The SPECIALIST'S OFFICE > Bone breaks around the knee

Tibial Plateau Fracture - surgery or not?!?


I have a lateral tibial plateau fracture that I got while getting to my seat at a recent concert (and, no - no adult beverages were involved!).  The MRI report showed a 1.5 mm depression.  The doctor scheduled surgery for me at the same time that he ordered a CT scan.  He had told me that anything over 2mm would be recommended surgery.  I am a teacher to 180 fourteen year-olds, so I was terrified when he told me about surgery - especially since I have NO pain!  That follow up day after my CT scan, he came in and told me that the CT scan showed a 2mm depression and that he wants to do surgery.  After weighing the pros and cons, I opted NOT to do surgery.  He said my risk is arthritis on down the road, of which runs in my family anyway.  He told me 6 weeks of NWB.  This is, of course, really fun when trying to teach but I was okay with it.  Today I went for my first 2 2 week follow up exam with new xrays.  He said that nothing had changed (which I now know is a good thing) and that I need 2 MORE MONTHS of crutches!  I need to get someone else's experience/perspective on this.  Please advise on your thoughts/experiences if you can.  I appreciate it -

Weightless in Cincinnati -


Hi Jane - sorry you had to join our group.  I see the kneeguru moved you to the bones breaks around the knee section.  That's where most of us with TPFs hang out. 
 can't help you on the non-surgery angle.  As you can see I have a small home depot in my leg.  It's fairly normal even with hardware installed to be non-weight bearing for 8 to 12 weeks or even longer. 
This injury sees a wide variety of pain levels too.  I had no very little pain post surgery and was off pain meds within a week and then no pain until I started walking.  Some are on pain meds of one form or another for the duration of recovery.
What you need to remember is to follow your OS and PT instructions with regard weight bearing and exercise.  The decisions you make now will have long term effects on your recovery and activity capabilities in the future.
Sending healing rays your way

one of the things that was so weird/frustrating about this injury (tpfx, surgery -- two screws, NWB for 3 months) was how painless it was. I didn't have surgery until about two weeks after I broke it, but by that point, it wasn't hurting anymore. & by two weeks after the surgery, it felt fine again! the only reminder I had that something was broken/healing was the NWB order -- which I didn't like, but also didn't test the limits of. & then as soon as the 3 months were up, I had no pain when starting to PWB/FWB! hopefully your transition to PWB/FWB will be similar.

especially without the extra support of screws/plates, it's really important to let that bone heal as fully as possible because it is one of the most weight-bearing parts of the body -- 3 months is closer to the more cautious end of the spectrum, but I'd argue that it's worth the extra couple of weeks of waiting.

good luck!

Thank you for the replies!  I am settling in to my NWB status and, well, it is what it is - right?  So, I am being VERY good because I know the long term is determined by what I do now.  I am going for a second opinion, but expect to hear the same thing.

Thanks again for the replies and ¡cuídate! (I am a Spanish teacher :)


hola janepaige! :)

In regards to the non weight bearing, be sure to listen to your dr & pt.  I'm guessing you've started pt by now.  Exercise, stretch & flex.  If dr/pt will let you, work out in the pool.   

Can't imagine dealing with 180 14 year olds, hopefully that's broken up into at least 5 groups.

The nwb passed pretty quickly for me.  Hope it does for you too.


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