# Tibial Plateau Fracture



## Pilot (Mar 1, 2004)

Two weeks ago now, I fractured the tibial plateau of my left leg... http://forums.mtbr.com/showthread.php?t=267848

It's a pretty bad break, the ortho said it is a Schatzker type 5, which means that both condyles have broken off the tibia. The fracture lines look like an inverted Y. There is a few millimeters of displacement, but so far I have not needed surgery. The ortho feels that the plateau is still pretty much where it needs to be, and so with immobilization it should heal fine without surgery.

I searched the archives, and I see that there are a few people here who have dealt with this kind of injury recently. I would love to hear how your rehab has been going if you have had this type of fracture. I am only two weeks in, and of course not doing anything is driving me crazy. I can't wait until I can at least climb onto my bike in the trainer!

I am especially interested in hearing from anyone who has had a bad TP fracture, but did not have surgery. How has your recovery worked out? I am a little worried about this approach, as surgery is the normal treatment for this kind of break. I have gotten multiple opinions from different orthos, but they all seem to equivocate a bit. I keep hearing 'yes, there are two valid approaches to this injury, surgical or non-surgical. They are both acceptable.' But, my primary ortho feels I will be better off in the long run without surgical intervention (dual buttress plates and screws). Since this is my leg, and all my hobbies depend so much on my legs, I am neurotic about this! I am not sure whether to believe my primary ortho who thinks my knee will be less stiff and more functional without surgery, or go with another ortho who leans more towards the surgical option.

Anyway, anyone have any rehab stories they want to share?


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## Bawitdaba (Sep 9, 2005)

See avatar, there wasn't much choice on mine. But I have a few more procedures to go because mine was a high altitude landing which did enormous damage to the soft stuff...Rehab to walk again was nothing to bad, but then I'm not really 100% either. I'll never run again or anything with significant impact or twisting....


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## ssinglesspeed (Apr 17, 2006)

*bichondryl tibial plateau fracture recovery*

I had the same exact fracture as you, I described it as bi-lateral because bichondryl escaped me. We're in a pretty exclusive club, as I didn't require surgery either. I broke my knee on 3 Nov 2006, and was released for work on 23 Jan 2007. The non-weight bearing time, about 2 months, was a real trial. This is something you want to pay strict attention to, as the "wings" have to have time to regrow spongy bone without weight bearing causing more displacement ( I too had a small amount of displacement on one side). 
Anyway, My recovery has gone well, I was doing a little easy road riding at about 1 1/2 months, just spinning. If you have a trainer, it will help. Living in the country, I just went on the road. There was a lot of soreness in my calve and ankle (sprained), in fact, I'd say they hurt more than my knee. Pretty severe bruising of ankle, calve, knee, and underside of thigh above the knee. Spinning has never bothered the knee, but SS mashing is a different story. I could tell that the knee was probably around 40-50% on strength, and dont push it. That being said, I put together a mid-level full suspension geared bike to ride for a while.You may have to change your riding style to allow you to spend more time on the saddle, spinning. I, my son, and riding partner are all single speeders, and they were pretty disgusted with me when I showed up on my new bike. 
Back at work, I still limp some, but it's getting better. This will probably never go away completely. For the first month of recovery I was in a brace that locked my knee out straight. Almost, that is. I dont have quite the same amount of extension as the uninjured knee. Talk to your doctor about that, it's something to avoid if possible. Also, in bringing the leg back under the thigh, as in a crouch, I'm not comfortable doing that with weight yet.
I do industrial maintenance for a living, and do a lot of walking over a large plant, somtimes with welders, tools, etc., and am ready to leave when quitting time rolls around. This is something to expect, the doctor will release you, but it will take some time to come back up to speed, physically. While I have very little pain, there is always an ache in the background to remind me. A quote from my doctor " This is one you'll remember." He was right.
Okay, on to current conditions. I've gotten out on my single speed some lately, and it feels pretty good. I have modified my riding style, in that I dont climb as hard, pay a lot of attention to what my knee is telling me when out of the saddle, and dodge some of the technical areas I used to ride thru. My riding partners say that I'm finally learning to 
Hike-A-Bike. I guess that by conventional wisdom, I may be going at this a litte too fast, but my knee tells me it's ok so far. Well, a lot of rambling, but hopefully some answers to your questions. SS.:thumbsup:


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## Pilot (Mar 1, 2004)

Thanks for the responses, guys. ssinglesspeed, I am glad to hear about your recovery timeline, it gives me something to shoot for. Plus, we have a remarkably similiar injury.

Went to the doc again yesterday, the bone has stayed 'perched' in place, so it looks like I am going to go with the non-surgical option. Or at least, no plates and screws. The ortho says I will probably need arthroscopy at some point to remove scar tissue and clean up any meniscal or ligament damage.

Anyway, at this point I am a little over two weeks out, and I am not in nearly as much pain. But man, am I sick of sitting around doing nothing day after day! I can't wait until I can get on the road bike in the trainer, or out on the road! Hey, ssinglesspeed, you say it took you six weeks from injury, until your first ride, right? So you got to ride before you were weight bearing? How did you know you were ready? I figure when the doc starts letting me bend my leg, as soon as I have enough range of motion, I should be able to get back on the bike... I hope!


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## ssinglesspeed (Apr 17, 2006)

At about 3-4 weeks, my doc had shifted me over to an articulating brace, and after a while sitting around with that, I was so frustrated with inactivity that I just did it. The Doc had said it was OK to bend the knee, and it was feeling pretty good moving. To me, the next step was spinning. Mind, all I was doing was spinning on smooth pavement, virtually no effort. I think I had an appointment the next week where the Doc gave me the official OK to get on a bike. He said I could spin before he allowed any weight bearing. It was kind of funny when I decided to get out on the road, both my son and my daughter decided they should escort me in case I had trouble. 
Now that I'm back out on the trails, it's all good, the knee's holding up well. I'm gradually increasing my effort level. I've been back on the SS's about two weeks, although my son has pretty much stuck with his geared bike. I guess he's enjoying beating me on some of the climbs. Although released by the doctor, I may go back for one more X-Ray to make sure it's still fine, and then hang it up in my shop as a momento. Good Luck with your recovery, SS.


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## sriracha (Jun 23, 2004)

waaay back in october, 2006, i broke my tibia plateau AND snapped my ACL. i was non-weight bearing for 3 months. after 6 weeks, i started physical therapy, bending and all that. i still don't have an ACL; we're waiting for the tibia to recover. i've got tons of swelling, my knee stiffens up if i walk more than a block. i can straighten the leg, but my bending range is only at 110 degrees, and doesn't seem to be improving. i pedalled my bike, lightly for 40 minutes last weekend, and my knee was stiff and sore for a solid week after. my knee is fvcked up. i've gone thru a lot of pain and will continue to endure more. this injury is very non-standard. different people have different results. i'm probably looking at a full year off the bike.
good luck with yours.


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## jomissa (Apr 18, 2004)

im reading this thread and feel lucky. i fractured my Tibia plateau but only slight fracture on right side of tibia (outer edge) of my right leg.

3.5 weeks in im sore and not walking but far from immobilized anymore. no surgery.

i hate the sitting around. will be 8 weeks the doc says till i can be back to riding.


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## cacatous (Dec 1, 2013)

I joined the club last week and I have an appointment at the hospital for next Monday. 2mm depression posterialeral tibular plateau fracture.


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