Tibial Plateua recovery after surgery

[chrisjcks]

Hey guys, I'm glad to have found this website, its nice to see other people with injurys like mine (meant in the best possible way)

What is the recovery of this surgery like?

My accident happened on the 14th April but I spent a few weeks just resting it at home as like most injury, I thought it would just heal.

Having been sent to the hospital after 3 weeks, my GP informed me I need to have it checked as 3 weeks is a long time without much improvement (this was the first time my GP saw my knee)

after my scan, they immediately set up a bed in the trauma ward only for me to be told I wasnt being let out. That night I had a blood thinner injection into my stomach, which I knew wasn't a good sign. The next day, I was told early in the morning that I would be having surgery on my knee and they explained what was needed. (A knee lift, screws, plate and a bone graft - they explained they would use animal bones as the other option was from my hip which they said would be very painful to me - I signed some forms and went on my way that very afternoon)

Since my op I've been in a full leg splint and am waiting for a knee brace so I can bend the knee, I've still been told no weight bearing but they wish me to go back next month which would be 6weeks after the op.

What happens next?2011-05-24 11.31.59.jpg2011-05-24 11.29.19.jpg2011-05-22 10.53.05.jpg2011-05-22 10.53.32.jpg2011-05-25 18.28.22.jpg

I should add that whilst it took me a while to get it checked, my consultant at the hospital assured me the injury and op procedure would have been the same if I'd reported it earlier (I was afraid having left it some weeks, I might have made it worse - but they informed me this was not the case .... phew!)

10 screws, a plate, a knee lift and a bone graft.... I'm still out of work and have been for a month and half, and work have been understanding but I am worried they may just let me go or something, leaving me with bills to pay.

Any advice or information is very much welcomed, I'm 25 yrs old and the doc said this is a good thing for me, but am very worried - my consultant has already told me I won't have a normal knee ever, not like I had before.

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[physiobob]

Wow!!!!! You did a good job. How did you do this? It has fractured into the joint line which is often a problem that delays and even prevents a ful recovery. Often the brain just won't let the quads return to normal function perhaps for fear of damaging the joint again. You have a long journey ahead of you. I would think about it in small achievable steps, the first being restoration of full knee joint range of movement (or at least maximizing what is possible). When you do begin to rehab the leg try to choose exercises that involve the whole leg and the normal function of the leg. Looking forward to hearing the details of the accident.

[chrisjcks]

Hi, it was a black cab driver - he drove off before I'd fully got out, and just drove off.

I'd ordered a different cheaper company and this guy turned up, me and my friend asked if it was for 'Jackson?' And he replied yes get in.

Only to realise during the journey it wasn't my taxi and he was just stealing someone else's fare, I told him I wouldn't have the money to pay his price and asked why he said the taxi was for me, he was a foreigner and just claimed he had nothing to do with the other company, so he told me to pay the fare as it stood (half way through the journey) and told me to get out.

As i did, he just drove off. I was mid-air and landed on one leg, and with the movement of the vehicle, I also twisted to the ground. I would put a claim in, but as its a self employed black cab and I didn't catch his plate number, I have no idea who to claim against.

I'm still waiting for my knee brace from the hospital, so at the moment I still have my full leg splint on, but when I get that - they want me to Bend it as much as possible, with no weight bearing of course.

Thank you for the reply bob, should I be doing a few leg raises whilst at home?

as when my dressings get changed - I can clearly see how thin this leg has become.

[physiobob]

Total bummer! That does explain the unusual presentation of the x-rays though. As for leg raises I should say that in general i am not a fan of the exercise perse as most people don't have enough abdominal control to prevent them from injuring the lumbar spine. But in your case I suppose a few to keep the quads a little active. But then that is mainly rectus femore and the other three are not going to work that much as they aren't involved in hip flexion. Maybe doing this type of movement in standing (think of a ballet class at the barre and you'll get the drift) as well as leg abduction (lifting to the side) when lying on your good side. There are a few variations of that such as doing them with the leg rotated inwards to maintain some gluteal function while you're waiting to be able to weight bear. Even in a fixed brace your physio may be able to do some gentle muscle stimulation to keep the quads active. I have used that before and have even drilled holes into a plaster to make room for a few electrodes. So long at the contractions are not to great this is a usful way to keep the twitch responses active in the quads. Let us know how you get on.

[chrisjcks]

Hey, I've been given my knee brace (eventually)

Just been told to bend it as much as possible, most pain I get whilst trying to bend it is on the right side of my leg but will keep trying to bend it as many times as possible.

Still no weight bearing...

2011-05-31 18.20.59.jpg2011-05-31 15.20.32.jpg

[Christie]

Did my Tibial plateau damage done whilst skiing, (type two shatzcker i'm told.) accident was on 6th March with the operation on 18th March. That took 4 1/2 hours, not sure if thats a long time ? and included bone graft.
Have been perplexed at the lack of pain throughout though !! when i broke the knee i have had more pain from stubbing a toe!, after that absoloutly nothing!! is this normal ? i can feel everything so no nerve damage.
Anyway..two weeks with pot on then stitches out, pot on again for two more weeks, which comes off tomorrow( 17th April 2013 ) and then knee brace, looking forward to being able to bend my knee again.

Is there a lot of pain when moving the knee or is it just difficult do to muscle loss ? and is there a rule of thumb when i should then be putting pressure on the foot ?

[physiobob]

Hi Christie, each and every tibial plateau fracture is different. A type 2 is on the less scale of what can be done which is good. Pain & mobility/range of motion is very individual as the brain responds to the trauma in very individual ways and it seems like yours is one that many others would like to have. Some people can't bend at all following the period of immobilization, some have full movement, some have pain, some have only discomfort. What I would say in general is that it can take a while to get the quadriceps working again and to take a long view on the recovery for this one. Normal daily activities will resume within months but getting the leg to have the bulk of the non-injured side will be difficult.

Let us know how you get one once you are back on your feet. If you can post an image of your x-ray that would be even better as a tool for others to look at and be assured that not all of these fractures are so problematic.

For peoples interest

The Schatzker classification system is one method of classifying tibial plateau fractures and splits the fracture into six types. In the Schatzker classification, each increasing numeric fracture category indicates increasing severity, reflecting not only increased energy imparted to the bone at the time of injury but also an increasingly worse prognosis.

The most common fracture of the tibial plateau, is type II.
This system divides tibial plateau fractures into six types:

• Schatzker I - is a wedge-shaped pure cleavage fracture of the lateral tibial plateau, originally defined as having less than 4 mm of depression or displacement.
• Schatzker II - split and depression of the lateral tibial plateau - type I fracture with a depressed component.
• Schatzker III - pure depression of the lateral tibial plateau.
  
  • divided into two subtypes
    
    • Schatzker IIIa - those with lateral depression
    • Schatzker IIIb - those with central depression
    
    
  
  
• Schatzker IV - pure depression of the medial tibial plateau, without a fracture fragment.
• Schatzker V - a bicondylar fracture.
• Schatzker VI - fracture through the metadiaphysis of the tibia.

[Christie]

Well. so far its going slowly..private physio seemed clueless so went to sports injury therapist, far better, using massage and pressure release to get the knee moving, plus a range of excersizes each session and during the day. using the cycle machine as an aid to helping bend the knee is fun !!
5 days to go then i start weight bearing, have stopped wearing the knee brace as this caused more problems that it solved.

[physiobob]

Great to hear and cycling is indeed a welcome movement for many post surgical knees. Just keep it slow and steady until you get a baseline of how your knee reacts to the exercise over a week of so. i.e. keep the resistance and time the same for a while (kind of thinking of it as training to be able to train).

[Christie]

wow ! You seem to have a lot of surgery entry points !

My accident happened on the 6th March, and on monday i will be six weeks post op and start weight bearing, the knee brace only stayed on my knee for a day!!!, did not seem to help!!
Knee only bends to about 40 degrees, had some soft tissue release work done but thats as far as we can go, just now waiting for knee to bend a tad each day, hopefully weight bearing may help !!!

I was told that after a few years i will need a knee replacement, as the cartlidge has been very badly damaged, i'm having max doseage of glucose & conjoitin to help with its rejeneration, hopefully over the next few years i might be lucky !!

[Christie]

Today started on my back with thigh supported vertically and with knee bending down on its own weight then using a pro muscle vibrator to help release soft tissue, the knee is now well past 90 degrees. Would recommend the use of the vibrator on soft tissue.

[Christie]

Doing 25 metres of supported walking every half hour, 22 kilos weight bearing at the moment with no problems apart from knee wont bend beyond 50 degrees, but theres plenty of time. One good thing. Some of the remaining swelking around the knee has gone since i started pwb. !!