 
                            Had Fracture In Lower Tibia Plateau. Not Recovering. What To Do?
 
 
                                    
                                    
                                          
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                                           Thu, 20 Jun 2013
                                           
                                        
                                        
                                        
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                                             Thu, 20 Jun 2013
                                                
                                            
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                                             Wed, 17 Jul 2013
                                                
                                                
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                                            Question : ifractured my lower tibia plateau 18 months ago still not right
                            
                                    Hi and welcome to XXXXXXX  Thank you for your query.
could you please explain bit more what kind of problem is there. Is there pain,movement difficulties, swelling or something else? Was there surgery or it was conservatively treated? How long was it immobilized?
when did you do last ct scan? Regards
                                    
                            could you please explain bit more what kind of problem is there. Is there pain,movement difficulties, swelling or something else? Was there surgery or it was conservatively treated? How long was it immobilized?
when did you do last ct scan? Regards
 Above answer was peer-reviewed by :
                              
                            
                                  
                                      Dr. Chakravarthy Mazumdar
                                  
                              
                                          
 
                                    
                                    
                                 
  
 
                                    they originally said i will need surgery. never happened by the time orthrpedic surgeon saw me was about 2 weeks later by then they told me to keep boot on for about 4 months   did rehab. sometimes i feel numbness by toes . at end of day soarness doesnt feel right . i was told in the beginning as long i dont walk on it i will not surgery  did rehab twice  i feel  since jan2 2012 was when i broke it it is too long it should feel better . i must have gotten about ten x rays   and 1 mri the mri was about 3 months ago they said it still shows a sprain. what to do
                                
                            
                                    Hi.
Yes, this is always complicated fracture because the knee joint function is usually affected.It is the most critical load-bearing part of skeletal system. Bone fracture is especially difficult if there is ligamentar or menisceal damage too. Also it often leads to posttraumatic osteoarthritis which could be your case. Today it is recommended to treat it by surgical repair in young(<65) and physically active patients. Of course, it depends on kind of fracture too.
Usually such fractures heal completely within 6 months, and full motion range should be achieved in that time too.
There is obviously some disorder in recovery if there is no improvement after 1.5 years, it can be pseudoarthrosis, osteoarthritis or there is incongruent joint surface.Also you need to rule out some systemic bone disorders such as osteoporosis, diabetes or thyroid abnormality; all these can cause healing problems. Numbness can be caused by nerve damaga and you should do EMG to evaluate this.
It is always possible to do surgery, although it was optimal to do it in early period. But even now some artroscopic procedures(debridement,lavage reconstruction) may be helpful to make smooth joint surface.You should consult your surgeon if this is available in your place.
Till that, you should continue with rehab. It is considered that hydrotherapy and magnetotherapy are most helpful. Rehab will help to recover muscle strength, facilitate healing, and kill pain,but if there is anatomical disorder in your knee then it must be surgicaly repaired and nothing else can help in this case.
 
WIsh you good health.
                                    
                                    
                                    
                                    
                                    
                            Yes, this is always complicated fracture because the knee joint function is usually affected.It is the most critical load-bearing part of skeletal system. Bone fracture is especially difficult if there is ligamentar or menisceal damage too. Also it often leads to posttraumatic osteoarthritis which could be your case. Today it is recommended to treat it by surgical repair in young(<65) and physically active patients. Of course, it depends on kind of fracture too.
Usually such fractures heal completely within 6 months, and full motion range should be achieved in that time too.
There is obviously some disorder in recovery if there is no improvement after 1.5 years, it can be pseudoarthrosis, osteoarthritis or there is incongruent joint surface.Also you need to rule out some systemic bone disorders such as osteoporosis, diabetes or thyroid abnormality; all these can cause healing problems. Numbness can be caused by nerve damaga and you should do EMG to evaluate this.
It is always possible to do surgery, although it was optimal to do it in early period. But even now some artroscopic procedures(debridement,lavage reconstruction) may be helpful to make smooth joint surface.You should consult your surgeon if this is available in your place.
Till that, you should continue with rehab. It is considered that hydrotherapy and magnetotherapy are most helpful. Rehab will help to recover muscle strength, facilitate healing, and kill pain,but if there is anatomical disorder in your knee then it must be surgicaly repaired and nothing else can help in this case.
WIsh you good health.
 Above answer was peer-reviewed by :
                              
                            
                                  
                                      Dr. Chakravarthy Mazumdar
                                  
                              
                                          
 
                                    
                                    
                                 
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