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Sports Medicine

Optimizing recovery: tibial plateau fracture

08/08/2008

Question:

Hi,

I`m currently recovering from a non-displaced tibial plateau fracture. It`s been approx 6 weeks since the accident. It occurred from falling hard on my right foot, with the impact mostly in the knee. The orthopedist doesn`t talk or say much. She says don`t put weight on your knee. She also prescribed an orthotic, which has adjustable range of motion. That`s it. Last week, I had another appointment and they adjusted the range from 30 to 90°. I unfortunately had to catch myself and prevent a fall, a week before, and I landed a bit hard on my right foot - it didn`t hurt but I could feel my knee didn`t exactly feel strong. It swelled a bit more than usual but I didn`t feel any pain or evident injury.

The x-ray showed the plateau had been pressed down a bit, slightly, or something like that. I`m not quite sure how to describe it properly. The ortho thought I had walked on my leg but I told her no (I hadn`t walked on it), it was most likely the fall, etc.

What I want to know is this: All she ever told me was to avoid putting weight on my leg, and she never stressed that I had to practice articulating the knee, although I read in many places that I should. She also says that glucosamine, chondroitin, etc don`t necessarily help but won`t hurt either. She just has so little to say, regardless of whether gluco, chondro, etc would help or not.

I find that she doesn`t inform me much.

Could you fill me in with what I should know to make a full or as good recovery as I can?

If this helps, I am a 44 y. male, been running for 11-12 years, it`s my first injury. I seemed to have fairly good bones, and at some point sustained pretty high (80-100) mileage without problem. I was already over 40.

My next appointment is on August 13th... a month from now.

Can you help me a bit more than my ortho herself does?! lol

Thanks!

Answer:

From your description, it sounds like you had a compression fracture of the tibial plateau.  Certainly, you should be non-weight bearing on the injured leg initially, but the length of time of complete non-weight bearing needs to be discussed with your orthopedist.  However, non-weight bearing range of motion exercises are important to help maintain the muscles in your leg.  This process can often be improved with physical therapy as the therapists are very instructive when it comes to recovery from these types of injuries.  If you feel that your physician is not giving you enough information, I would recommend that you ask very specific questions and if this course still doesn't get you the answers you are seeking, then it is always reasonable to seek a second opinion.  As to the question about glucosamine/chondroitin: these medications have conflicting evidence as to whether they may be helpful or not.  However, there is no evidence that they are harmful, so I would recommend giving them a try.  I hope this helps.

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Response by:

Charles Webster, MD
Assistant Professor
College of Medicine
University of Cincinnati