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Broken tib/fib from felling mishap

Started by so il logger, June 02, 2015, 01:45:47 AM

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so il logger

Well, a little over a month ago I got my lower right leg broken. It was pretty tore up as far as the bones go, the bigger of the two had a 3 inch or so section that was shattered. I got sent to a great hospital in st. louis and they done surgery on it. I recieved a rod and 4 screws, no cast or anything. As of now I am walking with somewhat of a limp, not complaining at all just glad to be walking ;D I am just curious if anyone else has had this type of injury? And if so how long before I can walk normal and without pain in my ankle? I understand everyone heals differently and so far I haven't had to take the pain med's for a couple weeks at least. I hope it isn't a 6 month healing process is all :)

oros35

 I broke my leg skiing January 23rd, sounds like a similar break to yours, mine may be a little bit worse. 

Big plate and about 25 screws.  Got put back together in Buffalo NY.

I was non weight bearing for 2 months, then partial weight bearing for 1 month.  Did PT for 2 months during that time. 
Went back to work with no written restrictions, but knowing that I was going to be working a desk job.  I still was walking about 1-2 miles per day on pavement. 

Now for the bad part....  After 6 weeks I went back.  It hurt like hell from the day I started walking on it but every day was a little better for about a month, then something changed and it hurt real bad again.  I muscled through it for another week or so till my Dr appointment.  Probably a bad idea. 

Found out that things were moving around and I broke several of the screws.  Basic explanation is the bone is softer than the plate which allowed some micro movement, bending the screws back and forth slightly (like bending a wire back and forth every step).  Eventually the screws break. 

So here I sit, with an aircast (boot), on crutches for the next month.  (**I'm going completely insane***)  Appears if all is good after the next appointment (fingers crossed but don't really have a whole lot of confidence) I will be back to walking, 5 1/2 months or so. 

My Dr yelled at me and said any pain is not good.  If you are hurting like I was, go see your Dr.  There may be problems like I had.  Or if your lucky it's normal and shouldn't last too long. 



 
 

  

Magicman

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so il logger

X2 Man that looks bad! I have no plate, so hopefully I don't have that going on, finger's crossed

doctorb

My, my. 

these are two different injuries treated two different ways.  so il logger's fracture is probably in the middle of his leg, away from the knee and the ankle.  A rod / nail placed down the central canal of the bone lines thing up well, and interlocking screws are inserted above and below the fracture to control the length and rotation of the leg.  Simple, elegant.  Doesn't disturb the healing at the fracture site because it's all done with x ray and no incision at the fracture.

orso's injuy comes close to his ankle, so the rod doesn't stabilize that well.  Hence, the plate and screws.

The rods starts weight bearing much earlier than the plate.  With the rod, it still takes 4-6 months for NFL players to run.  With the plate, non-weight-bearing is the rule for a minimum of 6 weeks, sometimes as long as 12.  Concentrate on motion of the ankle during your time away from walking normally.

Orso. Sounds to me like you were weight bearing a little too early.  Those screws are like bending a coat hanger.  If you stress them enough times, they will fail.  It's not that the bone is soft.  It's because the bone is not healed enough to absorb some of the forces you put through the leg with walking, so that stress was taken up by the screws.  Hence, they failed.  I couldn't quite tell.....di you have a reoperation after the screws failed?
My father once said, "This is my son who wanted to grow up and become a doctor.  So far, he's only become a doctor."

so il logger

Thank you doctorb, you hit the nail on the head on the procedure :) I am walking fine with running shoes, can't wear work boot's yet. My ankle is the only thing that hurt's after walking too much, but that surely has to be normal.

oros35

The pictures I put up before are at the 2 and 3 month mark.  Before the screws broke.

I didn't have any additional surgery.  Dr said to stay off of it for a month and re-evaluate.  He said the bone could harden up enough that more surgery might not be required.  Obviously anytime you can avoid surgery that would be the preferred way. 

I don't have a whole lot of confidence that I will be good to go in a month though. 

I've done everything the Dr said to do the whole time.  Didn't cheat.  Still some things you just can't tell from an x-ray.  Dr said the bone healed very quick and looked great on the 3 month x-ray.  But guess it wasn't quite enough (doesn't help that I'm a bigger guy and generally very active, walking 1-2 miles a day for me was taking it easy)

Here is the most current picture (taken off a computer screen so not the best quality)  You can see a few of the broken screws and how things moved down some.


  

so il logger

Man that suck's, I'm sorry to hear about that. And they say that them broken screws can just stay in there? That looks to me like something that would be painful forever, im no dr though  :D I have the option to get my rod taken back out later on, but i'm not sure if I want to

clww

Quote from: Magicman on June 02, 2015, 12:53:35 PM
Oh my, now my legs hurts.   :o
Makes my stomach do back-flips!  smiley_dizzy
Many Stihl Saws-16"-60"
"Go Ask The Other Master Chief"
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doctorb

Yes, the broken screws can remain, as long as the fracture heals.  You have very few pain fibers on the insides of your bones.  The outer covering of the bones, however, is very well innervated and sensitive.  So the painful issue here is whether your bone heals or not.  Most people with a nonunion of the tibia do not just "grin and bear it".  Most are reoperated upon.  I do a lot of that sort of thing.

While failure of the hardware often signals the need for revision surgery, sometimes the change in fracture position associated with screw breakage stimulate some healing that was not evident prior to the screw failure.  Many times, however, more surgery is necessary.
My father once said, "This is my son who wanted to grow up and become a doctor.  So far, he's only become a doctor."

Busy Beaver Lumber

Boy that is painful just looking at the pictures alone. Wish you a speedy and full recovery oros35
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so il logger

Doctorb I am just wondering how long I should expect to have a fever so to say in my hurt leg? Is that normal? If need be I can have my wife, jessica figure out how to get my x-rays on here. I got a cd from the hospital. I am walking, but with pain and a limp, is that normal as well? I am not normally one to complain but I am kinda worried that something is wrong. I need to be back working somewhat soon and as of now i do good to just get by with daily walking. I am not heavy only 180 lbs if that matters

doctorb

From re-reading your initial post, you were probably injured in mid-to-late April, about 6 weeks ago.  Certainly, you leg should still feel warm.  Using those muscles to walk on a fresh fracture increases that.  At 6 weeks, it's normal to not be walking normally.  You do need an xray in follow-up to make sure you haven't broken a screw or loosened one.  But your discomfort does not surprise me, especially if you're getting around a lot, although poorly, now. 

Rushing back to work is not a great idea a couple of months after this injury.  You are not supposed to be able to carry on normally by now, and you sound disappointed that your expectations haven't been met.  My advice is to slow down, if you can.
My father once said, "This is my son who wanted to grow up and become a doctor.  So far, he's only become a doctor."

so il logger

Thank's for the reply doc  :) I have a follow up tommorow to get x-rays and see how thing's look. I have been up and walking a good amount, I will take your advice and slow down. Thank's again, I will post the result's of my appointment

so il logger

I got the phone call today from my doctor, all looked well on the x ray. The bones are calcifying? Or so she said, she re-assured it was a good thing.  :) And the screw's looked good, Doctorb should I consider getting this hardware removed later on? Or just leave it be? My doctor would not say one way or the other, just said it may be years before that  ???

oros35

Good to hear!

I have screws in my other leg from about 14 years ago.  I was told leave them unless they bother me. No issues yet.

doctorb

OK, a little advice here.

That hardware failed for a reason....the bone had not healed and the screws were taking all stress applied to the leg.  Now, as I said before, the fracture can heal as more forces will be applied to the fracture in its new position.  But that is definitely not always the case.  Seeing some fracture callus (healing cloudiness around the fracture site) is good, but it does not assure healing.  I would suggest taking extra views of this limb next visit.  Let me explain. 

The standard views are called 1) AP (anterior to posterior) and are taken from front to back on the leg, and 2) lateral (side to side).  Unfortunately, fractures often are not in one of these two planes and can be missed.  Hold your hands, palms together, and about 1/2 inch apart.  On the direct lateral view, the space between your hands is evident and would show up on X-ray if one were taken with your hands in that position.  Now, keeping the palms parallel and maintaining the space between them, rotate your hands.  Now you see more of the back of one hand and no longer can see the space in between the two.  This is the problem with X-rays.  They look at three dimensional problems with only two dimensional analysis.  This is how persistent non healing fractures can be missed.

So I would ask your doc to perform internal and external oblique X-rays on your next visit.  One of these views will be closer to the plane of your fracture and may give both of you a better idea as to how the healing is going.
My father once said, "This is my son who wanted to grow up and become a doctor.  So far, he's only become a doctor."

oros35

Thanks for the advice!

My next appointment is June 23rd.  I never talk to my Dr before the x-rays.  I'm guessing he puts in my chart what views he wants.  I will ask the x-ray tech and see.  And discuss it with my Dr.  I trust him, plus there are usually 2-3 dr's that review my info and discuss it, with my Dr being the senior one making the calls. 

I'm not putting weight on it, but this aircast puts alot of twists and pressures on it.  Dang thing gets caught on everything feels like a ton hanging off my leg.
My leg has a slight pain occasionally, but kinda more of an itchy weird feeling.  And not always in the same places, mostly much higher than the broken screws. 
I sure hope it's healing cause the mental part feeling great but not walking is really wearing on me and my wife.  I'm pretty well useless on crutches. 


Autocar

I cut my left leg off just below the knee and they lined everything up and I had two eight inch rods screwed into my leg bone below the cut and then two more up above the cut the same length, with two 3/8 inch rods connecting them togather long wise. It happened in March and I never walked on it till the second week of September. No problem starting up walking but later in years I had a limb break the same leg splitting the leg bone lone wise plus crushed the knee. Not sure anymore how long I was laid up on that one but remember I had a heck of a time walking again. Ya gotta love logging  :D.
Bill

thechknhwk

Man, I hope you guys heal up well and as quickly as possible.

oros35

Went to the Dr yesterday.  Good news.  Dr says healing is evident on the x-rays, just slow. 
Wants me to start putting weight on is as tolerated.  Said I need to be my guide here, if it hurts back off, if it feels good keep going.  Try to transition out of the boot and off of crutches, Do as much as I can without causing it to hurt too much. 

So far it does hurt a little.  But nothing like it did before.  I'm staying on the side of caution. 

Feels good to have both feet on the ground again!



 


 

clww

Many Stihl Saws-16"-60"
"Go Ask The Other Master Chief"
18-Wheeler Driver

doctorb

Lots of callus on those xrays on the medial side of your tibia.  A good sign!
My father once said, "This is my son who wanted to grow up and become a doctor.  So far, he's only become a doctor."

Magicman

 :o  I understand that it is good, but those Xrays make me cringe.
Knothole Sawmill, LLC     '98 Wood-Mizer LT40SuperHydraulic   WM Million BF Club Member   WM Pro Sawyer Network

It's Weird being the Same Age as Old People

Never allow your "need" to make money to exceed your "desire" to provide quality service.....The Magicman

doctorb

My father once said, "This is my son who wanted to grow up and become a doctor.  So far, he's only become a doctor."

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