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  • #2744 Reply

    Hi – I was rear-ended by a car while waiting on my bike at a roundabout, and suffered a TPF. It was treated through surgery two weeks ago, and pain is gradually improving. However, I feel like I’m in a vacuum with regards to information about the way forward. I was told I was non weight-bearing for 6 weeks, and then at my appointment on friday, was told that the maximum time NWB would be 12 weeks, but that they would know more after an x-ray in 4 weeks time. I have no idea whether the consultant would say this just to give me the worst-case, or because there was good reason to think I might not be weight-bearing for this long… After I start PWB, what is the usual progression- is it another 6-12 weeks on crutches? When can I hope to be able to drive again – when would the insurance company be happy with me driving again? When should I be looking at physio? There has been no mention of physio yet other than some basic exercises outlined while I was in hospital. Can anyone give me some advice? Many thanks.

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    • #6258 Reply


      I broke the Tibia of my left leg in a couple of places on 02/01/2015 having had a ladder slip out from under me. I had surgery the next day to install a rod and plates to put everything back together. I was told that I would not return to work in 4-6 weeks. I assumed that I would not be able to drive for months as initially I did not see how I could get behind the wheel with my leg straight and being unable to bend my knee.

      Long-story-short, I returned to work in 9 days and was cleared to drive by my doctor. At the point I was cleared, I was off narcotic pain medication and only taking Extra Strength Tylenol as needed. I realized that if I pushed the seat all the way back in my car and fully reclined it that I could get in with my leg straight. As my car is an automatic, I could operate the gas and break, as usual, with my right foot which was uninjured. I then got a temporary Handicap placard so as to be able to park near my work and other places given that I am on crutches. I drive now as I always have and the ability to do so has greatly improved my mental health.

      Thus, if your doctor releases you to drive, you are not taking narcotic pain medication while doing so, and are physically able to drive; then I would say, “Go for it.”

    • #6251 Reply

      Hi to all
      It sure does help to read what others are going through and know I am not alone. I am 17 weeks out since surgery and am still having many of the same issues. I try to see the positive because yes I have made improvements however I am still only @ 90 degree bend. Ankle swells anx hurts along with knee pain. I am walking with a cane and just the last couple of days feel confident enough to do the baby steps unaided.
      My current anxiety is the manual stretching at physical therapy! I hate it!!! I cry uncontrollably. Almost to the point I am afraid to go and I know that’s the worst thing because I’ll just stiffen up more!!
      I did use heat prior to going this morning and it helped some I think, at least my physical therapist said it was a really good stretch.
      Anyway thanks again for all your comments.

    • #6249 Reply
      Pamela Taylor

      Thank you Leslie. So much. Yes this site is a saviour for sure!
      We lived downstairs for 2 weeks and I luckily have a wheelchair and a walker and crutches to use. But I am always praying that this house turns into a bungalow as it has too many little and big stairs. Anyhow I bum my way upstairs at night and downstairs in the morning now. It is difficult to stand up at the top of the stairs but it is getting easier. It is awesome that you are teaching – you go girl!
      Pamela with a smile

    • #6244 Reply

      Morning Pamela,
      I too developed a swollen ankle and foot even though I was non weight bearing. Sitting at the computer was agony after half an hour. My leg was a different colour to my other one for about 5 months. My legs looked as if they belonged to different people. My surgeon said this was to be expected so I stopped worrying. Elevate as much as you can. Use an ice pack to reduce swelling. All sorts of unexpected nerves are affected with a tpf and we all react differently to the surgery. You sound similar to me at one month. I lived downstairs for 11 weeks as I could not climb the stairs. I used a walker for all of that time and beyond and that was so helpful. You learn all sorts of ways to carry seemingly uncarryable objects! Keep moving that ankle and your toes to keep the circulation good. You can also stretch your calf muscle by stretching the toes and ankle back and forth. I had physio yesterday so a sore knee today but you have to keep going and looking forward. I have a day’s teaching tomorrow so I may need my stick but to go back to work is another step forward for me. I took early retirement at Christmas. I am 58 and the tpf meant I could not return to school last September. My recovery has been slow but steady so I went for it. Now my best friend has talked me into teaching one day a week at her school. I really enjoyed it last week but was exhausted by 3.30! I will exercise today on my bike and with some good stretches so I will manage. Good to hear you have heard from others. This site is a saviour and so many others have encouraged me and given me heart. You will get there. Have a good day.
      Best wishes,

    • #6238 Reply
      Pamela Taylor

      I am not weight baring but my foot swells by the end of the day and I have no idea why. The colour of my leg changes too.

    • #6223 Reply
      Sandy Adams

      Hi Chrintina,

      I just read about others who have experienced TPF and your response to a Helen. This happened to me in a fall while skiing (actually just finishing). I did not need surgery but am finding this whole thing frustrating. I’m now in a locking brace straight out and taking Tylenol because the pain is bad. You have been very helpful and I plan to use my hot tub at the end of this week. I’m so ready to move forward especially to get back to work. I hate crutching but know it’s necessary.

      Again thanks for that post to Helen!


    • #2838 Reply


      Hang in there. I have been weight bearing and using a cane for about three weeks after 15 weeks in a wheelchair. I have the same aches and pains, but I have found this helps:

      Heat in AM to loosen up the muscles and tendons. Ice in PM to help swelling and pain.

      By the way, my physical therapists explained that foot and ankle pain as being caused by using it after a long period of non/limited use. Think of it as the tendons and muscles having an extended vacation on a beach, and on day one back to work they are required to go put in a 20 hour shift. They are not happy.

      Again, keep hanging on.

    • #2835 Reply

      I am 14 weeks after surgery – plate & 12 screws. FWB and can even walk like a one year old for a few minutes without support. The most prohibitive thing is the pain in the ankle and foot. Knocked it pretty bad in the accident, but this all happened in India and I basically have to research myself what to look for. OS not very informative. My muscles feel just too tight. And muscle fatigue and swelling still require a one a day paracetamol. Anyone had a similar experience with the foot? How long before swelling stops? Psin stops? Foot muscles loosen up?

    • #2746 Reply

      Hi Helen

      Lisa’s right on all accounts: a TPF isn’t like other fractures at all, and it’s so finicky doctors don’t really have a blueprint in handling it. And she’s absolutely right in saying “it depends” in answer to all your questions. I know it’s frustrating to hear because you want definitive, quantitative answers, but there are so many factors at play.

      That being said, here’s a basic rundown of what needs to happen for you to get back to normal:

      -the fracture at your tibial plateau needs to form a callus; this is when bone cells knit together to start repairing the break
      -during the callus-forming stage, you can think of the fracture as being held together by glue (even though there may be pins/plates/screws holding the bones together), so it’s very delicate and liable of displacing
      -alcohol causes peripheral vasodilation when you need the blood more deeply instead of at the surface, and smoking causes vasoconstriction, which tends to restrict the amount of blood (and the nutrients it contains) getting to the injured site
      -in the first week to two weeks, your bone is in overdrive mode to heal itself, so you may notice a lot of pain, sleeplessness, muscle cramping, loss of appetite (because of the narcotics) and fatigue in trying to do what came naturally before.
      -it’s important to get things moving right off the bat so physio and rehab will be easier later on. This means flexing your ankle to keep your Achilles’ tendon stretched, rotating your ankle, flexing your calf, stretching your fingers past your toes (hamstrings), and lifting and holding your leg in the air (quads). All of this lays the groundwork for getting back on track fast after the first crucial healing stage is over.
      -using crutches will make you feel like you’re the most out-of-shape person alive, but it does get better…if you work on it. You have to push past the muscle aches/fatigue, sweatiness and feeling like you’re going to die, because no pro athlete ever got to the top without going further than they thought was possible. You can do this, and a lot of it is mind over matter.

      In terms of driving, this is a very tricky subject, and please don’t quote me on this. If your TPF is your left leg and you drive an automatic transmission, technically you’re able to drive (you’d have to check with your insurance company, but I’d recommend calling a competitor and blocking your number before asking if it’s legal). You can also ask a cop on the street. However, keep in mind that should you be in an accident, you’d have to prove that you were able to drive without any impairment, and that can be very difficult to prove. I’d also recommend not asking your OS or doctor because they can contact the Ministry of Transportation (or whatever it’s called where you live) and having your licence temporarily suspended on account of injury, and that requires a lot of paperwork and time to get reinstated. For me personally, I drove near the end of my cast-wearing period — and it was a risk I was willing to take on — because I felt okay in operating a motor vehicle. It was pretty uncomfortable having a straight leg stick out instead of being able to bend it, though.

      And in terms of NWB period and rehab, that really differs on a person-to-person basis. I was first told six weeks NWB with a cast on and then three months NWB with the cast off, and the latter part was reduced to six weeks after my x-rays came back great. Some people don’t get to bear weight for months and months (it depends on their age, health, severity of injury, lifestyle, bone mineral and muscle density, healing history, and so many other factors), while others are figurative freaks of nature and get back much, much quicker than that.

      Getting back to walking also depends on your muscular strength and ligaments/tendons in the knee area because your knee needs a great deal of support around it to get walking. That being said, it’s been shown that weight bearing facilitates bone healing, but it’s your decision and your OS’s decision when that happens. Your TPF will heal when it’s ready to heal.

      Lastly, what I found worked great is getting in a hot tub, positioning your knee inches away from the jet, and bending it that way. This thing will take time, blood, sweat, tears and more effort than you thought was in you, but you will get back to walking.

    • #2745 Reply

      Hi, Helen. I am so sorry this has happened to you.

      The answers to your questions are this: it all depends.

      TPFs are intense injuries. They take time to heal. The xrays will show how much healing takes place and when it is safe to bear weight. Eat well, don’t drink alcohol or large amounts of caffeine, and don’t smoke. I myself began physical therapy to work on ROM ten days post hospital discharge. I was NWB for 15 weeks. Yes, a portion of TPFs need 12-16 weeks before it is safe to bear weight.

      And it is not safe to drive until you can bear weight.

      I would ask your doctor able these very specific details. I was blessed with a great doctor, but most doctors will not offer details unless asked.

      Also, get into a physical therapy as soon as you can. Even with NWB status, ROM exercises can be done.

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