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Had fracture in lower tibia plateau. Not recovering. What to do?

Apr 2013
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General Surgeon
Practicing since : 2008
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ifractured my lower tibia plateau 18 months ago still not right
Posted Sat, 13 Jul 2013 in Bones, Muscles and Joints
Answered by Dr. Ivan R. Rommstein 22 minutes later
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
Above answer was peer-reviewed by
Follow-up: Had fracture in lower tibia plateau. Not recovering. What to do? 1 hour later
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
Answered by Dr. Ivan R. Rommstein 37 hours later
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.
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