Tibial Plateau Fracture - Osteosynthesis - Physio rehabilitation questions! (2013!)

Hi chaps.

I'm looking for some information on knee recovery times, and in particular if there's been mismanagement of my injury.

In a nutshell, I've had a tibial plateau injury in France whilst skiing. The French surgeon decided to 'lace' together the bone by drilling into the tibia, and sutured the plateau back to the proximal tibia. Anyway, the French doctor put my leg into a brace at 20 degrees.

Fast forward a fortnight and I'm back in the UK and the NHS hospital took the brace off, and cast my leg in almost full extention (maybe 5-10 degrees) for 4 weeks.

The Cast is now off and the condition of my knee is fairly grim, there is no give in it at all - and the muscle is notably atrophied. A week later and Im starting to get a bit of strength back in the leg, and have visited a private physio. There appears to be no real change in the angle of flexion since the cast came off and this is starting to worry me.

It seems to be a fairly bizarre injury, as it's hard to find decent information about it online, especially this osteosynthesis procedure the French have opted for in my case.

I'm still non weight bearing for another 4 weeks, at which time I'll be reassessed by a Doctor, the swelling is still pretty prominant too, so there's a lot of (non-cake) icing still going on.


TL;DR Version:

Is it normal to have almost no bend in my leg?
How long should I expect to get a 90degree bend in my leg to allow for sitting upright in a normal chair?
How painful should this physio recovery be? Should I push into pain in trying to bend my leg?

Well, I haven't heard anything from the forum which is disappointing.

In terms of an update: I'm 4 weeks out of a cast and flexibility has returned slowly to approx. 100 degrees. I need crutches to move around and I'm hovering between using one and two crutches. I do currently feel like I'll never be able to walk properly and without crutches again - and I can only hope this is transient and that I am wandering around soon enough.

The pain doing the physio is quite intense around the knee joint, extension exercises hurt the most.

I've been told I should be able to walk without a crutch around 12 weeks post-op (which is just under 3 weeks from now).

I'll pop back in then and update the thread again. I'm hoping that this will at least help people in the future who stumble here via google.

continuing on:

It's now just under 4 weeks since my last update: I'm walking without a crutch, but with some swelling and pain still in the knee. Flexion and extention have fully returned, but at the cost of pain at the extreme ends of both. I walk with a fairly prominent limp, which I hope will abate in time.

I'm set to see the physio after easter who should okay me to start going back to the gym with specific exercises on the legs.

Just came across your post. Do let us know, what did your physio say about continuing with the exercise?

Quote:

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Originally Posted by ReinaBoyle

Just came across your post. Do let us know, what did your physio say about continuing with the exercise?

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Well, it's now June and I'm fully walking again. I get a bit of stiffness in the morning and when I've been sat for a fairly long length of time. I'm not able to run, and slowly building up (down?) to being able to squat fully, although with no weights.

It's been a complete pain in the arse, but, 5 months after the injury i'm starting to feel a bit more normal again.

I hope that anyone who has this injury in the future who stumbles upon this 5 piece thread has a bit of hope in their heart that it won't be awful forever...!

It's over a year now; and for the benefit of people who find this page in the future with a similar injury I'll conclude my year long journey...

Currently my knee is still stiff, mildly sore generally and gives a bit of pain when tackling stairs (mainly going downstairs). However, in general my knee is working well again.

I will note that I have no nerve sensation on my knee, and when kneeling it feels like I'm kneeling on a foreign body - like a ball or something - it's weird and has made training etc on the knee a strange and difficult experience.

I'll also note that my musculature has atrophied in the whole leg. (excuse my poor terminology here) Whatever muscles used in walking, sitting, standing etc have rebuilt well however the muscules used in extention of the lower leg have still yet to fully recover, possibly because they're not used as often. In training this has become a very difficult thing to overcome.

In conclusion - 14 months after the injury I'm a fully operational human being again - It's likely to take me a further 12 months to get to 100% at the current rate I'm going.