Post-Surgery Concerns: Managing Swelling After Tibial Plateau Fracture

Postoperative care for tibial plateau fractures?

Hello, I sustained a tibial plateau fracture in April 2020 and underwent arthroscopy and repair of the fractured plateau, along with the placement of artificial bone and steel nails.
The plates and screws were removed in December of the same year.
Now, nearly a year later, I sometimes experience swelling and tightness from my knee to my calf.
Could this be due to poor circulation from the surgery, or is there another reason? How long might this condition take to improve? What exercises can I do to help? Thank you for your time in responding!

Miss Jiang, 40~49 year old female. Ask Date: 2021/12/02

Dr. Wang Shouji reply Orthopedics

Hello, intra-articular fractures may lead to post-traumatic arthritis as a sequela.
It largely depends on the condition of the joint after the fracture.
Applying heat therapy may help, but if there is no improvement, it is advisable to consider arthroscopy to assess the intra-articular situation.
Changhua Hospital cares about your health.
Sincerely, Dr.
Wang Shou-ji.

Reply Date: 2021/12/02

More Info

After undergoing surgery for a tibial plateau fracture, it is not uncommon to experience swelling and tightness in the knee and lower leg, even months after the procedure. This can be attributed to several factors, including the surgical trauma itself, the healing process, and the body's response to injury.

1. Causes of Swelling: The swelling you are experiencing could be due to a few reasons:
- Post-Surgical Inflammation: After surgery, the body initiates an inflammatory response to promote healing. This can lead to fluid accumulation in the tissues around the knee, resulting in swelling.

- Circulation Issues: If the circulation in the area is not optimal, it can contribute to swelling. This may happen if there is scar tissue formation or if the range of motion is limited, which can impede blood flow.

- Lymphatic Drainage: The lymphatic system helps remove excess fluid from tissues. If this system is compromised due to surgery or injury, it can lead to persistent swelling.

2. Duration of Symptoms: The duration of swelling can vary significantly from person to person. In many cases, swelling can persist for several months post-surgery, especially if there was significant trauma to the area. It is important to monitor the swelling and consult with your healthcare provider if it worsens or does not improve over time.

3. Exercises and Rehabilitation: Engaging in a structured rehabilitation program can help improve circulation and reduce swelling. Here are some exercises that may be beneficial:
- Range of Motion Exercises: Gentle bending and straightening of the knee can help maintain mobility and promote circulation.

- Strengthening Exercises: Focus on strengthening the muscles around the knee, such as quadriceps and hamstrings, to support the joint better.

- Low-Impact Activities: Activities like swimming or cycling can provide cardiovascular benefits without putting excessive strain on the knee.

- Elevation and Compression: Elevating the leg and using compression garments can help reduce swelling.

4. When to Seek Help: If the swelling persists or is accompanied by other symptoms such as increased pain, redness, warmth, or fever, it is crucial to seek medical attention. These could be signs of complications such as infection or deep vein thrombosis (DVT).

5. Long-Term Management: As you continue to heal, it is essential to maintain a regular exercise routine that focuses on flexibility, strength, and endurance. This will not only help with swelling but also improve overall knee function. Consulting with a physical therapist can provide you with a tailored rehabilitation program that addresses your specific needs and goals.

In summary, while some swelling and tightness can be expected after a tibial plateau fracture surgery, it is essential to monitor your symptoms and engage in appropriate rehabilitation exercises. If you have concerns about your recovery or the nature of your symptoms, do not hesitate to reach out to your healthcare provider for further evaluation and guidance.

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