replacement Surgery on the internet. Use any search engine to go to the page.
 
Last edited by a moderator:
Me again. Today is 15 weeks since my biking accident where I broke my tibia plateau. The flat area is healing just fine, and one displaced is healing. However. There is one bone that was displaced that simply will not heal. The bone loss there is too great, apparently. At least that's what the CT scan that was done this past Monday (September 13) appears to say and show. My doctor wanted to see me yesterday, however, my husband had an appointment in the opposite direction at the same time that had already been rescheduled three times, so he needed to go. So now I won't see my doctor until September 30.

I'm afraid that he is going to say that he has to go in now and do surgery to repair that bone. What does significant bone loss mean for a knee replacement? If he does have to go put a pin or several pins in, does anyone know how long the recovery is? And then they will have to remove the pins before they can do the TKR. It is making me regret not asking for the surgery immediately after the break if I'm going to end up with three surgeries anyhow.

Any suggestions for rebuilding bone, from a dietary point of view? I already eat very well, my husband and I are both tracking macros. He's lost 70 pounds and I've been maintaining since my accident. I was within 5 pounds of my goal weight, so that's fine. We eat a LOT of protein - chicken, eggs, some ham, turkey, beef - a lot of fruits, and vegetables, very few processed foods. I do take a calcium supplement, but honestly. I'm afraid of increasing that because I have had kidney stones twice and a kidney infection in January 2019. Anybody have any insight they would be willing to share with me?
 
I'm supposed to have my surgery in December, but due to a recent CT scan I don't know if that will happen or not. But I'll go ahead and add my name to the December list.
 
Hi @AZTeri

My wife is about 24 weeks post op commuted tibial plateau fracture. She had surgery and is working on rehab now. Her knee flexion (ROM) has been slow to come back, but slowly getting there at 117. It took her 12 weeks before she could weight bear. She has some bone issues and muscle atrophy, and although she is cleared to full weight bear now she is slowly transitioning from walker to cane and hopefully no assist. Would be happy to try and answer questions. Big thing here is patience, and recovery I am finding is taking longer than knee replacements. Some of the time of recovery will depend on type of fracture, how active you were before the accident, type and approach to rehab, etc.


Hi, it's me again. I'm now allowed to put 25% weight on my leg. But... there is one part of the fracture that at 15 weeks since my accident is still not healing. I just had a CT scan done that shows bone loss in that area. I have a foreboding fear that I'm going to have to have a pin put in anyhow, which will delay the knee replacement by who knows how long. I already have muscle atrophy even though I've been doing all I can to avoid it.

One question - did your wife experience swelling in her foot followed by dry, peeling skin because it felt like her foot was wrapped in saran wrap? I think that feeling is caused by the swelling, which stresses my skin. The bottom of my foot is literally shedding sheets of skin just about every day. I have been soaking it in Epsom salts, and it's unreal how much dead skin comes off. The discoloration and swelling are very bothersome, I sit with my leg elevated most of the day. My OS and PT have both assured me that the swelling is normal, especially at the end of the day. I've been icing it as well. To say I'm getting tired of this is probably a major understatement.
 
I'm supposed to have my surgery in December, but due to a recent CT scan I don't know if that will happen or not. But I'll go ahead and add my name to the December list.
We add members to the team threads when they have a surgery date. We post the list by surgery date so members can find others having surgery around the same time.

As soon as you have a surgery date post it in your thread, a moderator will add it to your signature and add you to the team threads.
Thanks for understanding,
Chris
 
@AZTeri

I merged all your threads into one, so that you have a history in one place of the recovery from this fracture. I also moved it over to the Recovery forum, since you are recovering.

This benefits you because all your information is in one place, easy to find, and maintains a nice journal for you.

This also benefits our staff, as your information is all in one place, and we often go back through your thread for previous details, so we know what you‘ve been through which helps us advise you better.

So, please keep all your posts in this thread. If you’d like a new title, let us know what you want, and we’ll change it for you. You can always bookmark this thread so you can find it easily.

Best wishes on your continuing recovery! :flwrysmile:
 
My wife is recovering from tibeal plateau fracture, and just passed 7 mo post surgery. My wife gets swelling in her ankle area at least 1x a week. She was non weight bearing for 12-13 weeks after surgery and it has taken along time to walk. In the last 4 weeks she has moved from walker to cane. The PT has told her b/c her foot was NWB for so long, it will take a time for foot, ankle, and knee to get use to walking again. Strange that her foot and ankle give her more problem than the surgical knee area. My wife elevates her foot at night and ices 3-4x a day for about 20 minutes. I think this will be normal for the first year or so. She had some dry skin the first few months, but that has stopped now.
 
Me again. I read (well, tried to) the results of my CT scan and from what I read it appears I have significant bone loss, which may well result in a bone graft. VolFan0927 - did your wife have to have that? A friend whose husband is an orthopedic surgeon in another state looked at the report and said that is likely, my surgeon may choose to do it now, then the TKR later, or he may combine the two, which would be easier on several levels, it just depends on his choice.

I see my doctor on Thursday and hopefully will have more answers then.
 
A friend whose husband is an orthopedic surgeon in another state looked at the report and said that is likely, my surgeon may choose to do it now, then the TKR later, or he may combine the two, which would be easier on several levels, it just depends on his choice.
If I were you I would see more than one surgeon for different opinions, so you get a plan that works best, both for the surgeon, and for you. If one surgery to fix both can be done, and if that’s what you want, I would see if that’s possible.
 

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