u/Godzillas_doom

TLDR questions:

1. are the plates and screws placed over and through muscle tissue? I can feel all the hardware in the leg and it’s extremely uncomfortable, is this typical early on? Is there any early recommendations regarding movement to support healing or prevent further injury?

2. pre-op the surgeon said 3 months before any weight bearing exercise, and 9 months total healing. From what I understand the hardware is placed with the intention of being permanent or at least semi permanent. They used stainless steel for the hardware. Is opting to have the hardware removed safe? Advisable? Is there a timeline recommended for that?

3. any movement has been extremely painful and difficult right now, even trying to get up out of bed. is there a typical timeline before movement is safe? Is it typical to be bed bound after a surgery like this?

I haven’t been seen by the surgeon and think I may not be. I’m trying to understand a little more about how this procedure is usually completed. I’m experiencing a lot of pain and swelling right now. Before the operation the surgeon explained to me that he would be rebuilding my tibial fracture by rafting the screws, with a cadaver derived bone graft, tamping the pieces of the tibia back into place from an 8mm depression. I have been in the hospital trying to keep my ankle mobile, and it feels like there is a lot of pull/resistance in the muscles alongside my shin where the plate is. I’m wondering if these plates and screws are usually placed over or under muscle tissue? Right now I can feel all the hardware that’s in there, and it feels like some of it is poking my skin from the inside, especially around the joint. I’m wondering if the hardware can or should be removed at any point, and is there a typical timeline for this type of procedure?

Also is there a typical timeline before movement is appropriate? Right now I genuinely can’t with the pain and swelling but the hospital wants to discharge me. There is talk that f trying to put me into a rehab center, but it’s not covered by my insurance.

I just want to know what kind of movement is safe for now and will not result in reinjury or hurting the healing process.

Surgeon before operation gave me the timeline of 3 months before any weight bearing and about 9 months before total healing.

My knee was injured about 17 days ago, someone fell on me from the side and my leg buckled inward. Felt the "pop" which I believe was my tibia breaking, it felt analogous to other bone breaks I've had, just more debilitating. The break is the anterior-lateral side of the tibia plateau of my right knee.

The TLDR Questions:

1. Would you operate or elect for surgery? If so what would that surgery consist of, i.e. plates, screws, bone grafts, anything else?

2. What material would you use for surgery? I know stainless steel is popular and have been reading about stainless steel vs titanium.

(from what I have read, titanium typically presents a better prognosis in orthopedic surgery because bone is able to graft to the surface of the titanium better, and in some cases bone callus formation was inhibited in the presence of stainless, leading to less favorable outcomes such as the plate and screws bearing the entire load and setting screws breaking. I'm no pro here just trying to read what peer reviewed articles I can)

3. What would prognosis without surgery be like?

The details:

Xray from the ER confirmed I have a tibial plateau fracture. It took some time for me to get into ortho, I was denied care from a lot of clinics based on insurance, and I ended up having to go back into ER to get a referral.

That ER referral has lead me to here, I just saw the DO ortho today and they DID NOT instill me with confidence in their knowledge, ability or efficacy of treatment, but I'm not sure if it's because I have a lack of understanding or if they are just not that great of an orthopedic surgeon.

At the appointment they did not offer any information readily, I did ask about what the surgery would consist of and what prognosis looked like if I didn't go with surgery.

The surgery they told me would be "putting a plate in with a bunch of screws, and maybe a bone graft because there might be an open space from where the bone is lifted up."

She said if I didn't get the surgery I might end up "bow legged" which was weird to me because the injury is on the lateral side and my knee was buckling to the inside (medially) after the injury/break happened.

I wasn't sure if maybe I just don't understand because I'm not knowledgeable, I want to trust they are the pro's here, but they didn't even get my age right when we were speaking, and said that they have no prognosis for "people of my age that don't get the surgery because those who didn't all went to jail."

I'm not totally opposed to surgery I just want to be confident in my surgeon too.

I am attaching some images from the ER visit here xrays of my leg.

I’m 6’3”, 170 lbs, 35 yrs old, non smoker, non drinker, all other factors considered I’m healthy. I take no medications.

Here it is. Hot out today 😅

Selling my K5.
Bike rides perfect needs nothing.
Has some cosmetic blemishes, I have a full fairing kit for it.
~35k miles, I still ride it occasionally so it goes up.
Really amazing bike.
I have it posted right now for $5500, but I can be a little flexible.
Come see it and test ride it!!