Compound fracture of tibia and fibula recovery

I had a ski accident on Feb 25th 2018 that resulted in compound fracture of tibia and fibula.  They broke inside my boot, close to my ankle.  I had an emergency surgery that evening in South Lake Tahoe, they installed a 315mm titanium rod in my tibia and fastened it with 3 screws.  They made an incision above my knee and inserted the rod through the knee.  They explained the procedure as routine with 100% recovery. I was released from the hospital the next day.   We went back to Bay Area, to my Kaiser Permanente insurance.  Since the surgery, I saw an orthopedic PA at Kaiser only 2 times, once a week after the surgery, and once a month later.  They basically took an X Ray, and both times there was no bone growth, so they just sent me home and told me to elevate and ice the leg, and come back in a month.  I am now almost 7 weeks into this, and no PT has been prescribed to me yet, they said I wasn’t ready. My current situation (7 weeks after surgery):

• The pain is better, but still hurts at the point of fracture and in the knee. 
• The knee and ankle are locked. 
• The muscles on the entire leg atrophied and it is so weak, I have to move it with my arms. 
• The incisions around my knee are closed up and clean, still sore, and the incision around the puncture are still bloody and very painful. The puncture point is still bleeding from time to time and painful. 
• I have several completely numb spots on my leg, around the fracture and incision points. These numb sport border very painful spots, a very strange and unnatural feeling.  
• I have a boot, I keep my leg elevated most of the day, and I use crutches to get around the house. 
• I eat all the foods rich in minerals and vitamins needed for bone growth. I eat very healthy and a lot. 
• I massage my leg with gel for swellings, and with oil to stimulate some blood circulation.
• I work from home, lying on the couch. I am falling apart from lying on the same position all day and twisting in order to use my laptop. I try to do some upper body workout, but still while sitting with one leg up. 
• And I wait…. 

I would like to hear about experiences of those who had similar procedure done.  I get so little information from the doctors, and they always have the same answer to all my questions- “it depends on a person”.  I would like to know some timelines and milestones so that I can manage my expectations during my recovery, and also to get some hints on what I can do to recover faster.

1. The swelling- my knee, ankle and foot are swollen and my leg is blue from knee down. There has been a significant improvement on the knee since the beginning when it was like a balloon, but its’ still swollen compared to the other knee which I believe restricts the range of motion. Any thought on who to reduce swelling and bruising?
2. Procedure impact on the knee- how much did this procedure disturb my knee? How to recover it? Will this procedure cause any knee pain in the future? 
3. Locked joints- my knee, ankle and now even my hip became stiff. I cannot move my knee, its locked, and my ankle also, but it’s just so close to the injury I wouldn’t try to move it yet. How do I do about trying to start to move them, and when?
4. PT- what kind of rehabilitation therapy is most effective? Where should I seek PT (my insurance or private studios)? How should I ask my insurance for it (since they are not offering any other than a person manually moving my leg, and even that not yet)? What can I do on my own? When to start? How to start?
5. Numb spots- anything I can do about this? How long can I expect them to be numb for?
6. Scars- how to minimize them? What to use, when, and for how long?
7. Impulse stimulation- Does anyone recommend buying one of those impulse stimulators online? 

Thank you all in advanced for your thought and suggestions, and sorry for the lengthy message.

Hi Zorana, I am sorry to hear about your injury, I had a relatively similar injury in May of last year. I had a compound fracture of tibia and also broke the fibula, but closer to the ankle than the knee. I was in a cast or boot for roughly 4 months. 

My timeline was (roughly) as follows:

- A week in and out of hospital for two surgeries, first for a external fixator and then the second for plates and screws. Morphine and oxycodone constantly.
- A "soft" cast for a month or so with almost constant elevation and rest, only lowered my foot for the bathroom and to move rooms. Dropping my leg below my waist made it swell tremendously and hurt something fierce. Oxycodone at first, then switched to hydrocodone once the pain went down somewhat.
- A plaster, hard cast for two weeks. Dropping my leg below my waist will cause my leg to swell and change a horrible purple color, still pain and itching if I let it drop for too long. I think this is when I got my stitches and staples out.
- Another plaster cast for another two weeks I think, the bone and soft tissue hadn't healed quite enough. I think the soft tissue was the limiting factor here, did not want it to split open. Same reason I had the external fixator surgery too.
- A removable boot for about two and a half months. I was non-weight bearing for the first month or so. Being allowed to put weight on it was super weird, my heel was the sorest spot by far, the actual bones that broke didn't seem to hurt. I think it was my foot muscles had atrophied so much and were not used to bearing weight.
- After the two and a half months, got the boot off and limped pretty hard for a while.

Took about a month to be able to use my calf muscle in my step. I went climbing the day after I got my boot off and biked ~8 miles the day after that. Biking for me is where I notice it the least, climbing was hard at first because I could not stand on my toes, my calf was so weak and I was terrified of falling on it all for a few months. Now I don't notice it climbing at all, it came back fast. I didn't do any upper body work outs besides crutching for fear of injury. My calf is still a little weak because I think I baby it, working on that still. My ankle is still stiff, maybe about 80-90% flexibility. It hurts when I try to run, and sometimes going down stairs or the like. Climbing and biking are basically unaffected by it now.

I followed my orthopedic surgeon's advice religiously, I know some people begin weight-bearing or PT prior to doctor's orders, but no way was I risking anymore time in a cast or boot. When I say I kept it raised except to use the bathroom or move rooms (maybe twice a day) I mean it. My surgeon was awesome and was very clear with me about timelines and expectations, all I can say is I'm sorry you seem to be getting the run-around. Your injury also seems to be more severe, I had little damage to the joints which I heard helps a lot with recovery and the need for PT.

Numb spots: Still have some, but they are shrinking slowly. I also have that weird, painful feeling if the numb spots or spots near them are hit, does not feel good.

Scars: I have a scar on both sides of my leg, one side is fading fast, the other, main scar is large and probably will never fade. I am not actively trying to do anything about that, I don't really care what it looks like and it has a decent shape to it.

PT: I did none. Luckily for me it would have been covered by my insurance, but the doctor said I probably did not need it given my age and active life style, just doing things would strengthen it. Also, with the business of the last year of college, I didn't really have the time.

Sorry for the wall of text and the general rambliness to it, I wish you the best in your recovery. I was lucky that the fire chief who assisted on the rescue had a similar injury and was able to keep me informed about what to expect, I would be glad to elaborate or talk about anything else if you have any more questions or concerns.

The ex-rays give me shivers. Trust your doc. Get a second opinion.  

Check your dins. Energy goes somewhere.

It gets better. Do your PT. You'll be back in months. (Sorry to be vague on your direct questions; it's bad luck, but with work it repairs.)

I’m going to respond to your post but I have never experienced a similar injury, though I have a lot of experience around people that get fucked up.
MDs and people in the industry always talk about things like they happen every day. They do, the MD probably does multiple similar surgeries a day, but your body has not been through this before, I’m assuming since you’re asking. In my humble experience lower limb surgeries from traumatic injuries take a long time to heal. Do your PT. I can’t emphasize PT enough. It’s as instrumemtal to healing as the surgery itself.
 If you don’t trust your MD get a second opinion. I took my car into the shop last week and they said I needed 1500$ in brakework. You bet your ass I got a second opinion and that’s a car, not my leg. 
Hang in there though. It looks and sound like a nasty break, it’s going to take time. 

I experienced a similar break almost a year ago, although it was not compound, and had the same surgery as you did. The first 2-3 weeks were the worst due to the swelling and pain. I'm not sure why you haven't been prescribed pt yet as I started it the day after surgery. The first few weeks were mostly just massage and very light mobility exercises but they helped a ton and got me out of the house. I'd recommend starting pt as soon as you can, it was by far the most helpful part of my recovery. My doctor also told me I could be weight bearing on it basically immediately depending on my pain tolerance. He said the quicker I started lightly using my leg the faster the bone would heal. The first two weeks I could barely put any weight on it because of the pain and the swelling. 3-4 weeks in I saw dramatic improvement in the over all pain and was able to put 50% or more weight on the leg. 5-6 weeks in I was able to put 100% weight on the leg, but very carefully. The most annoying and worst part of the rest of the recovery, besides the first 3 weeks, was the lack of mobility in my knee and especially my ankle. It was a very slow process but between pt and the exercises they gave me to do at home I slowly started to regain mobility in my ankle and knee.

I wouldn't worry too much about the scarring and numbness for now unless it gets worse. The scarring, once the swelling went down and the incisions healed got better and better. Almost my entire foot was numb after the surgery and it still hasn't completely gone away, but it slowly got better and better. Basically my doctor told me there was very little they could do for the numbness because it was likely just irritated nerves, it would just take lots of time for it to heal and eventually its gotten to the point I rarely notice it.

As soon as I could, I started top-roping with one leg and the boot on. I very gradually started to put more and more weight on the leg on top-rope as it was very easy to control exactly how much weight I put on it. I actually started this about 4 weeks out from the surgery which is probably not advisable, but I took it very slow and was as safe as I could be and in the end I think it made my recovery much quicker. The pt was still the best for recovering mobility and I would highly recommend starting it as soon as you can.

It sound like you are still in one of the more frustrating stages of the recovery but you are through the worst of it and it should start to get better faster at this point. Especially if you can start pt and being more active.

Good luck! 

I feel your pain because I had the same injury as you describe and I had Kaiser (at rhe time).
It sounds like you’re 4 months into Your healing process, you have a long way to go.
Here’s some advise (I had my accident 20 years ago & STILL have chronic pain) regaining Kaiser-
1. They will not give you enough post break PT unless you fight hem.
2. My tibia & fibula we’re set crooked - it was a BAD break. I looked down and my ski boot was facing backwards and so was my foot). In shock, I grabbed my bot to turn it around. My boot just flopped back again. It was gross!
3. Did you have metal screws placed in your bones? If you did and you feel burning on our skin (or just hotter skin) GO IMMEDIATELY BACK and see your surgeon. You may have an infection. I did and had my pins removed.
4. You’re in this for the long haul UNLESS you get at least six months of PT and REST your leg as much as possible. When your cast is removed don’t be like me and hop right back into normal life. You sustained a serious injury.
5. The rest of your life you will have issues. It’s a sad fact. Your injury was life changing. I am so sorry to tell you.
6. If you are working make sure you have a desk job for awhile. Again, the recovery process takes time!
7. Follow up and demand to see a sports med or orthopedic surgeon at least every three months for a couple years. Kaiser is great at giving its patients the least amount of care without being sued.Demand care!
8. Forgive yourself. We all fall.
Good luck!

You done broke em gooooood! I've shattered my femur. Compound fractures to my humerus (not so humorous) and clavicle. Yep, recovering from compound fractures takes forever! You can do your own ROM exercises to speed up recovery. The human body calluses and strengthens when stress is applied. I've had a fracture that I didn't get treated at ALL. I'm fine. I'm one of those stubborn dudes that tries to be the hero. The doctors have done all they can. The only thing they needed to worry about was nosocomial infection -- take your antibiotics.

Get the metal removed if you can find a surgeon that's willing! That metal causes pain years down the road!  Get well soon!

Hello,

I know its an old topic but my search ended here, I got mountain bike accident 3 months ago, surgery the next day with 2 plates and 15 screws.
My next appointment is in 2 months... Its crazy how long is the healing process, I been prescribed ultrasound treatment  (which cost 1800$) EXOGEN,...

Reading this post I'm curious If Zorana now ok...
This pic was after 6 weeks,, its now only a little better. 

Danny. It's been 9 months (to the day actually) since I broke my tib. and fib. in my ankle. I went ice climbing last weekend and indoor climbing several times. I still have a lot of stiffness and descending stairs is still challenging. Doesn't really impact my life much any more though, it's kind of become the new norm. It's definitely getting better but imperceptible day to day.

Don't be too lazy during recovery. I didn't have much choice having also broken my arm but if you can continue upper body workouts definitely do it. Swimming and water walking were a life saver for me when I could finally get some aerobic activity after several months.

Also be grateful to everybody that's helping you with your recovery!

alpinejason wrote: Danny. It's been 9 months (to the day actually) since I broke my tib. and fib. in my ankle. I went ice climbing last weekend and indoor climbing several times. I still have a lot of stiffness and descending stairs is still challenging. Doesn't really impact my life much any more though, it's kind of become the new norm. It's definitely getting better but imperceptible day to day.

Don't be too lazy during recovery. I didn't have much choice having also broken my arm but if you can continue upper body workouts definitely do it. Swimming and water walking were a life saver for me when I could finally get some aerobic activity after several months.

Also be grateful to everybody that's helping you with your recovery!

Thanks for the info. Im already doing upper body,

Rehab exercices even if limited and swimming. I guess 3 months is not unusual...But mentally its tough and I cant wait to get back on my 2 feets at 100%!

Zorana Dicic wrote 
Locked joints- my knee, ankle and now even my hip became stiff. I cannot move my knee, its locked, and my ankle also, but it’s just so close to the injury I wouldn’t try to move it yet. How do I do about trying to start to move them, and when?

Your doctor will prescribe physical therapy when the time is right.

PT- what kind of rehabilitation therapy is most effective? Where should I seek PT (my insurance or private studios)? How should I ask my insurance for it (since they are not offering any other than a person manually moving my leg, and even that not yet)? What can I do on my own? When to start? How to start?

Healing is most important. Don't put any pressure on the leg until instructed to do so by the doctor.

Scars- how to minimize them? What to use, when, and for how long?

You can eliminate scars and also eliminate plaque based arthritis by taking Serracor-NK (1 capsule per day) available through Biomediclabs. I have been taking Serracor-NK ever since I shattered my ankle, fibula, and tibia. It will also clean out your arteries, which is important now that you are no longer as physically active. I had an external fixator for four months before my bones grew back (my bones were left in the yard).

Impulse stimulation- Does anyone recommend buying one of those impulse stimulators online? 

I have a TENS unit that I inherited from my dad. They are available on eBay at a reasonable price, along with replacement pads. The TENS unit was an invaluable tool for me to regrow my bone and also to reduce pain.

You are eating lots of minerals and vitamins. This is good. However, if you are consuming any commercial calcium, you will likely be visited by persistent and never ending bone pain; even years and decades after recovery. Calcium citrate, calcium chloride, calcium tri-phosphate, and calcium carbonate are just a few of the calcium sources that are added to foods and supplements. All of these calcium products cause constipation, hypertension, calcified teeth, and most relevant to you, bone pain. You can look up the side effects of calcium supplements on the Internet. It took me ten years to track this down and figure it out. It was actually a calcified tooth that made me try ridding my diet of commercial calcium. Not only did I permanently eliminate the tooth pain in three days, I was suddenly no longer constipated, my blood pressure normalized, and the pain in my ankle was reduced considerably.

It did not take me long to find natural supplements with adequate calcium to rebuild and maintain my bones. In fact, the calcium supplements I discovered were vastly superior to the commercial supplements. Not only did my tooth pain go away, but within a couple months of eliminating commercial calcium and consuming only natural calcium, two fillings popped out of my teeth. Over the course of the year, the voids filled in with brand new tooth material. I now have two regenerated teeth in my mouth. I reason that if my body is so happy with the natural calcium and the elimination of the commercial calcium that it would regenerate two of my teeth, imagine what it is doing for healing my bones and increasing my bone density!

The natural calcium I take is one 00 capsule of moringa powder, one capsule of broccoli powder, and one capsule of hackberry powder, along with a cup of dandelion tea every morning. You get much more than just calcium in these supplements. They are loaded with other natural minerals and vitamins. The most potent and most important herb of the list is hackberry. I happen to have a hackberry tree growing in my yard (and broccoli and moringa, too). I make my own powder from the hackberry's Spring leaves and premature berries. The hackberry is a true miracle worker for people who need natural calcium in their diet. I would not be surprised if it could cure osteoporosis and other bone degeneration, but that is pure speculation at this point. Hackberry used to be a staple food in the diet of ancient North Americans and Europeans, and I can see why.

I had an almost identical break. Did it mountain biking. I had 3 surgeries and spend the first month lying in bed. Then wore a boot for 3 months and then started walking. Recovery has been extremely slow.It’s been 3 and a half years and I can’t run most the time and biking hurts too much. But most hiking and walking is ok. (Most of the time)

My recommendations:
-Do PT
-Be patient. It took years to be able to walk distances without pain
-Work on your ROM in your ankle. I didn’t and mine is still very limited

Hi! I had a similar break in March 2018- I, too, broke my tib fib while skiing (although my fib break was higher up, near my knee), and I also had a rod inserted thru my knee. I was off my feet for 2 months (icing & elevating constantly, using a walker to get around), then I gradually started using crutches & putting more weight on. My PT didn't start until 6 weeks post-surgery, and we mostly worked on bending my knee (as you know, your knee has no range of motion after that surgery!) and ankle flexibility. I also had a lot of trouble bending my knee to walk down stairs- I couldn't control my knee, and it would just snap down. We worked on that a lot in PT, but later on, when I was 100% weight bearing.

Now I'm fully walking (usually with no pain) but I cannot run. I've started to try more high-impact work (such as jumping rope), but I can't sustain for long periods of time or else it really hurts me (and causes me to feel like I have shin splints in the leg I broke). I still have knee pain, as well (and wonder if this will ever go away)- it's most noticable when I'm doing squats or kneeling on a hard surface. I do a lot of barre, pilates, and indoor cycling- low impact exercises that don't aggravate my leg. I haven't been to PT in a few months (ran out of sessions thru my insurance), but I'm considering going back, as I'd like to be able to run & jump rope again with no pain.

Daniel- it's disappointing to hear that 3 years out you still can't run most of the time. Have you been trying, or just given up on it?

And Zorana, I'm curious to hear about how you're doing now? I haven't encountered too many people with the same rod that was inserted thru knee & spans the entire lower leg!

Leigh L wrote: Hi! I had a similar break in March 2018- I, too, broke my tib fib while skiing (although my fib break was higher up, near my knee), and I also had a rod inserted thru my knee. I was off my feet for 2 months (icing & elevating constantly, using a walker to get around), then I gradually started using crutches & putting more weight on. My PT didn't start until 6 weeks post-surgery, and we mostly worked on bending my knee (as you know, your knee has no range of motion after that surgery!) and ankle flexibility. I also had a lot of trouble bending my knee to walk down stairs- I couldn't control my knee, and it would just snap down. We worked on that a lot in PT, but later on, when I was 100% weight bearing.

Now I'm fully walking (usually with no pain) but I cannot run. I've started to try more high-impact work (such as jumping rope), but I can't sustain for long periods of time or else it really hurts me (and causes me to feel like I have shin splints in the leg I broke). I still have knee pain, as well (and wonder if this will ever go away)- it's most noticable when I'm doing squats or kneeling on a hard surface. I do a lot of barre, pilates, and indoor cycling- low impact exercises that don't aggravate my leg. I haven't been to PT in a few months (ran out of sessions thru my insurance), but I'm considering going back, as I'd like to be able to run & jump rope again with no pain.

Daniel- it's disappointing to hear that 3 years out you still can't run most of the time. Have you been trying, or just given up on it?

And Zorana, I'm curious to hear about how you're doing now? I haven't encountered too many people with the same rod that was inserted thru knee & spans the entire lower leg!

Hi Leigh,

I also haven't encountered too many people who had the intramedullary nail inserted through their knee.  So, I am glad you wrote back!

Since my surgery was an emergency due to a compound fracture, I was operated in South Lake Tahoe outside of my insurance.  For this reason go to checkups by a different doctor than the one who did my surgery.  Much to my surprise, this doctor didn't know why they inserted the rod through my knee. I went back to the surgeon to ask, and the answer I got was that it is easier to maneuver the X-Ray machine around your leg during the surgery.  When they insert it below the knee, they need to bend it so tight, and keep it bent throughout the surgery, its hard to get the X-Ray around it.

I feel that in the process of drilling through my knee caused a lot of damage and now I have more knee issues than anything else.  

Here is my situation now after 11 months:
1. I have a lot of knee pain. I do PT, but most exercises I do for strengthening the quad hurts my knee.  When quad is engaged it moves the knee cap (as it should), and that hurts a lot including the knee cap falling out of place and nasty clicking while going in and out of the socket.  For this reason, I have hard time doing exercises and my leg is still very weak.
2. I've been doing some high intensity low impact exercises like spinning, and I thought I was doing so well, but it turned out that I was compensating too much with my good leg and my broken leg stayed weak.  This is why PT is so helpful, they give you good exercises specific to your situation. They have given me single leg bridges and they seem to help.  I cannot do strait leg lifts as that causes my knee cap to fall out of place.  I still cannot have any impact, it hurts pretty much everywhere, my knee, ankle, and all the screws.  I am starting to do a little bit of hopping and side stepping, as I cannot run yet. I also have noticed that my coordination has gotten so bad, that I don't trust that leg.  I used to have very good coordination before.  I hope that gets better.  
3. I still have a numb spot around the break.
4. I still have the bruise at the break.
5. I can walk and stand just fine, but after sitting for some time its hurts to make the first several steps.
6. The leg tends to swell and bruise sometimes
7. When not using my leg, I have no pain.  Also most of my walking in painless.  
8. My knee was super stiff and I had only 5 degree range of motion when I started PT.  Now its functional, but I still can't completely straighten it and bend it.
9. My knee still hurts when I put any pressure on the leg, I have a limp when walking up and down the stairs.  That is slowly getting better with strengthening the quad.  
10. It hurts when I kneel.  I need extra padding in yoga class.  
11. My ankle is still stiff, but its functional.  I never really had a lot of problems with it.  

I'd be interested to know what exercises you do and if you can do strait leg lifts.  Do you also have knee issues and what kind?  Do you still have the bruise? Any pain?  Do you plan to remove the screws?  

This is definitely a life changing surgery.  So far, it has taken a year from my life, I spent 5 months on the couch, the pain kept me from wanting to do anything, I did no sports, I am taking a year off from skiing.  I hope I will go back to it, but for now, I don't feel comfortable even thinking about it.

I sit at my job all day long and recommendation is to get up more often and walk.  I try that the best I can, of course its never enough, but I try.

I can go on most hikes, but I need poles for walking downhill (my knee is too weak).  6 months after the surgery I hiked Vernon falls in Yosemite.  It was difficult, and my leg swell and turned red and purple, but I did it.  

I still go to PT about once per month.  I am disappointed that they are not doing anything for my knee.  They don't give me much info, I don't know if this is normal or not, I don't know if it will get better or not...  Their answer to all my questions is the same: everybody is different, for some people it gets better and for others it doesn't.  

I had an MRI on my knee to see if there was any damage from the injury.  They didn't find anything.  And it was hard to see due to signal scattering from the metallic dust left from the surgery.  

I hope some of my experiences are aligned with yours.  Id be interested to know what is aligned and what is different.

Hi Zorana,
That's so interesting what your surgeon said about inserting the rod thru your knee vs. below the knee- I never thought to ask about that. Did your surgeon indicate that there are instances where they insert the rod under the knee to avoid affecting the knee area? I made my surgeon x-ray my knee every time I went for a followup, and he's always tell me that my knee was structurally perfect, and any discomfort I was experiencing should be worked out in PT. But, I had the opportunity to choose where I had my surgery- I broke my leg in upstate NY, and a hospital up there wanted to do emergency surgery, but I didn't feel comfortable with that. So that hospital splinted my leg & I returned to NYC to have my surgery done by a doctor from Hospital for Special Surgery, which is one of the best orthopedic hospitals in the country. So if he chose to insert thru the knee, I have to think he had a good reason.

I agree with your knee issue comment- most of my problems have to do with my knee. My first issue was not being able to fully bend my knee- that was resolved thru the PT I started 6 weeks after surgery. I had a physical therapist who visited me at home 1-2x/week, and within 6-8 weeks, we had regained full motion of my knee (i.e., I could fully straighten & bend it). Since we fixed this, I've had no problem doing straight leg lifts.

My second knee issue became apparent after I became full weight bearing- I couldn't control my knee when I walked down stairs. It would 'snap' down, and you could hear the cracking noise my knee made & see my kneecap shift (not to mention that it hurt quite a bit). By that point, I had started going to PT at a chain- one of those places where the actual physical therapist spends 15 mins with you, then hands you off to an assistant to do the rest of your exercises. I had a similar experience as you when I asked them about my knee- they'd write me off or give me some vague answer, then have me go back to doing the same exercises. I wasn't happy with that, so I found a physical therapist who ran his own practice- he immediately identified the issue & a plan of action. He said that my kneecap was moving too far to one side when I bent it while putting weight on it, and that in order to stabilize it, I needed to strengthen a certain smaller muscle that supported the kneecap (I wish I could remember the name of the muscle, but it's towards the inner part of the upper leg- it's not a major muscle like the quad, tho). I went to him 2x/week for about 4 months, and even though going private was significantly more expensive, it was so worth it! These are some of the exercises we did often:

1. Knee extensions: like this ( youtube.com/watch?v=GOnfofJ…)
2. Stepping up & down on an aerobic stepper, mimicking the way you'd go up or down a stair: we did this over & over again, and each time, I worked on controlling my knee so that I didn't make jerky movements.
3. Balancing exercises: we'd do these every single appointment. I'd stand with both feet close together on a thick piece of foam, keep my knees straight, close my eyes, and not hold onto anything. I'd stand like that for 3 minutes. Then, we'd alternate standing on one foot at a time for about 30 seconds at a time (still on that thick foam, with eyes open this time). Balance is something I've noticed I've lost, so this really helped me to start building it up again.

So now, I have little to no issues walking up or down stairs- I don't limp, and I put even pressure on both legs. I do have some pain when I do movements like squats (but not enough to discourage me from doing them), and when I kneel during a workout class, I usually put my towel down for extra support. Not sure how familiar you are with barre classes, but thigh dancing is the one thing I have a lot of trouble with ( youtube.com/watch?v=DOrnWm3…)- it's hard for me to sit back on my knees, and this movement hurts my knee a lot.

I try to do a lot of barre & pilates, because these classes work out the smaller muscles vs. the bigger ones. I also do spin occasionally, but I don't usually stand up on the bike. We have Aqua Cycle here in NYC (basically an underwater spin class)- I try to take a class there once a week, since being in the water with no resistance feels so good on my leg! Since I've focused on barre & pilates more, I've noticed increased strength & balance in my bad leg. I want to get back to running & jumping, and I'd love to ski again, but I've shelved that thought until next winter.

I suppose I'm a bit numb around the screws in my ankle, but I think that's normal. I don't have any bruising, though, and my leg never swells. Have you tried turmeric for the swelling? You can buy it in pill form, or take it in a juice shot...it worked wonders for me in the early days post-surgery, when my swelling was out of control. After long periods of time sitting (or when I wake up in the morning), I also feel stiffness & light discomfort when I start to walk. I have no plans to remove any of the hardware, because so far, I don't think it's the cause of any discomfort.

My biggest takeaway from reading your last post: I hope you find a better physical therapist! Yours isn't addressing your knee issues, and that's not right. The issues you are having with your knee sound similar to the ones I was having, and they can probably be greatly improved with the right treatment program! Once you find a good person, go at least twice a week- and in a few months, I'm sure you won't need a pole for walking downhill on your hikes! Btw, I'm so impressed that you hiked Vernon Falls 6 months after the surgery!

I think I struggle with finding the balance between pushing myself too hard & not at all. I've had to learn what kind of pain is normal & ok (i.e. the knee pain when I do squats- that's almost the new normal, and just because it hurts doesn't mean that it's bad for me) vs. what kind of pain indicates something more serious (for instance, over the last few days I've felt like I have shin splints in my bag leg- I suspect I overdid it with the jumping rope, and now I need to take a time out & ice).

It's so fantastic to be able to compare experiences & learnings with you- I look forward to reading your response and hearing your thoughts!

I’m 5 weeks post op on an rod & 3 screws for a broken tibia and fibula. I broke the bones playing softball (slid into 2nd base and my foot caught under the bag).  I’m an extremely active person, so this injury has been pretty traumatic (both physically and mentally).The first few weeks were just horrible, but every day is progress. I started going to a Physical Therapist week 4 and they focused mainly on knee and foot movements— just trying to bend those stiff joints. I go 3x a week, for 5 weeks. I have an appointment with the surgeon again on week 6 and 1/2, so I’m just trying to stay focused and positive until then. I was told to not put any weight on it until I talk to the surgeon. At this point, I can’t even imagine putting weight on it—-I can’t bend my foot or ankle more than a few centimeters. My foot turns bright purple when it is not elevated. Is this normal?
I’m still taking hydrocodone and Ibuprofen for pain — wondering if 5 weeks is too long for hydrocodone.
I’m so worried about getting back to normal activities. I loved Crossfit, but I can’t imagine doing any of that anytime soon. I just hope I can be active again and not live in fear of this happening again. I’m really glad to hear from people who have been through this because I don’t think anyone understands how painful this is unless they’ve gone through it themselves. Thanks for any positive thoughts you can send. 

Hi all,
I am 7 weeks post op on rod and 8 screws on my fibula. I dislocated my ankle, and had closed broken fibula. after the ER Dr put my ankle back in position. the fibula broken about half distance between the knee and ankle. it was a clean break and non displacement. I feel fine, not much pain. I could even put some weight on it. Two days later, went to Ortho Dr. immediately he said I need surgery. he told me if I don't, he will put me on a full cast to my hip for 6 month (crazy), and he said if not operated I will have arthritis for the rest of my life. I should have gone for other Dr for second opinion. This Dr is no good. BUT long story short. I wake up after the surgery with extreme pain both mental and physical for the first 3 weeks.

for those out there, I totally understand how you feel after the surgery. In my case, I should have studied more before I went in for surgery. With ORIF surgery your still get arthritis as one of side effects. There are so many cases stated that my injury could just heal by its own. So be thankful if you have a good Dr.
   side effect associated with ORIF include:

• bacterial infection, either from the hardware or incision
• bleeding
• blood clot
• allergic reaction to anesthesia
• nerve or blood vessel damage
• tendon or ligament damage
• incomplete or abnormal bone healing
• metal hardware moving out of place
• reduced or lost mobility
• muscle spasms or damage
• arthritis
• tendonitis
• audible popping and snapping
• chronic pain due to hardware
• compartment syndrome, which occurs when there’s increased pressure in the arm or leg

Anyway, what's been done has been done. I am thankful for my health and when I get knocked down, hope and faith keep pushing me forward. I took few steps on my own last night, believe in yourself and human body has incredible healing power.  Everything happen for a reason, it is incredibly humbling when your life changes in an instant.

Thank you David Thompson- I cherish your share on the natural remedies- I will sure to look up those natural minerals and vitamins. I often ask myself a question, how did our ancestors get cure without any surgery?  not saying all surgery is bad. The technologies is amazing now days, but how if its over used?    

For those who has problem swelling

• raise your leg (must)
• Soak your feet in hot water. But!! Only can be soaked after your would is healed. I soak in hot ginger water, and an herb called wormwood grass. This process really helped me.
• Movement, appropriate activities as soon as possible to reduce the swelling of the affected area. Increase your blood flow. Blood to the bones to grow, bones are also formed by blood. Movement as simple as : put a ball on the ground and use your feet to roll it around.
• Ask questions, get second opinions. Trust your body and mind intuition.
• Mentality is very important – be kind to yourself : it’s all experience, everything is the best arrangement. The experience it's a blessing in disguise.
• The current situation is not your final destination.

sincerely,

Su

J Jo- I think it's normal for you to swell when not elevated, my foot & ankle used to swell a lot in the first few months. I was 0% weight bearing for 2 months; when I went back to work after that, I dragged an extra chair over to my desk, put a pillow on it, and kept my leg elevated for probably 80% of the day. Do you ice often? That really helped me, as did taking turmeric, which is a fantastic natural anti-inflammatory esp when taken in pill form. Don't despair tho- you will be able to do Crossfit again in the future! It'll just take some time. I'm 14 months post surgery, and I feel like once I passed the one year mark, some of the things that were still causing me discomfort (like cycling while standing up during spin classes) got drastically easier. Listen to your body & it will tell you when it's ready for certain movements!

Also- I think good physical therapy is key. My biggest learning was that I had to be an advocate for myself when it came to PT- I wrote a bit about my experiences in a prior post, but if you ever feel like your physical therapist isn't answering your questions or addressing persistent issues (esp later on when you are weight bearing & re-learning to walk normally) you should take action! Not all physical therapists are created equal, and sometimes you have to try a few to find one who will actually help you the way you need.

Su Li- it's terrible to hear that you had a bad experience with your doctor...but you seem to have such a fantastic attitude! Be kind to yourself is such good advice, and I really relate to this. We've all experienced very serious injuries & major surgery, and It takes much patience and kindness to learn to not push yourself too hard. 

Moon stones bro, moon stones!

Hi everyone! I broke my tibia and fibula February 15, 2019 when I was skiing. I had the titanium rod put in through the knee, with screws fastened in ankle and near knee. I was just given permission to not use my walking boot last week, but the doctor gave me an ankle brace to use. It is terribly uncomfortable because of swelling and frankly, easier to not use anything at all. When you any of you have gotten out of your boot or cast and started walking again, did you use anything or just go "cold turkey"? I don't really know if the brace is just to protect me and is it bad NOT to use one. I can't get the doctor to return my call so I thought I would check online and find someone who also has gone through this. Thank you!

Hi Zorana,
I was hit by a car (a hit-and-run) on November 19, 2018 here in the Toronto area, and sustained basically the same thing as you, plus a deep bloody wound that went to, or near, the bone.
I've had two surgeries, as the first was a mistake in the decision 'not' to insert the metal rod. The orthopaedic surgeon (plus a plastic surgeon helping to repair the wound) decided from X-rays that the tibia might heal on it's own. The orthapedic surgeon had already put a plate and screws on the fibula. Because of infection, I was in the hospital for three months, which was also to monitor how things were going (it was a complicated injury), then physiotherapy for about three weeks.
After that, I continued going to the hospital to check up on how things were going, but there still seemed signs of possible infection, so was finally sent to another hospital in Toronto for surgery with a much respected surgeon, just this past May 10th, 2019.  The surgeons at the former hospital (along with an infection specialist), felt I should get the rod inserted after all, as well as a P.I.C.C. line ('periphery inserted catheter'), inserted into the arm, attached to a little box which injects powerful antibiotics close to the heart in order to try to get rid of infection.
Anyway, I have about four and a half weeks left (using the PICC line), before they can finally unhook it. It remains something I have to cart around in a little shoulder pouch, until then. In the meantime- during the past 5 or 6 months, I was doing physiotherapy, and doing not bad for what I was permitted to do. Since there seemed to be little bone growth in the tibia, I was very restricted as to how much weight gain I could put on my leg. Even though the orthapedic surgeon eventually said I could put 50 lbs. of weight (then later 75 lbs.), on it, it was difficult to tell how the hell much weight I was actually putting on it! For all I know, I may have put too much weight on it, and disturbed and disrupted whatever little bone growth there was!
During the pre operative meeting with the specialist at the new hospital, he looked at an X-ray, and asked something like, "Why did he put the clamp on there!?", referring to he original orthapedic surgeon's clamp and screws applied to the fibula. I can only guess that perhaps it healed so nicely, that he didn't know it had been broken originally, or that he may have thought it was in a very good position to heal on it's own. Perhaps he wondered why the rod was not bothered with in the tibia instead.
So anyway, about a week and a half ago I had that second surgery, and the rod was inserted (which apparently should have been done in the first place!), the clamp and screws were removed from the fibula, some sort of synthetic bone material- maybe in the form of a paste something- was pressed between the broken parts of the tibia to help stimulate bone growth, and an 'irrigation' done, which I guess means a good cleaning, especially around the bones. Also, surprisingly, I recall him saying that the rod was inserted from around (or just above), the ankle to the knee, instead of the other way around.
So, how is it going after all that? Well, I don't feel so bad. There is still much swelling after surgery, done only a week and a half ago, but I do sit in front of the computer much more than I should! But already I have a pretty good feeling about the agility of my lower leg, ankle mobility, etc., and I can't help but think that's very much due to the fairly intense physiotherapy I did all those months 'before' the recent, second surgery.
I'm probably much older than yourself (and everyone else on this page), and not much into anything 'athletic', other than pushups, a few stretches, riding my mountain bike a bit, and lots of walking- all of which are put on hold for awhile, the point being that everyone younger likely has a good chance of good recovery, which is usually the case regarding age. Also, it's also good to bare in mind that, even if none of us had experienced these similar (or near identical) injuries, that we might tend to forget that it can be naturally painful in the knees to squat for awhile; legs can feel stiff and even sometimes sore when waking, or getting up at night; legs can feel sore after sitting in front of a computer or watching TV for a long time, feet and legs can ache after long walks and hikes, along with many other typical aches and pains we may have forgotten about 'before' these injuries. So, in other words, it probably doesn't hurt to keep in mind that some ongoing pain (which we might attribute to the injury), may actually be natural, and not necessarily related to the injury, but that's the first thing that to comes to mind, nevertheless!
Finally, looking at your X-rays, I was quite surprised that it appears they didn't clamp the fibula! I'm guessing that (like the surgeons who operated on me at first), that they thought it would heal on it's own? In my case, it was the opposite- the tibia being the one they thought would be fine, healing on it's own. Anyway, I had noticed someone said you would have issues all you life. I'm not so sure about that. My physiotherapist broke his tibia and fibula years ago, playing soccer somehow, and he's fully recovered, still has the plate on his fibula, but runs, does various sports activities, etc. You may have arthritic pains sometimes when it rains, and the like, but a lot of people have that sort of stuff- injury or no injury, including younger people. Also, most (if not all) numbness will likely go away, but it takes time.
Lastly, I've always wanted to try skiing, but after all the posts I've seen (here and several other places, along with talking to people regarding broken tibia and fibula), I just might pass! In the end, like everyone else says, keep up the physiotherapy- you'll be so glad you did, even if it still takes a while! And any scars are the last thing to worry about- they'll be barely noticeable in time!