Welcome to the Tibial Plateau Fracture Wiki
This wiki is written primarily by patients who have had Tibial Plateau Fractures (TPF), emphasizing the information we would like to have known earlier than we did. This wiki was origninated by users of the TPF thread at Teton Gravity Research's Gimp Central Forum . It is primarily written from the viewpoint of younger, active TPF patients, with an emphasis on active patient involvement in their own medical care and decision-making and a return to sports activities.
We solicit informative contributions by patients and health professionals.
How to Contribute
In short, anyone can add new pages or edit any page other than this home page. If you'd like to be involved in editing this home page or curating the overall wiki, please join the TPF Thread, as linked above, announce yourself, and send a private message to the EastMtn user, who is the founder of this wiki.
This wiki is not intended for medical advice. Patients are encouraged to consult medical professionals for medical advice.
What is a TPF?
A Tibial Plateau Fracture (TPFs) is a break in the top of the shinbone, on its top (proximal) surface, at the bottom of the knee. 80% of such breaks (Etiology ) are due to motor vehicle accidents, and most of the rest are from sports activities or long falls. TPFs can also be caused by surprisingly minor accidents, yet they require months of recovery and have the potential for permanent impairment of mobility. See Wikipedia for an extended, techincal treatment of TPFs.
These answers consist of the information that the patients who founded this blog wish we had known, in the order we wish it had been available. Follow the links for more detail about each answer.
- Diagnosis and repair: Your fracture will generally be diagnosed from X-ray and possibly CAT imagery , and most cases with more than minor plateau fractures will require surgery. Once confirmed as a TPF, you should seek the best orthopedic trauma surgical care you can obtain, since the success of the treatment will determine how your knee works for the rest of your life. If your insurance and means give you a choice, ask how frequently the surgeon treats this particular condition and check their reputation online.
- Pain relief: Pre- and post-surgical pain relief will generally involve narcotics. Due to side effects and danger of dependency, you will probably want to transition as quickly as possible to over-the-counter pain relief medications.
- Recovery: Expect to spend anywhere from 2-6 months on crutches, depending on the severity of the TPF, your body's healing rate, and the recovery approach you arrive at in consultation with your doctor. If you will be recovering in a geographical region remote from your operating surgeon (OS), choose a local doctor of similar specialty, including trauma surgical experience. You may also have the option of retaining the OS as the primary doctor for your recovery care. If in doubt about any recovery decisions, feel free to demand a second opinion and to change doctors if you find their approaches or manner to be lacking.
- Physical Therapy (PT): PT is usually a major factor in recovery. PT may begin immediately with instruction in safe use of crutches and continue during early recovery with emphasis on restoring Range of Motion (ROM) in knee and ankle, in so far as is possible with your injuries. Every week you spend without moving your knee and ankle to the limits of what your injury will safely allow will have dramatic effects in lost ROM, muscle atrophy, and possibly weeks or months of additional recovery time. In most cases, your doctor will prescribe professional PT within three weeks of your injury, even before you can bear weight. If your doctor refuses to prescribe PT, challenge that decision and if necessary get a second opinion from another doctor. If you cannot obtain or afford PT, create a home exercise program in consultation with your doctor. Many online written and video resources are available.
- Weight bearing: Doctors' recommendations and standards of care for post-TPF weight-bearing vary greatly. For typical cases you may wait from zero to 16 weeks until Partial Weight Bearing (PWB) is permitted on the injured leg. Discuss this thorougly with your OS, followup-surgeon, and PT.
- Resumption of sports. Many sports activities involve impacts with over ten times body weight. This should also be coordinated with your followup-care doctor and PT.
We need to add Information on a number of related topics.
- Return to work
- Second opinions and firing a doctor or PT
- PT exercises
- Medical imaging
- Muscle atrophy
- Other associated trauma