Bone breaks around the knee :
Tibial plateau fracture - - Posted by Daveski (Daveski), 16 August 2004
I fractured my TP on July 29th. No surgury was needed (yet). Last Dr. visit(Aug. 10th), he said looked like the bone was healing correctly. I asked the dr. if I should start flexing the joint yet (am in a straight leg brace, which I can take off). My question is "when can I start flexing the knee?", sounds important to me!
Posted by Jo_h (Jo_h), 16 August 2004
Daveski,
I broke my tp about 4 months ago. I had a full straigth leg cast for 1 week after surgery and then i was in a leg brace set at 0deg - 90deg. In my experience the sooner you can start to bend your leg and work on your ROM the better. I am pretty sure that there is a higher chance of you developing scar tissue if your leg is immobile for too long. I have not had the scar tissue experience, but from reading some of the other posts here it is not good and you want to do everything you can to prevent it.
i think you should get in touch with you Dr. again. But dont start bending until he has given the ok, there may be a genuine reason for keeping your leg straight and you dont want to do more damage.
Happy healing
Jo
Posted by sfmama (sfmama), 17 August 2004
When you asked teh dr. what did he say?
Yes, in general the sooner you can start bending the better the chances of your regaining complete ROM. what kind of TP fracture do you have?
Posted by Yooper (Dawn P.), 17 August 2004
I have to agree, the sooner you get it moving the better! My doctor had me keep my knee completely straight for almost two months then had me adjust my brace to 90 degrees, without giving me any excercies to do! If it weren't for me knowing a little bit about ROM and trying to bend it while I sat etc...I probably still wouldn't be able to move it! Then he had the nerve to be totally surprised that I couldn't bend it! He didn't even plan to send me to Physical therapy! And even with months of therapy I couldn't only get my knee to bend to 90 degrees and extend to -2! I just had my hardware removed at my 6 month mark because the screws were causing such God awful pain! I am now seeing a new OS, and he seems to think that there is more going on with my knee! But at least now I am generally pain free without the screws! My biggest advice is to call your OS and ask all the questions you need to feel comfortable with what you are doing! You came to the right place for support though here at kneegeeks! Best of luck with your recovery!
Posted by Daveski (Daveski), 17 August 2004
The Dr. did not give me a good reason why I shouldn't bend it, he said "you have injured the surrounding tissue as well as an incomplete fracture of the Tibial plateau."
He said it was too easy to rebreak the bone and then I would need surgury, BUT all he did was look at my x-ray, he never touched my knee or leg, then said "looks like its healing correctly, I'll see you in two weeks"
what do you think?
Thanks,
Daveski
Posted by wewillbefine (wewillbefine), 17 August 2004
Hi Daveski
I do think the doctor has a good reason to keep your leg straight and he has already told you!
0 degree of flexion should help to put the fractured piece back into its place. Because if it is not surgically repaired, it is relatively easier to be displaced again if you move your joint.
I beileve you can find lots of research about non-surgical way dealing with tibial plateau fracture using google. 6 to 8 weeks immobilization seems the usual form.
As for the worry of loss of ROM, I guess since you don`t have a surgery, you should not form as much scar tissue as people who had it.
If it were me, I would listen to the doctor`s instruction. If you are still worried, maybe to seek a second opinion is not a bad choice. At least it could put your mind at ease.
Good luck
Rui
Posted by sfmama (sfmama), 18 August 2004
this may not be teh answer anyone wants to hear, but . . .
1 week after surgery, when I was having my stitches removed, the OS asst. told me to get into physical therapy ASAP to work on ROM (my leg was previously in an immobilizer brace) and all the stuff I read on the web said your shoudl be working on ROM within days after surgery.
Well, there was a screwup (my OS office never got the referral to the PT office until weeks later) and as you can imagine I was quite stressed about it. The PT shrugged it off, and said -- worst case scenario, you have to have another operation where they _____ (can't remember the name of the procedure) and you get your ROM back.
I KNOW no one wnats more surgery, but I think teh point she was making is that it's not teh end of the world if you have problems with your ROM. there are treatments for it.
Posted by Daveski (Daveski), 18 August 2004
I was really looking for someone to say "I started bending my leg early and it helped". I don't think anyone is going to say that, but I am stubborn, and I know my body. What I am saying is the day after the Dr. told me to keep my leg straight I started bending it in a whirlpool. I will report on if that was the wrong thing or right thing to do. I'm not doing anything that causes pain, except slight stretching pain, not pushing it though.
Posted by HHB (MHB), 18 August 2004
Quote:He said it was too easy to rebreak the bone and then I would need surgury
Bending your knee pulls on the patellar tendon, anchored to your incompletely fractured TP, right? I know very little about TP fractures, but with no hardware to fix/strengthen the break, your doctor's advice makes sense to me -- the patella tendon stress might break it completely -- early on, any healing bone is "soft."
For example, about 10 years back, had simple but complete fibula fracture. Fibula bears no weight, so had walking cast for only 5 weeks. Break filled in fine, cast removed, but ortho emphasized the need to walk carefully on flat surface for at least two more weeks -- said to avoid accidentally turning foot over on the ankle because the soft new bone would then re-break. His advice worked fine.
I also agree with what wewillbefine said:
Quote:As for the worry of loss of ROM, I guess since you don`t have a surgery, you should not form as much scar tissue as people who had it.
Best of luck in recovery and avoiding complications.
MHB
Posted by caroline_f_98 (caroline_f_98), 20 August 2004
It all depends on your own fracture and state of health (asusual). I has a v serious type 6 TP and was allowed to start to bend 6 weeks post surgery. I gained full ROM very quickly before even starting physio.
Posted by Daveski (Daveski), 21 August 2004
Thanks all for the replies, I am off to Lake Powell, I will be a good boy and not bring my boat...............just sit on a houseboat.
Posted by CarylB (CarylB), 24 August 2004
I just went through a nonsurgical TP Fx, probably one of the most mild ever. No soft tissue damage. I started flexing just as soon as the swelling went down.
I was allowed to put weight on after 3 weeks.
I'm now 6 weeks out. The fracture is healed. I have full motion and am out of the brace. I have no restrictions on what I can do, just start slowly and work back up. No PT required.
Sound similar to your situation?
CarylB
Posted by Daveski (Daveski), 1 September 2004
Dear CarylB,
Thanks for the reply, my break was a little worse. I am coming up to 5 weeks scince the accident. Still not putting any weight on it, and when it is dragged (ie:walking on crutches) for a long time my knee and foot swells up pretty good.
Patiently waiting,
Daveski
Posted by kgrosskurth (Kathy G), 2 September 2004
I haveta say I agree with the majority who say that since you didn't have surgery that you should err on the side of caution and follow Dr's orders. Of course, I had surgery and the day after surgery my Dr. was saying to work on bending IMMEDIATELY!! I thought he was crazy, but I am glad I followed his advice. And like others have said, you will regain your ROM in due time.
Hope that helps - and I wish you all the best in your recovery! 
Posted by Daveski (Daveski), 3 September 2004
I went to the Dr. on Wed. sept. 1st he said it is now ok to start bending my leg. It has been almost 5 weeks scince the accident. The Dr. took off the brace and asked to see how far I could bend it. He was suprised to see me bend 90 degees. I was laughing inside. The physical therapist was concerned with the swelling and gave me some simple exercises. Now that I am bending it all the time the swelling went way down. Now I am thinking I sould have worked it harder.
Posted by ghardey (ghardey), 5 September 2004
Good morning - you lucky dog, no surgery for a TP fx. I too fx my left TP, patella, and my femur with a blown ACL and mensicus(s) to boot - 4 screws and plate in the tib and 1 screw in the patella. I was in the immobilzer brace as you as well for 2 months with the brace set at 0-45 for 3 weeks and then to 90 for 5 weeks. BEND your knee SLOWLY as much as you can - work it - work the extension as well, as I sit here this morning writing to you my good man, about ready to go to the gym, I walk with no crutches or cane, although with a limp due to I cannot straighten my leg - my extension is only 8, flex with alot of stretching and my new best friend Bextra 20mg is 115 - I had to have a 2nd surgery on July 26th to fix the lateral meniscus and have a ROM manipulation under anesthesia due to I could not bend my knee past 60 degrees without having to yell Uncle at the therapists a million times!!! I found sitting on the edge of the couch and practicing sitting and standing really helped as well as lay on your back with your feet against a wall and move your leg up and down the wall was extremely helpful and as soon as you can get on the stationary bike, get on it, take the discomfort and get the leg bending and straightening. Take care, good luck, and keep us posted on your progress.
Gary in Denver
Posted by Cheryl_Phillipson (Cheryl_Phillipson), 14 September 2004
I broke my knee 
(Tibial plateau fracture)Aug 04/04 playing baseball go figure. Had surgery on it Aug 05/04. They were very surpised I did it playing baseball. They said the damage I did was nothing they have ever seen ( from a baseball injury at least) it broke in three places ( a v shape break in the front and one at the back) They are still concerned with it. I'm not allowed any weight on it what so ever. I seem to be healing okay, most of the swelling has gone down and scaring will be okay and a good reminder that I have to start acting my age..........lol. I still have brusing and pain. I go to see the surgeon today and hope I can start putting a little weight on it and start physo soon. It's been almost six weeks and I'm getting really bored and a little stir crazy..... 
I'm also reading that ROM is something I should worry about.............I do try to move my leg (bend it as much as I can, but still nervous I will make it worse.) Doc is worried I may lose clearance between the bones and have to go back in a fix it................please I don't what that to happen.........
Updated Mon Oct 13 2008