Tibial Plateau Fracture

A little over two weeks ago (August 6th, 2011), I was bounding up the front stairs leading to my apartment when I tripped and fell forward.  I was not able to brace myself, as I was carrying groceries at the time.  I came down on my left knee and knew pretty much right away that I had probably done some good damage.

The following 48 hours, the pain was pretty intense, but I was able to hobble on the leg at the very least.  I was convinced that while there was probably some ligament damage, the chances of me having broken something was probably slim.  

After those 48 hours, the pain had diminished pretty drastically and I actually felt comfortable walking on the leg, though it was a bit unstable.  However, when I got home and went to take a shower, I noticed that my leg had ballooned (August 11th).  While there had been some pretty decent swelling in the knee previously, it had now spread to my leg from the knee down.  My calf was giant and my foot was very fat too.

I went to the emergency room that night where they performed an X-Ray and a Doppler Ultrasound.  The X-Ray determined a fracture of the tibial plateau (looks like the fracture is in the back) and the DU came up negative for blood clots.

Since that point, I have seen two different Orthopedic specialists, both with different prognoses regarding the need for surgery and the severity of the damage done.  Both agree however, that the PCL is torn as there is some sag during stress tests.

An MRI has been ordered, but in the meantime I would like to know how to control the swelling.

Some days are better than others, but there doesn't appear to be much rhyme or reason to the frequency of the swelling itself.  I have no pain associated with this injury, but the swelling of the leg comes and goes.  I'm also curious to know how long the swelling can be expected to continue.  The knee swelling is greatly diminished, as I had the sucker drained this past Thursday (August 18th, 2011), but my calf and ankle like to swell from time to time, seemingly without aggravation.

Any tips and thoughts regarding my injury would be greatly appreciated.  Looks like I have a long road to recovery ahead of me.

[S. Kaul, MD]

Hi there!

The swelling is most likely to be due to inflammation. You could try elevating the leg and avoid keeping it in a dependent position for long. Ice packs and NSAIDS may also be helpful in bringing the swelling down. You may also try light massage and crepe bandage is the swelling seems to be bothersome. The swelling may take a few days/ weeks to subside (as long as the inflammatory process continues).
Hope this helps.

Take care!