Compound fracture of tibia and fibula recovery

I didn't have a second surgery, but my rod was not fixed on both ends with screws.

For bone growth to occur, the bone ends need to impact each other with some varying stress.

   https://en.wikipedia.org/wiki/Wolff%27s_law

It seems like if the rod is fixed on both ends, the bones stay in fixed position,

instead of being able to make this repeated contact.

Your situation sounds frustrating.  It seems like a new surgery is needed.

Read up and get an explanation from your doctor that you agree with.

P.S. A couple of my friends have had second surgeries, but because of staph infections.

(You don't want that).

http://www.stephabegg.com/home/tripreports/recovery

You should definitely get a second opinion. Look into artificial bone grafts and bone growth stimulation.

Mike S wrote:

You should definitely get a second opinion. Look into artificial bone grafts and bone growth stimulation.

I agree a second opinion is needed. I do have a bone stimulator that I use once per day as well. Thanks for your reply! 

Almost three years ago I fell on ice and when I lifted my leg up, it just dangled to the right. I took out both my tibia and fibula really good and also have various other fractures down into my ankle. 

Went to the ER, was admitted and had them set my leg as much as they could at that time because I had to wait for surgery until morning.  Felt the entirety of that whole situation because the morphine they had given me on the way there wasn’t strong enough and whatever other drug they said they administered to put me into a “twilight” state so I wouldn’t feel them setting it, did not work at all..... I got the good pain meds immediately after that lol. 

My breaks look similar to a lot of the ones I’ve see here. 

Morning comes, I have my surgery they do an Open Reduction and Internal fixation. Titanium rod was inserted in below my knee and runs the length of my tibia to my ankle. Screws were placed down by my ankle and also up by my knee. I was stapled the fuck up and shipped out to recovery. 

Stayed 2 more nights in hospital, remember very little of it as I was on so many pain meds I basically just slept. When I went home, I remember how painful and uncomfortable I felt all of the time. I was given really good pain meds, thankfully, that knocked me out for hours. I actually fell on my leg a few times during my recover. Two of the times were within two weeks of the surgery where I just had bandages on and not yet a cast... I’m terrible. 

Anyway, I went back in two weeks after for surgical follow up. They removed my bandages, cleaned things up a bit and then removed the staples which is when I noticed that I had absolutely no surface feeling on my knee. Completely gone. I asked about that, surgeon said it could wasn’t uncommon and that I’d likely start to regain feeling over time. And we moved on. 

Fast forward to about 3 months after surgery and recovery is going well. I’m walking, I don’t have a limp, I’m slowly regaining muscle, I think I was completely off crutches and only had to wear my boot if I was going to be any place where I’d have to walk a lot or if I had a higher risk of falling or what not. Anyway, still no surface feeling on my knee and then i went to get onto my knee to kneel down and OH MY GOD NO. The pain that I can feel on my knee internally is enough to make you vomit. It not only hurt but it felt unnatural. 

I had to go see my Surgeon again because that had to be addressed. I didn’t injure my knee when I fell. I had no fractures, no tears, no bruising, nothing. I told him what was going on and was informed that it was likely nerve damage that happened when I was sliced open on my knee. There is a group of nerves that live over top of your knee, they kind of cross over the top, and he said he had to cut them to get access to my leg to insert the rod. That most likely, I am just going to have to learn to live with some pain.

Well, while I am not happy about that, at all. I’d rather he had just made a bigger scar anywhere else than have my nerves severed to allow for a smaller incision. I will never be able to feel touch on top of my knee, and I will never be able to kneel down on my knee in any manner, for the rest of my life without experiencing an immense amount of pain. I didn’t realize how often I actually did kneel down on my right knee until I could no longer do it. Did any of you ever have this issue/still have this issue?

Also, what are your thoughts on removal of the rod and screws? Has anyone? Does it grant relief? Because I do have pain related to those things being in there, and if there is hope for relief with removal I want to do that!

No numbness in knee. It could happen when next surgery happens.  We are still awaiting a surgery date due to Covid-19 the hospital's around here are kinda full.  We are now 9 months into the break.  Loosing hope since we can't get a surgery date anytime soon.  Hope you get better and the feeling comes back in your knee. I cannot kneel down and put any pressure on knee cap without terrible pain. I have read on other sites some people have the hardware taken out after a few years because the break is healed. Not sure if that would be an option for you! Have a great day. 

Hi, 

I’m at a loss as to what the next steps are. I had the accident on the 14th March 2020. I broke my tibia, fibia and ankle. The tibia came out of my skin (compound). I had the surgery the next morning: a week in hospital and then home. 2 weeks after I had my Telehealth catchup with my surgeon (due to Covid). At this check it came out that they had forgotten to given me clexane (blood thinning injections to take home). 2 days later in a Telehealth with my gp. She flagged my leg (colour and huge swelling). Went straight away for emergency ultrasound. I was riddled with blood clots. Fast forward 4 more weeks I now had to big clots measuring around 15 / 20cm in the injured leg. I started rehab 3 days a week at around the 7 week mark post op. It was a combination of hydro pool and gym / physio. No one would get in to my leg due to clots. The swelling was painful. 5 months post op I finished at rehab and started a private physio. I’ve had around 7 ultrasounds since they discovered the clots. I’m in physio 2 x a week. He’s helped with the swelling and fluid etc. I’m on a reformer machine with him also. I’m writing as I’m still stiff, my knee bends but not without discomfort, my ankle swells up every day. It’s my right leg that I broke and all up the inside of my leg is sore I feel a constant pulling and aching. The back of my knee is so tight. I have no strength to just walk up the stairs it’s like my leg is a bit floppy and not really doing what I want it to do. My physio suspects a tear but what I describe above is what I’ve had from the beginning. It hadn’t really changed. I’m still on blood thinning tablets not injections anymore. My physio maintains my case was one of miss management due to Covid but I’m not interested I just want to be able to walk better and not feel pain. Please anyone have any suggestions on how I can move this along. I’m active, walks daily (unfortunately I often need a crutch), bike at the gym (when it’s open), swimming at the hydro pool or ocean. I’m in Australia so weather is on my side. Thankyou 

I had a distal tib fib open fracture (my tibia through lower medial leg) in 6/2018. I was stepping down step when my ankle turned and the torque snapped both bones. I had surgery that day (ORIF plates and screws). I was in Austria on vacation :( . I was NWB (non-weight bearing) for 2 months. For first 3-4 weeks, throbbing pain just lowering the leg down. As soon as my stitches were out and incisions healed, I got into the pool and walked and swam and did toe stands and ROM exercises. I did them for hours every day because i was home on medical leave and needed to get back to work. 2 months later i returned to full duty.  Had swelling of lower leg most days. Pain at top tibia screw with every dorsiflextion of foot. Numbness and pain over the surgical scar on medial tib. 

Got back to walking but really uncomfortable to run after year of recovery. Tib plate never stopped hurting...like nerve got hung up in screw. Second surgery to remove hardware resolved that. Now only have some nervy pain over medial distal tib where bone exited.

I can run again but it hurts a little. I skied this spring without any problem. No daily significant pain.  Despite NWB orders, I walked in pool about 3-4 weeks postop. I think those hours in pool helped a lot. It definitely hurt doing the exercises but every week was better.  Bearing weight helped increase bone deposition and I know I healed faster than if NWB. 

This thread is a bit old, but I just went through this surgery about 6 days ago. I got a spiral fracture through part of my tibia while snowboarding on the 16th. Ended up twisting my right leg till the bone snapped. Fibula is fine and my knee is also fine, which confused the doctor. I had a splint put on at the ski resort and my friend drove me home. Immediately went to the ER and they scheduled surgery for a rod to be put in my bone for the next day. Surgery happened and i was put on oxycodone, and ibuprofen. Day one and two i could walk with a crutch with pain levels 4 or 5. I kept my leg raised all the time due to slight swelling and because the doctor said so. Avg pain throughout days 1-2 was about 2-3. Day 3, pain was about 0-2, so silly me decided to stop taking the oxycodone and switch to ibuprofen and tylanol only. Day 3 continued with the same 2-3 pain level and day 4-5 dropped down to a 0-1 pain level surprisingly. By the start of day 5, i could bend my knee up to a 45° angle or so with mild discomfort, lift my leg on its own and put pressure on it from every angle without pain. The only issues i had were the staples were beginning to itch and poke my leg, causing slight pain. Today is the end of day 6 and i havent taken any oxycodone since. Still on tylanol and ibuprofen, rotating every 6 hours so i have some thing every 3 or so, up to recomended dose of course. Day 6 went back a little bit on pain. My semi hard semi soft cast has been slipping since it was put on, pulling on the staples causing itching and a bit of stabby pain.  Nothing major until i try standing up then the staples in the bottom of my leg feel like they're being ripped out almost. Pain level is about a 5-6 for a few seconds till it evens out around a dull 4. Just interesting to me. It sounds like a lot of people on this thread had it much worse than me, but i'm not far into it yet. I'm due to get this cast taken off in 5 days when i have my first checkup. Hopefully it will fix the staple pain. Here are a few xrays. Interested to here any comments!

The fracture goes all the way through, and all the way around in a 'spiral' as the name suggests.

I broke tibia, fibula and ankle while climbing. 4 plates and multiple screws after ORIF. The accident happened on 10/11/20 and ORIF on 10/21. Unfortunately, I developed an infection which required two additional interventions to clean up the infected area, and one additional surgery to do a muscle flap to close the original incision as it was not closing. Now, it's 3 weeks from that last surgery. Having being in a splint for probably 6 weeks until the muscle flap took and the infection was under control, I only started physical activity after 12/14 or 7 weeks after ORIF. I started foot rotations and elevation exercises, on the floor, and kept my leg elevated all other times. This was critical to reduce swelling and avoid clots. 9 weeks after ORIF, I was allowed to start weight bearing at 25 %. I have read a lot on bone healing and it seems critical to put weight to promote bone growth. I walk a lot with crutches and have started walking at the beach on sand as it allows me better "control" of the weight bearing on the injured leg. I also started cycling in the gym, which contrary to my initial fears, is doable and produces no pain. I am still concerned about loading weight on the injured leg but the more I exercise, the better it feels. It increases blood flow and improves sensitivity after all the surgeries. The insensitive areas of the skin are gradually improving and I would say it's the heavy exercising that is doing it. PT is like 30 minutes so I would say it's really up to the individual to really increase the exercise regime. I agree with some of you that swimming is ideal. I had a broken fibula some years ago and I would swim often, improving recovery. Unfortunately, with COVID, it's now an impossible option. 

Friend had a broken tibia fibia fracture. It happened while skiing today and she had to have the immediate surgery, which takes a relatively long time compared to some other complicated orthopedic injuries. Her boot was left on while being X-ray and yes I heard she was in a lot of pain requiring morphine.

I feel awful it happened to her.  My friend’s brother, her boyfriend stayed with her at the hospital, so I will only get partial updates. I think the surgery went successfully and there was optimism that the break would fuse well. She’s relatively young and has good attitude, so I’m hopeful for a speedy recovery, but realistic that it’s probably a year plus.  

I am unclear if the rods are ever removed.

I hope she can ski again someday.

She was a beginner intermediate and it was a low visabilty day with piles powder buildup (not well-formed moguls).  It happened on the first run near the top of the mountain.  My other friends and I had skied down and were not aware it had happened until 15 minutes later.  We assumed a natural separation of a group of five.  By the time we got to the approximate location of her fall again, the patrol had taken her off the mountain. My friend’s brother was with her and stayed again with her for surgery at the hospital.  There was nothing the other three of us could do and we second guessed ourselves the rest of the afternoon while we tried to enjoy skiing a bit more (I hadn’t been in two years and consider myself an advanced lifetime skier).  Again there was nothing we could do at that point, but I would like to be supportive of my friend as she deals with this problem over the next year, hopefully having a 98% recovery by Valentine’s Day next year.

Update: 24 hours later and she is already on crutches.  Maintaining a positive attitude.  Things may not go your way but just keep going.

So glad I found this group! I broke my right tib/fib on 02/12/21 and had surgery to place rod on the 13th. I am not in a cast or walking boot, able to get around with a walker and the pain is improving. My concern is the inability to flex my foot at all. I look at it it and will it to move up and down but there is no movement. I can manually pull it into a flex position but as soon as I let go, it flops forward. Has anyone else experienced this? I will see my surgeon on March 1st and I hope he can provide some reassurance. BTW, I am 66 years old, so I expect my healing journey may take a little longer. I just want to walk and drive again!

Kathy Walker wrote:

So glad I found this group! I broke my right tib/fib on 02/12/21 and had surgery to place rod on the 13th. I am not in a cast or walking boot, able to get around with a walker and the pain is improving. My concern is the inability to flex my foot at all. I look at it it and will it to move up and down but there is no movement. I can manually pull it into a flex position but as soon as I let go, it flops forward. Has anyone else experienced this? I will see my surgeon on March 1st and I hope he can provide some reassurance. BTW, I am 66 years old, so I expect my healing journey may take a little longer. I just want to walk and drive again!

It took me a year to be able to move my big toe. I still have some numbness 5 years later 

Zorana Dicic wrote:

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.
 

Zorana, I was just curious as to how your knee pain is now? I broke my tibia and fibula February 2018. I had surgery with the rod being inserted at the knee down to my ankle with two screws at top and bottom. I was back to mostly full normal activity by late April 2018, with no physical therapy. While I do think I want to have the hardware removed due to some discomfort I have, mostly everything is ok.... 

But not my knee. THE ABSOLUTE worst part is my knee. When I’m walking I’m usually completely fine, I have full motion, I can squat and jump ok. But if I even THINK about putting any pressure on my knee cap it sets me into a panic. I can no longer rest any weight on my knee, it’s excruciating. Which is also quite interesting as it is completely numb to the touch. It REALLY bothers me, and I don’t know that there is any fix for this. I never realized how often I crouched down on my knees until I was no longer able to on my right knee. I had my last follow up with my orthopedic surgeon two months after the initial surgery, I brought up the fact that my knee was numb and he said unfortunately in order to access the bone to insert the rod, they had to make an incision right where a group of nerves crosses over the knee cap and sometimes the feeling comes back and sometimes it doesn’t, but he said that usually if there is no feeling within 6 months It is most likely permanent. Unfortunately I had not yet attempted to crouch onto my knee and bear weight so I had no idea what pain I was about to experience in order to address that with him. But it really, really bothers me. I can deal with all of the other pain. Not this. My husband is an active sleeper and some nights I am on edge at the thought of him accidentally bumping into my knee. I am now always very aware of my surroundings so I can avoid anyone or anything coming near my knee. Which means I’m tense in pretty much any situation I cannot completely control.  

So, I am hoping your knee is fairing better than mine. Maybe then I’d have a glimmer of hope for eventual recovery. But I have a feeling that this is just how it is for me now. One thing my surgeon did enlighten upon me was that “Unfortunately, sometimes there isn’t a fix and you have to live with some pain”  lol I mean, he’s not wrong, but that’s about the last thing I wanted to hear while recovering from a painful break that required painful surgery and adding hardware that my body actively lets me know is unwelcome.

SergioNusi, I also developed an infection. I received IV antibiotics in the ER two days after surgery and I am finishing up 10 days on oral antibiotics today. The infection is still there and skin keeps splitting open so wound is larger than when this began. Discouraging as I don't want to end up back in the ER with an open wound. How long did it take for your infection to clear up?

Zorana Dicic wrote: 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.

How are you doing now?

Thanks for your story I had cancer in 2018 in my right leg they took out my fibia out of my left leg and put in my right leg.

I’m walking and driving still pretty sick I lost 40 lbs

Bob 

Robert Primack wrote:

How are you doing now?

Thanks for your story I had cancer in 2018 in my right leg they took out my fibia out of my left leg and put in my right leg.

I’m walking and driving still pretty sick I lost 40 lbs

Bob 

Hi Bob, so sorry to hear of your situation, how are you coping now?

Hi, from Sunshine a coast Queensland Australia, mid March fell down stairs and compound fracture of both t an f, two different breaks in both bones plus broken ankle.

Surgery, rod inserted plus screws at ankle and knee. Bed rest, no WB for 4 weeks, lot of pain, physically exhausted.. in a moon boot.

6 weeks post op, allowed small amount of weight bearing while in boot and then small web without boot and on crutches.

Pain in knee and ankle, ,wound healed well thankfully no infection . Didn’t want to stay on pain killers but pain in knee particularly can be intense. So take meds morning and night only.

Glad can shower without boot, and can walk a little. Starting Physio/rehab in week.

Been doing foot flexors and leg raises while in bed, trying to get some flexibility. Notice my foot ( broke right leg) on injured leg swings right out to the right all the time when I lay down. But not easy to turn inward. I look as though I am doing ballet position. Hope rehab will improve this.

Am a very fit 70 year old, but recognise with age bones heal slower, can’t wait to get back in the pool.

You know my biggest complaint other than pain is tiredness. I am a Psychologist with a Private Practice so have been doing some sessions Telehealth, but get pretty tired.

Best wishes to everyone.  Cheers Linda

Alright. Been a solid 5 months since I broke my tibia. I have a post in this thread up higher describing it a bit more in detail. It was a spiral fracture needing a titanium rod and 3 screws immediately. I had surgery the next day and that was January 17 2021. I did about all the physical therapy they told me to do until about midway into april where I got lazy. I was beginning to walk properly and kinda slipped my mind one day, and from then I had forgotten about it. I stopped going to my weekly therapy appointments about 2 or 3 weeks ago and I'm walking basically good as usual. I still don't have much feeling in my toe and knee after surgery, and the cut they did directly over the break feels really weird still. I have a small amount of pain, or pretty sore I suppose, when I take a proper full step, stretching out my shin muscle. My muscle definition has returned pretty much, although I weigh probably 15-20 pounds more than before. I haven't tried walking long distance, but I can walk around the block without issue, and I haven't had problems at stores. I've gotten to a mild jog occasionally with work, and it was a bit sore. I'm pretty sure I shouldn't have skipped out on PT so early, but I'm glad to not have to do the exercises anymore. I suppose there's a chance this could leave lasting problems, but I haven't had any issues since.

I just experienced the same thing. They put a rod from knee to ankle. I had 3 operations and just got home from hospital. They only advice i have is stay positive, Eliminate stress.