hello, im 14 years old and i fractured my Tibia whilst playing Rugby. The pain has gone its just slightly achey. I'm going on a family holiday in just over 8 weeks and im wondering if the cast will be off by then or if i can fly with a full length cast. i have been resting non stop since the incident also i have been taking calcium tablets twice a day. just wondering if there is any tips for a speedy recovery? i fractured my tibia 20/5/11 today is 29/5/11 22:25
You do have youth on your side. In terms of bone healing, you just need to need to eat a balanced diet, with some extra protein. Consuming more milk, calcium, or vitamin D than the recommended daily requirement, though it won't hurt you, it will not help speed up the healing process. By ten days, the fracture may have enough healing to be "sticky". As you have found out, when the bone ends aren't moving around, they hurt less.
In general, tibial and fibular shaft fractures, in the pediatric population, are treated with a long leg cast, with the knee bent at around 30 degrees, for about 2 weeks or so. The reason for the long leg cast is to prevent rotation (and angulation) at the fracture site. Once there is radiological evidence of callus formation (bone healing), some surgeons will go to a straight long leg cast and allow weight bearing. Then, around 4 weeks or so, depending upon healing, the long leg cast can be changed to a short leg walking cast or a fracture brace (if the patient is reliable). Shaft fractures of the tibia and fibula (tib-fib fracture) are usually healed enough by 6 to 8 weeks to get out of the cast completely.
In terms of helping the fracture heal, by changing to a weight bearing cast, the stress across the fracture site that is produced, actually helps the fracture heal faster (called Wolff's Law).
Of course, don't expect to start playing rugby as soon as the cast comes off. Your gastrocnemius muscle (as well as other muscles in that leg) will have atrophied from not using them. Your calf may look really small. The ankle will be stiff. So, you are going to have to work on rehab to get back into playing shape.
As to flying with a cast on, it depends upon the airline. You should check now as to their policy. In general, during the first 2 or 3 weeks after a fracture (acute stage), most airlines will not allow a person to fly with a cast on. Or, if they do allow it, the cast has to be bivalved (the plaster[fiberglass] is cut down both sides, spread just a little, felt is placed in the saw cuts, and then it is overwrapped with ace wraps). This is done, so that if the leg starts to swell from the pressure changes (and having to sit with the leg hanging down, unless you can fly first class), and a problem with circulation ensues, the cast can be removed (or at least half of it). The airlines don't carry cast saws.
After the first 2 weeks, the airlines still prefer for the cast to be bivalved. However, if it is late in the process, sometimes the airline will take a letter from the orthopedic surgeon saying it is okay. But, again, every airline has its own policies. So, call them now to find out.