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Mary_J's diary | Respond to this comment
Comment : TPF recovery
Posted by sheepish in seattle on Sun 9:51pm 30 October 2011


Wow. Your first surgeon was an arse. BL's are bad enough under the best treatment, but being treated badly and condescendingly makes it far worse.

I fractured my TPF in May 2010 (Type II fracture). My OS told me that it "used to be" conventional wisdom that about 5 years after surgery for a TPF they would see the patient again for a knee replacement. He said that he had just read a study that showed that with recent advances in techniques, it's actually down to only about 10 % of TPFers that eventually need knee replacements, and most of those are for the more severe Type V's and VI's. So, you certainly shouldn't think that it's inevitable that you will need a replacement, although the fact that your original surgery was botched may have a significant affect. My ROM at 2 months after surgery was about 40 degrees. With PT it improved pretty quickly over the next month up to about 120 degrees and then plateaued there for several months. Now, a year and a half later, it's probably around 145 degrees, only a degree or two less than my good leg. So, every case is different, but don't be discouraged by your 95 degrees of flexion at three months out. It takes time to regain flexion, but the good news is that it can continue to improve for a long time. And it can plateau at some level for several weeks and then suddenly improve some more. What you have now is in no way an indication of the best you can hope for.
I was NWB for 10 weeks, and when I did begin WBAT it only took me about 2 or three days to transition to a single crutch, at least for getting around the house. I needed two crutches for longer distances for a few weeks, and it took me a little over a month before I transitioned from one crutch to a cane for any substantial distance. But two months after that I was walking across pastures unassisted for a couple miles. My stride was shorter and my pace was slower, and I had to watch my footing but I could do it. A month after that I was scrambling in and out of ditches and hiking up to five miles across open fields. So, again, don't be discouraged by your progress to this point. Everyone is different, and I know I'm luckier than many TPFers. But, even though it feels like forever to you at this point, you really are early in your recovery. There is lots and lots of improvement ahead for you.

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