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I went out for a hike almost three weeks ago. (I hike a lot.) It wasn't a particularly challenging trail, but in one of the those random incidents, my boot heel went into a small hole, my knee snapped back, then I shifted to the side and hit the ground. I could tell it wasn't a normal fall. I've fallen and sprained things before, or fallen and bruised parts before, but this was a different sensation. I'm 65 but had never broken a bone before so it was a new feeling for me. It wasn't at first particularly painful, but I couldn't get up and once helped up by my husband, I couldn't bear weight on it. With him on one side and a large sturdy stick on the other I hobbled that last 1/2 mile to the trail head. I'm glad we were on our way back and not too far left to go at the time it happened.
I was diagnosed with a "mildly displaced, mildly impacted tibial plateau fracture". No damage to the fibula or ligaments or tendons. The cartilage surface of the joint looks smooth and undisturbed. Minimal soft tissue damage, nearly all resolved at this point. The ortho doc decided on a non-surgical approach because the slight nature of the the displacement combined with multiple hairline fractures from the compression that run in directions that wouldn't be helped by surgical pins and plates.
I realize this could have been a lot worse, but I'm in that stage now where I'm pretty immobile. My leg is in a brace, no weight bearing, I can hobble around the house on my good leg with the help of a walker, but getting out is challenging (lots of outside steps). Yeah, I'm going crazy and I know there's nothing to do right now except support the healing nutritionally and BE PATIENT. Geesh, it's much harder for me than I thought it would be. I have a long way to go before I get two feet on the ground again. And a long time after that to get strength and a normal gait back. :::grrrr:::
I see a fair amount of these injuries in my job as a PT. In fact, I am treating one such case right now. The best thing you can do is follow the ortho doc's recommendations. At the same time, exercise your uninjured leg because it will have to do more than its share, when you are finally allowed to put weight on the fractured leg. Usually the weight-bearing will come in increments, e.g., 25% then 50% then 75% and finally "WBAT" (weight-bearing as tolerated).
Are you seeing a PT? He/she can show you exercises to keep in shape yet that do not interfere with your injury, and techniques to go up/down steps safely.
Thanks for your insights, 2nccoast. The doc hasn't referred me to a PT yet. I'm assuming he will once we get to any kind of weight bearing status. He's given me a few simple exercises to do, first just to get my injured leg to fully extend, and also a couple simple moves just related to getting flexibility back in the ankle of the injured leg so its ROM is not severely limited when we do get to weight bearing. He's given me a little knee flexion in the leg brace now (just to 50 degrees) so sitting upright is more comfortable, but wants it fully extended and locked when I'm hobbling around with the walker.
I wish I did have a PT to help me with techniques for managing steps and stairs better. That's where I feel most uncertain and a little anxious that I could fall and injure myself again. I get a lot of help and support from my very tall and strong husband, but I would never attempt a step by myself right now.
I do feel like the uninjured leg is getting much stronger since it's doing all the work now, plus some increases in upper body strength from using crutches and a walker. Since my injured leg can't be on the ground at all, every step is really a kind of an upper-body assisted hop on the good leg.
I have a question, when you talk about increasing percentages of weight bearing, how does a patient typically measure that? How do you know what 25% of weight bearing actually is? Or is it more of a mental approximation of what you think it might be?
WB percentages: it's more of a mental approximation than anything else.
Toe-touch: imagine you are resting your foot on an egg; you should not crack the egg.
25%: ok to put the injured foot down to stabilize yourself when standing or walking.
50%: ok to put "some" weight on it.
75%: ok to put more weight on it. As you can see, it's very subjective.
Going up/down stairs: if your stairs have handrails, face sideways as this will allow you to have both hands on the rail. Go one step at a time. When you go down, the injured limb goes first; when you go up, the healthy limb goes first. That way, your body weight is always mostly on the healthy limb.
Thanks! I was wondering because if there was some mathematical formula, one would have to assume 50% WB, for example, would be standing on two feet with each foot bearing equal weight (since it would be your body weight divided equally between your two feet), but I was pretty sure 50% WB couldn't possibly mean that in this context!
I had a tibial plateau fracture many years ago I got in a skiing fall. The ortho doc said he could go in there and put some screws in it but he would probably just muck it up worse and it was best to let it heal on it's own. I was in a soft cast for a few weeks and then used a single crutch for a few more weeks. Less than 2 years later I went on a backpack mountain goat hunt, which is some of the toughest hunting there is (climbing & brutally rough terrain) and I did fine.
It's now 22 or 23 years later and I'm starting to go a little arthritic in that knee, which the ortho doc said I would, but for the most part I do fine.
Sounds like you had a really efficient recovery, westslopeguy! And 20+ years later and you are only starting to feel a little arthritis is pretty amazing.
Sounds like you had a really efficient recovery, westslopeguy! And 20+ years later and you are only starting to feel a little arthritis is pretty amazing.
Well, I was still fairly young when it happened; just turned 60, it bothers me sometimes, worst when I'm kneeling down and then have to get up. After I'm up and moving though it doesn't bother me hardly at all.
I realize this could have been a lot worse, but I'm in that stage now where I'm pretty immobile. My leg is in a brace, no weight bearing, I can hobble around the house on my good leg with the help of a walker, but getting out is challenging (lots of outside steps). Yeah, I'm going crazy and I know there's nothing to do right now except support the healing nutritionally and BE PATIENT. Geesh, it's much harder for me than I thought it would be. I have a long way to go before I get two feet on the ground again. And a long time after that to get strength and a normal gait back. :::grrrr:::
Anyone else dealt with this?
I joined this forum because I saw this post!
I have a tib/fib plateau fractures with surgical repair. I'm told it could be months before I can walk again, though I'm hopeful my recovery will continue to go ok. I'm almost 2 months out and will be returning to work soon- teaching from a wheelchair. Being patient is so hard to do when there is so much to be done! I was in the hospital for 2 weeks, and I've only left my home 3 or 4 times since being home because the stairs are such an ordeal for me. I recently got a cane to help get down the steps, also using the rails but a ramp would be a godsend.
Good luck, I hope we both can continue to heal and heal completely!
My tibia plateau fracture happened on January 2nd skiing. Surgery took place on January 13th. I had 8mm of depression and multiple fractures. Luckily, not displaced. I have seven screws and a plate. I was told I would be non-weight bearing for 12 weeks. After my non-weight bearing I would begin PT and could expect to be back to something like normal 12 weeks after that. So, I was looking at 6 months to a return to something like normal.
Surgery on the 13th went well. It was Covid, so I was sent home about an hour after waking up. I was given pain meds, but importantly I was given a nerve blocker. The nerve blocker basically stopped any pain. It also left me unable to feel or move my foot. The nerve blocker lasted about 24 hours. When it wore off, the pain began. I had wanted to avoid the pain meds, but that was not an option. The lesson I learned in the immediate aftermath of the surgery as it relates to pain is stay ahead of it. If you wait for the pain to become unbearable, you're in for a tough ride. Once I got a routine, the pain was well managed. Definitely don't forget stool softener. Definitely.
I was able to get of the pain meds after a couple of days. But, nights were the toughest. Try to find a set up that doesn't allow you much movement. You don't want to be able to turn on your side in the night. Pillows are your friends. Initially, I slept on a chase lounge that I put pillows up and down the side of. Really kept me sleeping on my back and unable to move too much. You want to be in a sleeping position that allows only minimal movement. Keep your leg elevated pretty much all the time. Try to spend a good amount of time flexing your foot back and forth.
The first two weeks after surgery are the toughest. Bathroom trips are no fun. Get yourself something you can use bedside for the nights. Learn to use crutches properly, and be very careful to make zero mistakes. Try to get up only when necessary. Exercise your bad leg with leg lifts, obviously you won't do any knee bending yet. Try to keep the rest of your body in some kind of shape doing little exercises throughout the day. Hopefully, you have someone in your life who will be your caretaker during this time as you will need help with pretty much everything. Sponge baths are about it during the first two weeks as getting into a shower is treacherous. Additionally, your wound is wrapped up so you wont want to get it wet. You can get a trash bag and wrap it up, but the entire shower endeavor should be carefully considered and planned based on the facility that you have at your disposal. If possible a chair in the shower is what I used and I think pretty much the only feasible solution. Be very careful getting in and out of the shower. Highly dangerous. Slippery floor, crutches, its a bad combo.
After two weeks my staples were removed and a different type of bandage was applied. I was also give a new brace to replace the immobilizer. The new brace allowed a range of motion. After a week, of wearing the new brace I began working on bending my knee. I didn't start sooner as I was a little concerned about making sure the wound wouldn't be affected. Probably just paranoia on my part. So, at three weeks post surgery I began testing out bending my leg, definitely with the brace on. Initially, I couldn't get very far. I was able to get about 50 degrees maybe. It was tight and felt dense. It was a strange feeling. I worked on it everyday, pushing it until it was uncomfortable but not painful. Slowly but surely I gained about five degrees a day. It would take a little time each new day to loosen up, but I would find I could go just a little bit further. I found massaging and rubbing the underside of the outside of my knee helped loosen it up. After about two weeks, my range of motion was at the limit set by my brace about 130 degrees. I was always stiff in the morning, but i just kept working it throughout the days. I wore my brace almost all the time.
After six weeks, I had a pretty full range of motion. I felt pretty good. I was able to sleep on my side and generally had no real pain just occasionally achiness and some stiffness. I went to my surgeon for a check up and my X-rays looked good. He told ne that I was essentially healed, but we should give it a little more time. He expected that when I visited again in four weeks he would clear me for weight bearing. That would be the 10 week mark! I was ecstatic. Over the next four weeks I had some moments wear I didn't feel like I was making progress. My leg at time felt stiff and kind did this popping thing when i was bending it in certain positions. The popping wasn't painful just weird. I found if I held my knee, it wouldn't pop quite so much and determined the supporting structures were just a little weak. All the same, I had some moments where I felt I was a long way off still.
Couple of important notes. At two weeks, I lost my balance briefly and put my bad leg down for a split second. I was very concerned, but no issue. At six weeks, just after the doctor visit, I accidently put my foot down and placed my weight on it. This time, unlike the first time, I felt an electrical sensation shoot up my leg. It wasn't a pain in the knee, it was more like being electrocuted. Again, I was concerned, but no damage. I was very careful, but it only takes a moment to make one of these errors, so do your best to guard against them. Every time you get on your crutches you need to be focused.
Today, I went back to see my surgeon. My X-rays look good and he cleared me for weight bearing as tolerated two day shy of ten weeks! When I got home, I tried putting my weight on my repaired leg with the aide of my crutches. I discovered the sensitivity is in my foot. My knee feels weak, but good. I am happy to report I took my first unassisted steps today, 10 weeks after my injury. I can tell I will be walking fully very soon. The main discomfort was in my foot and up my foot to my ankle, but it will resolve.
I am nowhere near 100%, but I am walking. I am back on my feet and relatively pain free in under three months. My doctor has set me up for PT, but feels I am not going to need much. He says I just need to use it, listen to my body and I will be just fine. He continues to tell me it will be 12-14 months before I am 100% but he said at that point I will probably feel like it never happened.
I know this post is forever long, but this board and others who shared their experience were very important and helpful to me. I hope that this info helps someone. The sitting around unable to move can be pretty tough, but hang in there. It has a happy ending.
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