Surgery This Week - Displaced Tibial Plateau Fracture

[Wizard29]

Thread title is what I have after a mountain bike crash last Tuesday. Basically broke my leg right at the knee joint. Going to have surgery on Thursday (9 damn days later) to get everything put back together. Plates, screws, and pins is apparently what it's going to take.

I've been injured pretty good before, but this is far and beyond the worst pain I've ever had in my life. Almost to the point of passing out if I move the wrong way. Doesn't help that I've had to wait so long for the surgery and things are free to move around in there in the meantime - muscles still attached and pulling on broken bones.

This surgery will apparently take all day and it will be the first time I've been put under for anything, so that will be a new experience. I'm nervous but at the same time can't wait for it. Getting everything put back together has got to make this feel so much better.

With all of the motorcycle, biking, and other althete-types we have here, there have got to be at least a few of you that have had this. What was your experience as far as how the surgery was and the recovery? I understand this is a fairly common sports injury.

Pretty sure I'll be riding the bikes much slower in the future after going through this bullshit.

 

[King295]

While not the injury you've got I've blown my ankle to pieces with nothing but skin/muscle/tendons holding it together and a spiral fracture on my tib/fib. The tib/fib was a piece of cake with a rod down the tibia with some screws to hold it in place. My ankle was a whole different story which was an eight hour surgery to piece it all back together with plates and screws the best they could.

The blood rush down to your lower extremities after a surgery sucks, plain and simple, but eases over time. I wasn't putting weight on my ankle for six + months which really made things suck. All I can say from both incidents is that rehab needs to be your number one priority as it dictates the long-term results of the surgery and your ability to live comfortably thereafter. I was in my 20's for both and didn't do enough rehab for either and have to stay on top of frequent exercise to maintain a normal way of life. I literally just stood up wrong and my ankle is killing me all from playing a round of golf yesterday.

No matter the surgery, rehab is critical. Do more than they tell you to, just listen to your body, it will tell you when too much is too much.

 

[Dunerking]

Good luck with the surgery! That pain you explained sounded just like when I compound shattered my Tibia and Fibia at Glamis….pass out type pain. Said I take both collarbones broken at the same time instead of that pain. Speaking of I need to get the rod removed because my leg kills me every once in awhile.

 

[DarkHorseRacing]

Get a sharpie and write on the non surgery leg down by the knee “NO” and write on your surgery leg “YES”. Or something similar. Don’t want the doc flipping a coin about which leg to work on once he walks in and you’re already under the happy gas and no one else in the room knows which leg either.

 

[Bobby V]

Get a sharpie and write on the non surgery leg down by the knee “NO” and write on your surgery leg “YES”. Or something similar. Don’t want the doc flipping a coin about which leg to work on once he walks in and you’re already under the happy gas and no one else in the room knows which leg either.

Ha Ha. I just had eye surgery. I must of told at least 5 different nurses and doctors which eye they were doing the surgery on. Same as my knee surgery a couple years ago.

 

[rrrr]

With all of the motorcycle, biking, and other althete-types we have here, there have got to be at least a few of you that have had this. What was your experience as far as how the surgery was and the recovery? I understand this is a fairly common sports injury.

Pretty sure I'll be riding the bikes much slower in the future after going through this bullshit.

It's gonna hurt worse when you come out of anesthesia. There's no sugar coating it. It'll get better in 24 hours.

I hope your recovery goes well.

 

[havasujeeper]

Ouch. Good luck!

 

[Wizard29]

It's gonna hurt worse when you come out of anesthesia. There's no sugar coating it. It'll get better in 24 hours.

I hope your recovery goes well.

Ahhh, don't tell me that. Hopefully it's just a different kind of pain I can handle. The "bone pieces grinding together and things bending the way they aren't supposed to" pain I have now is pretty unbearable.

 

[badgas]

Get well soon brother

I don't know how old you are but I'm 55. At age 26 I tore more ACL playing flag football and had ACL reconstruction. I have had so many broken bones and injuries that I can't count them all. I would always get upset about the injury but in time would not even remember it.

I meet people in their mid 70s with new hips and new knees and they are more active than I am at 55. You will be all good, just keep your chin up and TAKE YOUR THERAPY SERIOUSLY ! Rehab is a huge factor.

I have a friend who is 60 that has a new knee and a new shoulder and rides more miles ( MTB, Road, Gravel ) than anyone I know.

 

[CarolynandBob]

Hope you feel better. Way did it take 9 days to get surgery?

 

[X Hoser]

I know before my knee replacement there was bone on bone contact. Had actually worn down the bones 3/4”. The pain was bad and I was living on Tylenol! After the surgery the swelling made the knee feel tight but the agonizing pain was gone!. Re-Hab was painful, once again because of the swelling and tightness.

Praying you have the same results with your leg as I had with my knee.

 

[coolchange]

If it’s that bad why don’t they just do a TKR?
Qualified medical professional here.

 

[Wizard29]

Hope you feel better. Way did it take 9 days to get surgery?

Availability of time slots and surgeons is what I'm told. One of the techs commented that it's summer now and people are back out getting injured. Makes sense. They were going to try and put me on stand by today for a spot but after looking at the CT scan they decided they would need to book a full day, which is more than a stand by spot can provide.

I can't imagine letting something like this go for 9 days before working on it is a good thing (definitely not from the mental health perspective) but really no other good options exist.

 

[Wizard29]

If it’s that bad why don’t they just do a TKR?
Qualified medical professional here.

I guess I'm still young enough (mid-40s) and my legs are well built enough to be able to heal and work with what's there. They said if I was older, a TKR may be a better option but apparently it's not right now?

 

[Looking Glass]

Ahhh, don't tell me that. Hopefully it's just a different kind of pain I can handle. The "bone pieces grinding together and things bending the way they aren't supposed to" pain I have now is pretty unbearable.

DON'T Believe all this "BULLSHIT" After three surgeries, I never experienced that pain. I guess Modern Doctors and Hospitals make a difference.

 

[coolchange]

I guess I'm still young enough (mid-40s) and my legs are well built enough to be able to heal and work with what's there. They said if I was older, a TKR may be a better option but apparently it's not right now?

I guess I'm still young enough (mid-40s) and my legs are well built enough to be able to heal and work with what's there. They said if I was older, a TKR may be a better option but apparently it's not right now?

TKRis good for about 20 now. So makes sense.

 

[Wizard29]

TKRis good for about 20 now. So makes sense.

What area of medicine are you in? I could definitely use a different perspective as this goes forward. Not that I don't trust my doctors, but it's good to hear a third party's take.

Like putting weight on this thing. The PA told me it might be 12 weeks before I can put full weight on it but I've heard from other areas that sometimes full weight is recommended immediately? I really don't want to wait 12 weeks before I start to build this thing back up.

 

[coolchange]

What area of medicine are you in? I could definitely use a different perspective as this goes forward. Not that I don't trust my doctors, but it's good to hear a third party's take.

Like putting weight on this thing. The PA told me it might be 12 weeks before I can put full weight on it but I've heard from other areas that sometimes full weight is recommended immediately? I really don't want to wait 12 weeks before I start to build this thing back up.

Sorry I didn’t use my sarcasm quotes here . lol. But I have had 2 tkr plus multiple other family orthopedic events. When my doctor see’s me driving around he waves from his GTR3 I bought him. lol

 

[X Hoser]

If it’s that bad why don’t they just do a TKR?
Qualified medical professional here.

If that is in response to my comment, they did do a Total Knee Replacement. That was back in 2008. Zero issues with it. Best thing I ever did.

EDIT: After rereading I think now you were talking to Wizard29.

 

[ArizonaKevin]

Tibial Plateau fractures are gnarly. Definitely reiterating what others are saying on here that the rehab is going to be the most important part. Was there any damage done to the knee joint as part of the trauma?

Pain may or may not be worse when you wake up, in my 7 different surgeries (2) of them have been worse when waking up, (3) of them have been effectively no change in pain, and (2) of them they had a nerve block on the limb so I was numb for another ~24 hours which I think really helped. Not sure if they are going to do a nerve block for you.

Can we somewhat normal to have to wait ~1 week after major trauma like that before operating, in my experience mainly due to swelling. When I mangled up my foot, I had to wait 8 days for surgery because they were concerned they wouldn't be able to stitch me back up correctly because my foot was the size of a football.

Since this is your first time "going under," it can be normal to be nauseous when you wake up, especially when you go vertical for the first time after you wake up. For the first few surgeries I went through, it was a ritual to throw up before leaving the hospital.

 

[McKay]

That's a horrible break! Did that back in 2013. 9 days sucks to wait! Mine took 3 but was originally over a week before I started calling in favors.

One thing to note, this often causes damage to the knee as well and have been told many will need a replacement in the future, I've had two small repairs made to that knee but will need a replacement eventually. The shitty part they is they say the plate and screws will need to be removed first in a separate operation .

Best of luck! Long recovery.

 

[dribble]

I had a similar injury 21 years ago, after a high speed wheelie went wrong. Broke the tibial plateau in 3 sections and shattered the tibia about an inch below that. Had compartment syndrome causing the loss of blood circulation below my knee.

Six hour surgery putting the leg back together. The surgeon ground up pieces of the bone and mixed them with my blood to fill in the holes. Fasciotmy to relieve the pressure and get circulation back. A week in the hospital. Three subsequent surgeries including skin grafting to close up the fasciotomy. Was told I’d never walk right again and would need a total knee replacement in ten years. It was a long recovery. I never took pain meds. 21 years later no knee replacement, I walk with a slight limp and can do everything but run.

The key for me was to work it. I started on a stationary bike. Then a regular bike. Hiked. Waterskied at six months. Hit the MX track at 14 months. Worked out in the gym. Dealt with the pain for about two years but it went away and rarely comes back.

The doctors will tell you that your going to need a knee replacement down the road. If you stay active, keep your weight down and your muscles strong you can avoid it. I’m 68 now and these pics were taken in the last four years.

 

[X Hoser]

Tibial Plateau fractures are gnarly. Definitely reiterating what others are saying on here that the rehab is going to be the most important part. Was there any damage done to the knee joint as part of the trauma?

Pain may or may not be worse when you wake up, in my 7 different surgeries (2) of them have been worse when waking up, (3) of them have been effectively no change in pain, and (2) of them they had a nerve block on the limb so I was numb for another ~24 hours which I think really helped. Not sure if they are going to do a nerve block for you.

Can we somewhat normal to have to wait ~1 week after major trauma like that before operating, in my experience mainly due to swelling. When I mangled up my foot, I had to wait 8 days for surgery because they were concerned they wouldn't be able to stitch me back up correctly because my foot was the size of a football.

Since this is your first time "going under," it can be normal to be nauseous when you wake up, especially when you go vertical for the first time after you wake up. For the first few surgeries I went through, it was a ritual to throw up before leaving the hospital.

I had my TKR with a Spinal Block. They also did a nerve block to my knee. No recovery for the anesthesia. I really think the nerve block got me on the right road to recovery as there was very little pain in my knee for days it seemed. By the time it wore off, I only needed Tylenol after PT.

 

[HNL2LHC]

Best to you and your journey a head of you.

 

[Wizard29]

Was there any damage done to the knee joint as part of the trauma?

Not entirely sure. I don't recall anything mentioned about it and they don't seem to have any concerns about being able to fix what's wrong.

 

[FreeBird236]

Not entirely sure. I don't recall anything mentioned about it and they don't seem to have any concerns about being able to fix what's wrong.

No experience here, just wishing you well.

 

[Wizard29]

I had a similar injury 21 years ago, after a high speed wheelie went wrong. Broke the tibial plateau in 3 sections and shattered the tibia about an inch below that. Had compartment syndrome causing the loss of blood circulation below my knee.

Six hour surgery putting the leg back together. The surgeon ground up pieces of the bone and mixed them with my blood to fill in the holes. Fasciotmy to relieve the pressure and get circulation back. A week in the hospital. Three subsequent surgeries including skin grafting to close up the fasciotomy. Was told I’d never walk right again and would need a total knee replacement in ten years. It was a long recovery. I never took pain meds. 21 years later no knee replacement, I walk with a slight limp and can do everything but run.

The key for me was to work it. I started on a stationary bike. Then a regular bike. Hiked. Waterskied at six months. Hit the MX track at 14 months. Worked out in the gym. Dealt with the pain for about two years but it went away and rarely comes back.

The doctors will tell you that your going to need a knee replacement down the road. If you stay active, keep your weight down and your muscles strong you can avoid it. I’m 68 now and these pics were taken in the last four years.


View attachment 1392882 View attachment 1392883 View attachment 1392884

Nice. This is my plan. Work it and return it to service as soon as possible. There are many weeks where I mountain bike or hike 6 days in a row. I will continue the physical activity strategy until it's just no longer an option.

 

[TBulger]

Geez, best to you sir. Can’t imagine what you are going through, had both knees replaced at 75 and after 9 years still the best thing I ever did.

 

[rrrr]

DON'T Believe all this "BULLSHIT" After three surgeries, I never experienced that pain. I guess Modern Doctors and Hospitals make a difference.

It's not bullshit, tough guy. This isn't a TKR, it's a significant injury. It's going to be at least a six hour surgery, perhaps longer. In addition to my bilateral TKRs, I've also had a TKR revision, where the failed prosthesis is beat on until the glue releases and can be removed from the tibial and femoral bone socket that were drilled during the original TKR surgery. The post-op pain was double that of a normal TKR. Repairing the tibial plateau is to involve a good part of that violence, Wizard asked, and I'm just laying it out straight.

Depending on the severity of the injury, the repair of the tibial plateau is going to involve at least one plate, and multiple screws through the upper end of the tibia. That the surgeon has told Wizard the surgery will take "all day," there must be more than one fracture path in the injured area. Those bone fragmentations don't happen in a TKR. The body feels every inch of those fracture surfaces, producing additive pain. There will also be a pretty big incision, held open with retractors for several hours, the patella will be displaced, and the surrounding muscles will have to be pushed aside to do the bone work.

The post-op pain is going to be significant. Find out if the anesthesia will include a peripheral epidural block. This is an injection of anesthetic near the immediate area of the spinal cord through the membrane that protects it. It numbs the torso and legs below the block site. The immediate post-op pain will be greatly reduced. The effects last four to six hours.

Talking to the surgeon and anesthesiologist to discuss their pain management plan before the surgery is important, and there needs to be an agreement that the surgeon can be contacted in the hours following surgery in case the patient needs an increase in pain med dosage and decrease in time increments. There were unforeseen difficulties during my revision surgery. After 5½ hours in the OR, which finally ended at midnight, the surgeon wouldn't respond to messages left with his service. I was in fucking agony, pain that I didn't think possible. He should have been available. Don't let it happen to you.

Wizard, you just need to be matter of fact about it. Don't come off as weak, tell them you will do your best to get by on what's prescribed, but there needs to be an agreement that can be revisited after surgery. I'm not trying to grandstand, brag about my experience being the worst ever, or frighten you, the information is provided so you can have an upfront conversation. You have to own the situation.

 

[Looking Glass]

It's not bullshit, tough guy. This isn't a TKR, it's a significant injury. It's going to be at least a six hour surgery, perhaps longer. In addition to my bilateral TKRs, I've also had a TKR revision, where the failed prosthesis is beat on until the glue releases and can be removed from the tibial and femoral bone socket that were drilled during the original TKR surgery. The post-op pain was double that of a normal TKR. Repairing the tibial plateau is to involve a good part of that violence, Wizard asked, and I'm just laying it out straight.

Depending on the severity of the injury, the repair of the tibial plateau is going to involve at least one plate, and multiple screws through the upper end of the tibia. That the surgeon has told Wizard the surgery will take "all day," there must be more than one fracture path in the injured area. Those bone fragmentations don't happen in a TKR. The body feels every inch of those fracture surfaces, producing additive pain. There will also be a pretty big incision, held open with retractors for several hours, the patella will be displaced, and the surrounding muscles will have to be pushed aside to do the bone work.

The post-op pain is going to be significant. Find out if the anesthesia will include a peripheral epidural block. This is an injection of anesthetic near the immediate area of the spinal cord through the membrane that protects it. It numbs the torso and legs below the block site. The immediate post-op pain will be greatly reduced. The effects last four to six hours.

Talking to the surgeon and anesthesiologist to discuss their pain management plan before the surgery is important, and there needs to be an agreement that the surgeon can be contacted in the hours following surgery in case the patient needs an increase in pain med dosage and decrease in time increments. There were unforeseen difficulties during my revision surgery. After 5½ hours in the OR, which finally ended at midnight, the surgeon wouldn't respond to messages left with his service. I was in fucking agony, pain that I didn't think possible. He should have been available. Don't let it happen to you.

Wizard, you just need to be matter of fact about it. Don't come off as weak, tell them you will do your best to get by on what's prescribed, but there needs to be an agreement that can be revisited after surgery. I'm not trying to grandstand, brag about my experience being the worst ever, or frighten you, the information is provided so you can have an upfront conversation. You have to own the situation.

OH, "F F S" "Write A Book"!!

 

[Wizard29]

It's not bullshit, tough guy. This isn't a TKR, it's a significant injury. It's going to be at least a six hour surgery, perhaps longer. In addition to my bilateral TKRs, I've also had a TKR revision, where the failed prosthesis is beat on until the glue releases and can be removed from the tibial and femoral bone socket that were drilled during the original TKR surgery. The post-op pain was double that of a normal TKR. Repairing the tibial plateau is to involve a good part of that violence, Wizard asked, and I'm just laying it out straight.

Depending on the severity of the injury, the repair of the tibial plateau is going to involve at least one plate, and multiple screws through the upper end of the tibia. That the surgeon has told Wizard the surgery will take "all day," there must be more than one fracture path in the injured area. Those bone fragmentations don't happen in a TKR. The body feels every inch of those fracture surfaces, producing additive pain. There will also be a pretty big incision, held open with retractors for several hours, the patella will be displaced, and the surrounding muscles will have to be pushed aside to do the bone work.

The post-op pain is going to be significant. Find out if the anesthesia will include a peripheral epidural block. This is an injection of anesthetic near the immediate area of the spinal cord through the membrane that protects it. It numbs the torso and legs below the block site. The immediate post-op pain will be greatly reduced. The effects last four to six hours.

Talking to the surgeon and anesthesiologist to discuss their pain management plan before the surgery is important, and there needs to be an agreement that the surgeon can be contacted in the hours following surgery in case the patient needs an increase in pain med dosage and decrease in time increments. There were unforeseen difficulties during my revision surgery. After 5½ hours in the OR, which finally ended at midnight, the surgeon wouldn't respond to messages left with his service. I was in fucking agony, pain that I didn't think possible. He should have been available. Don't let it happen to you.

Wizard, you just need to be matter of fact about it. Don't come off as weak, tell them you will do your best to get by on what's prescribed, but there needs to be an agreement that can be revisited after surgery. I'm not trying to grandstand, brag about my experience being the worst ever, or frighten you, the information is provided so you can have an upfront conversation. You have to own the situation.

Oh, nothing negative taken from this. I appreciate the input and am always interested in what others experience so I might know what to expect.

It was mentioned a nerve block will be used, so that will hopefully help. As far as other pain management, I'm not sure yet. They are very aware the pain level is currently extremely high and did say that it should be much better after everything is put back together and no longer free to move. I will inquire as to what the pain plan is though. Surgery will start early in the day and go roughly 7 hours, so there should be time later in the day to make adjustments. Not sure if they will be keeping me overnight. I guess that depends on how everything goes along with how much bleeding there is and all that.

I'm looking forward to the surgery but I'm not. This has to get fixed and I'm looking forward to getting some relief while at the same time being pretty apprehensive about how it will all go.

 

[Bulldogs]

Happy to provide answers/insight - this is in my ‘wheelhouse’
Message me if you’d like

 

[Wizard29]

Update for anybody who cares...

After a 9 hour surgery, here is the shiny new hardware that is in my leg and will likely accompany me through the rest of life. One is a front view, the other is a side view.

I will not be able to put any weight on this leg for 10 weeks, 4 days, 6 hours, and 23 minutes, but who's counting. On the positive side, I'm told it is an excellent repair and I should be able to walk normally hopefully not too long after I'm able to apply weight to the leg again.

Special thanks to @Bulldogs for solid advice and guidance as I deal with this. He has been great in giving me the ability to validate what I'm being told by my medical folks and also making me aware of special things to look out for. I can't thank him enough.

If anybody is thinking of going out and breaking their leg at the knee joint, I give this experience zero stars. Go do something else.

 

[RCDave2]

Damn.....looks brutal

 

[PaPaG]

Thread title is what I have after a mountain bike crash last Tuesday. Basically broke my leg right at the knee joint. Going to have surgery on Thursday (9 damn days later) to get everything put back together. Plates, screws, and pins is apparently what it's going to take.

I've been injured pretty good before, but this is far and beyond the worst pain I've ever had in my life. Almost to the point of passing out if I move the wrong way. Doesn't help that I've had to wait so long for the surgery and things are free to move around in there in the meantime - muscles still attached and pulling on broken bones.

This surgery will apparently take all day and it will be the first time I've been put under for anything, so that will be a new experience. I'm nervous but at the same time can't wait for it. Getting everything put back together has got to make this feel so much better.

With all of the motorcycle, biking, and other althete-types we have here, there have got to be at least a few of you that have had this. What was your experience as far as how the surgery was and the recovery? I understand this is a fairly common sports injury.

Pretty sure I'll be riding the bikes much slower in the future after going through this bullshit.

Prayers for a Successful surgery and a very speedy recover.

 

[DRYHEAT]

Didn’t see this before today, only thing I would add is when you start physical therapy, question the pain. Yeah I know PT is supposed to hurt, but misunderstandings of procedures can be an issue.

1986. I shattered my left forearm and took five operations and two years to put Humpty Dumpty back together again.

That repair looks great. In my opinion, medicine has come along way in 38 years.