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Recovery time for broken Tibia and Fibula ? (Page 1)

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Im 18 years old. Good health and very atheletic. I broke my Tibia and Fibula playing ball hockey. Its a clean break right through both bones in the middle of my right shin. I was in a full leg cast for 5 weeks and I've been wearing a walking brace for the past 2 months. I recently was told I no longer need to wear the brace around my house, but should continue to wear it at work and at school. Its been just over three months since the incident. I want to join the military asap, but I need to wait for my leg to be ready for boot camp (climbing, jumping and running). I would really like to know how much longer it will take to be 100%. Thanks
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First Helper shericabral
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replied September 10th, 2009
Reply:
Hi Mark

Usually it takes 12 weeks. But depending on the person it may vary. But my honest suggestion is wait for at least 4 month. Don't do x-ray of your leg too often. after 4 month do the x-ray and you will be sure about the cure by your own.

Do exercise regularly.

My best wishes for you.

Rupak
India
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replied March 27th, 2011
Hey,
I received a spiral fracture about 3 inches above my ankle on the tibula about 3 inches long as well on Jan 30/2011.
Full leg cast Feb 1, below knee cast Mar 3, Air boot Mar 24.
Today Mar 27 my Leg feels good, ankle and knee are swollen, stiff and ugly looking. They all hurt to walk with crutches. I am applying ice,taking aleeve and stretching it out, EVERY COUPLE OF DAYS IS AN IMPROVEMENT. Aiming to be walking with out crutches by April 15...
I am a 50 year old very active male( was) playing hockey is actually how it happened.. this much I know at me age and any age "use it or loose it" is the motto to follow.. I fully intend on getting right back to life however long it takes, laugh, love and enjoy all you have.. these are the good days my friends.. live them to the best of your ability...
Happy healing to all!!
tom
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replied April 26th, 2011
Brokeb Fib and Tib
hi,
I broke my Fib and Tib on Dec 17, 2011, playing hockey. Had surger on Dec 20, 2011. now i have plate, many screws and 23 staples. I was given clearance to put 50% weight on it after 12 weeks, and full weight 2 weeks after that. It been over 4 months now and i am walking without crutches and/or a cane.

I am 51 and want to return to playinf hockey again. First thing i asked doctor before surgery was " when could I skate again?" He said i should be able to return but screws could be a problem. He said i could have them removed. walking has taken longer then i expected, but acording to Phsyio i am progressing well.

Does anyone have an info on removing plates and screws and what to expect to returning to playing again. I dont play competive anymore.

thanks Albert
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replied January 26th, 2012
leg bone not aligned properly
omg, i broke my leg on DEcember the 17th too Sad the Dr put me in a bootcast, then two weeks after that another doctor in the same clonic told me to take pain killers and walk on it in addition to removing the boot when i sleep. Now 6 weeks later, i went back to the clinic for the re-check, the new Xray showed that the bone is healing but it has slipped off line, They had to push the bone to align up correctly and have put me in a cast. I am so miserable! I am a healthy 55 year old women, my bone density is better then the average women of my age, I am an active person this time period is devastating to me and my life. i want my leg and life back so bad!! i go back for re-xray in two weeks, wish me luck!!
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replied March 26th, 2012
I had a spiral tib/ fib and got my plate and screws removed after almost two years. It was the best thing I ever did. I had pain in my leg with the hardware in which disappeared after I had it removed. I had more mobility in my ankle, better muscle tone in the leg and healthier tendons and ligaments, since the hardware was no longer interfering with the bio mechanics of my leg and ankle. It also no longer hurt when it was going to rain. I'd say once the x-ray looks good, take it out. The recovery was a breeze!
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Users who thank Backinaction for this post: jkpap 

replied April 14th, 2012
Thanks for the info. I too feel that the hardware in my ankle is impeding my full recovery/mobility and hope I don't have to wait too long to have plates removed. Would like to know more about removal process/recovery time
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replied June 30th, 2012
Tib/Fib fracture playing hockey
Hi Albert... I saw your post and wanted to reach out. I am 46, April 22 2012 was chasing a puck behind the goalie ad my skate hit a rut/tear in the boards.... Snapped my Tib/Fib in man pieces with shearing fractures. You know he drill, rod inserted in my bone, 3 screws. I am in a lot of pain still 10 weeks out, but been walking with a boot for about 2 weeks now..... Started rehab but concerned about the bottom screws, one is protruding a bit now that the swelling s down..... What is your prognosis regarding your screws? My doc says he's not taking them out anytime soon. I want to gt back on the ice, but fear I may never get back to my hockey gals or even walk withou a limp.... It's bad enough that my leg is totally deformed.
Hope your healing well....drop me a line
Best,
Julie
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replied October 30th, 2012
G'Day All, I am a 38 yr old father in spam unapproved and broke my tib/fib doing martial arts training with my children 6 weeks ago. I have had an IM nail and 4 screws inserted and am healing quite well. I am surprised to read some of these posts and see the huge variation in treatment and recovery times. I have not taken any pain relief for about two weeks now and am starting to weight bear and rehab exercises. I have been told that it will be 3 to 4 months before I return to work. The hardware that I have will have to be in place for at least twelve months but about 50% of patients choose to keep it where it is. Hope that you all heal well and get back to where you were before!
Jimmy
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replied November 11th, 2012
Thank you for posting this. It has really encouraged me. I broke both bones March 29th from a bad fall in the house. Had plates and pins put in. It's been a long journey. I'm walking now but with a limp. I'd really like to get back to a normal life but have no clue when that will be - did you get any help as to how long it would take? Any advise on what type of exercises I should be doing to make my leg stronger and more flexible?
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replied November 11th, 2012
Especially eHealthy
bevchahonyo,

Sorry about your injury.

As to your limp; that can come from from several factors: pain, decreased range of motion, decreased strength, habit, lack of confidence, decreased balance/agiltiy, or a combination of factors.

You have to figure out what is causing the limp and work on that factor or factors.


If it is lack of strength that is causing the limp, you can do just about any activites. Just walking is a great way to rebuild strength in the leg. But, you can also hit the gym and do the usual lower extremity lifts. (As long as your fracture is completely healed.)


It is not uncommon for it to take 12 to 18 months to recover from a tibia fracture. While the bone was healing, your muscles were getting weaker. So, you will have a long road of hard work to get back to your usual level of strength and fitness. Recovery does not "just happen", you have to really hit the gym and work hard to regain motion and strength.

Good luck. Work hard in the gym.
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replied July 8th, 2011
Hello MY name is Rick, i also just had this happen to me june 25th 2011. It a spiral break about 3 inches above my ankle and a higher fibula break as well. I see alot of people had to have plates and screws placed in but i also have a cast put on. I was given the option of a rod down the inside my shin or a cast. I went with the cast. I was in a splint for 2 weeks before just getting my full leg cast today. I was wondering how you were doing right now and if theres any advice you can give me. Ive only been in this a few hours and already cannot take it and almost want to call my dr and have the surgery done. Any more info would be great Thank you
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replied July 9th, 2011
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Ricky,

The treatment of tibia fractures depends upon several factors. It is often said on this forum, that every patient is unique and reacts to treatment differently. Well, the same can be said about fractures. No two tibia fractures are exactly the same.

An orthopedic surgeon has to consider the fracture pattern, in terms of stability, blood supply, location, whether it is open or closed, etc. Then he/she decides what the best treatment options are, considering the risks and benefits of each.

Some tibia fractures will heal very nicely with just a cast or fracture-brace, with minimal interference of the patient's daily activities. In these cases, the risks of surgery outweigh the benefits.

It is also known that certain fracture patterns don't do well with just immobilization, so surgery is usually offered in these cases, without even a trial of immobilization.

When selecting what type of internal fixation to use, it again usually comes down to the pattern and location of the fracture. Plates are usually used in very specific fracture patterns, such as pilon fractures at the ankle or tibial plateau fractures at the knee. Otherwise, an IM nail is usually used, as it is buried in the bone (thus you can't feel it under the skin) and it acts more physiologically than a plate. It has a bending modulus very close to that of bone and it can load-share (rather than load-spare) during healing.


Unfortunately, in the US now days, surgery has become a lot safer than it was just a few years ago, and thus, patients will sometimes opt to have surgery when a cast would do just as well, if not better. If the risk/benefit ratio is the same for surgery and cast treatment, then, if a patient opts for surgery, that's fine. But, I has seen patients demand surgery for reasons like: I don't want to have an uneven tan line, I can't go swimming (you swim with a cast on, you just have to take precautions), I can't change the color of the cast everyday, it doesn't go with any of my clothes, etc, etc.

But, because surgery is so much safer now, almost all adult tibia fractures are treated surgically, if it has any displacement of the fragments at all. (Children's fractures are totally different from adult fractures. And, kids are not small adults, shoot, sometimes, they aren't even human, when it comes to how they react to medicines and treatments.)


Surgery has the benefits as allowing the patient to move the ankle, so it does not become as stiff. The muscles that move the ankle can be exercised, so they do not atrophy as much. The bone can be placed back together with greater acuracy (though exact reduction is not absolutely necessary to obtain a good result). You don't have to deal with a cast.

Risks of surgery include - pain; infection (which may require antibiotics and/or surgery to irradicate it); bleeding (which may require transfusion); damage to structures such as nerves, blood vessels, joints, cartilage; nonunion or malunion of the bone; scarring; failure of the hardware; may still need a cast/brace; and need for further surgery.


So, Ricky, if you are leaning towards having surgery, you need to do it soon. The longer you wait, the harder it usually becomes. By, 3 to 4 weeks, quite a bit of callus has started to form, and thus the bone has started to heal. Then, surgery would have to "take down" (or remove) some of the callus, so the bone ends can be reduced (put back in place) and the internal fixation placed.


Whatever you decide to do, make sure it is based on as much information as you can obtain about your particular fracture. The best person to get this from is your surgeon. He/she has examined you and has access to all of your studies (x-rays, labs, etc). Be sure to ask about the risks and benefits of each proposed treatment option. And what is the expected outcome.

Good luck.
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replied July 9th, 2011
Thank you for the information it really helps. I've been doing some research online and have seen quite a few opinions and knowledge of others in similar situations. I think im going to continue dealing with the cast,yes its terrible but also deal-able. I've seen some go just a month or so before the cast can be cut down, which would be great. Its been 2 weeks as of today and i realized i just need to calm down and relax and accept im stuck in this situation and cannot go back in time and change anything. I now see how mentally this is a huge deal in accepting the situation. I've gone through more emotional disturbance and confusion then i ever have. from loneliness to not being able to do anything on my own, being helpless, and just over all not being in control. Its been hard and i know i just started but coming to peace with everything and trying to carry on. As you see im rambling on now cause im extremely bored and have nothing else to do and a whole lot on my mind lol. I am deciding though to continue with the cast, i understand its going to take time. One of my main concerns is the fact that my leg will have no more muscle on it and i wont be able to walk. i have read that your bones become very stiff and that i will have to learn how to walk again, which kinda scares me and is originally why i wanted to get surgery. Now in my cast i also feel my bone clicking and rubbing when i make moves and was wondering if that is normal. I don't know how my bones will heal if they are still slightly moving? and also is it to soon to start using slight pressure on my leg to help growth? Another concern of mine is that when i was at the Dr's yesterday we did an xray with my original splint on and my bone was still slightly off a little less then a quarter inch,maybe smaller. But then after they put the hard cast on and did another x ray and straightened my foot and bent my knee, it caused it to separate more, not much but was noticeable to both me and the Dr. He said the cast would still be fine and he used a piece of paper to see a straight line on the x ray from a front view and he said it was still in line, and then another from the inside of my right leg which also was still in line. So im hoping this cast will heal it and mend it back together even though it was pressed out just a little more then it was in the splint. Also i feel a lot of pressure from my doctor to do surgery,i don't know if its the money in it for him or what, but he says either way will work but every time i say id like to do the cast he says it will work as it traditionally has, but there is always surgery but he always ads the risk of infection and problems with anesthesia. so i do feel pressured but hoping all is well with the cast, and over time it will work out. well i better stop now but im just venting out im lost right now and feel out of control. Your advice as well as others has been great.Thanks again
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replied July 9th, 2011
Hang in there! It gets better! I broke my tib/fib june 1st. I am getting out and about here an there was I look for an excuse to be out of bed. I had surgery but wasn't really given a choice. I think I did a good number on mine! I sure hope you have a quicker recovery, I am praying I can start walking here in a few weeks but think i might be a little too optimistic!

The pain does get better hang in there...I am occasionally taking meds now and am even just taking tylenol at times! it does get better
Beth
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replied July 30th, 2012
Beth, I read your post and broke both my tibia and fibula while roller skating. I'm 49 and broke my leg on June 3rd. Had surgery on the 12th. Today 7/29 I'm still in my fiberglass cast but it should come off in 10 days. Smoking has definitely slowed my healing time.

Good luck to you I'll have to wear a walking boot for 4-6 weeks! Does anyone know if this is normal? Desperate to get back to my active lifestyle!!
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replied July 30th, 2012
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andriea,

I do not know if Beth will respond to your post. That was her only posting, and it is over a year old.

As to your question, of you having to be in immobilization for another 4 to 6 weeks, and is that normal, the answer is yes, it is quite common.

What type of immobilization, and for how long, is dependent upon the fracture characteristics and how well the surgeon feels the orthopedic fixation is holding the fracture in place (and how well the fracture is healing).

However, in tibial shaft fractures, it is not uncommon for it to take 3 months or more for the bone to unite (low energy frx: 10-13 weeks; high energy frx: 13-20 weeks). So, it is not uncommon for the surgeons to use supplemental support while the fracture is in the process of uniting.

And, you are correct, in that smoking is very detrimental to tissue healing. It can slow the process down significantly and in some cases cause a fracture to go on to a nonunion. So, if you still smoke, this would be a good reason to quit (at least till the fracture is healed).


You will have quite a bit of work ahead of you, once the bones have united. The above time frame is just for the union of the bone, and does not include rehabilitation of the injury. It is not uncommon for it to take many months for a patient to recover from a tibial shaft fracture. In some cases, it may take as much as a year to 18 months for full recovery. That is not to say that you will be laid up for that long, but that it may take that long to know what the final outcome is.

Good luck. Hope you do well.
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replied July 31st, 2012
Broken rib and fib
Gaelick,

Thank you so much for the information! I had a clean break to both bones and was stabilized by a plate and 5 screws. The RX reads : pneumatic short leg walker.
I'm definitely cutting down on the cigarettes down to 3 a day. But I'm also using a bone healing system (ultrasound tx) for 20 min daily.

This is supposed to increase healing rate by 38%.
We will see and I'll keep you posted
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replied July 9th, 2011
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Ricky,

Cast treatment of fractures has been very successful for millenia. It is a true art, and takes a lot of skill. An orthopedic surgeon can't just slap some plaster (fiberglass) on the leg, it has to be applied just right, with proper molding in just the right areas, so that the fracture is properly aligned, using the principles of physics and three-point bending.

You are right in terms of the surgeon making more money with a surgery. He gets a big payment for a short amount of time, whereas with cast treatment, there are several small payments over a long period of time. And it can actually take quite a bit of time to treat a fracture by casting. The surgeon completed residency training, to learn about orthopedics. He went into the field because he likes to do surgery (and the money), so he is, of course, going to want to do surgery if he can (it's fun).

But, anyways. Since surgery has become so much safer in the past few decades, many patients (and doctors) sometimes don't think of it as being as dangerous as it really is. Many patients think, "Oh, I'll just have surgery and I'll be fixed, better than I was before I got injured, and I'll be back to "normal" in a few days". Not likely.

And, you are also correct, in that it takes a lot of dedication on the patient's part, it deal with a cast. In the past, there was no choice other than the cast. But, now, if you don't like the cast, you can always have surgery (up to a point). I know what you are going through. I was in a long leg cast for four months. I lived in a high plains desert, where the average daily high temperature that summer was around 110F. I got really buffed upper extremities from having to use the crutches all the time. My leg was like a pencil, the knee and ankle were really stiff, the skin was very soft (my leg hair was really long too), and I felt really weird without the cast on. It took about another month before I could walk with just a cane. It was about a year, before I got back to where I was doing most of the athletic activities that I had been doing before the cast.


Okay, in treating a fracture with a cast, the ends of the bones may not be reduced exactly (to within a millimeter or so). But, it is not necessary. As long as the overall alignment of the bone is correct, the offset can actually be several millimeters with no problems. An IM nail doesn't reduce a fracture perfectly either, there is always a little "play" and therefore offset.

It is okay for you to feel the bone ends moving a little. There may be a clicking or rubbing sensation. That will decrease as the fracture becomes "sticky". And, the slight motion actually stimulates the body to lay down more callus (healing bone).

In terms of you losing muscle mass while in the cast, that is true. But, you will also lose some muscle mass after surgery. Usually, in the progression of treatment, a long leg cast (LLC) will be left on till the fracture is partial healed, as it appears on x-ray, with a bunch of new bone around the fracture. The LLC is needed so the fracture fragments don't rotate or angulate during the first few weeks of healing. The knee has to be included to be able to do this.

Occasionally, once the fracture has become sticky, and is not likely to displace easily, the cast may be changed to a LLC that is partially weight bearing.

Then, the surgeon usually goes to a cast called a PTB (patellar tendon bearing) cast. Here, the cast is reapplied, but the knee is free to bend. The upper portion of the cast is formed into a triangular configuration, which still helps with rotation. But, it is constructed so that most of the pressure is taken on the front of the upper tibia (where the patellar tendon attaches). Thus, the patient can start to weight bear and move the knee. This helps with the knee joint stiffness and muscle atrophy.

Also, it is a well known fact, that by placing stress across the fracture site, it will stimulate the fracture to heal faster (Wolff's Law). So, weight bearing is a good thing.

You have now gotten to the point in fracutre healing, that most of it is done. It is just a matter of finishing it off. Usually, at this time, the cast is removed and a fracture brace is applied. This can be taken off, so that ROM of the ankle can be started and the muscles can be strengthened, while the body consolidates the fracture callus.

The general steps of bone healing are essentially the same, no matter how the fracture is treated.


As you can see, gettinbg a bone to heal is a lot more complicated than just slapping a cast on, or ramming a rod down inside the bone.


Sorry about the length of the reply, but you had a lot of questions. If there is something I missed, I'll be happy to try to answer it. Also, remember to ask your surgeon about things.

Good luck.
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replied July 11th, 2011
Yes thank you for the advice it really helps.... quick question though..If they say this is the slowest healing long bone in the body because of a lack of blood flow, then why does elevating the leg help? wouldn't there be more blood flow if it wasn't elevated. I mean obviously its not good right now cause if i stand more than 3 minutes my toes go purple and i feel my leg swell. And actually one more thing my cast right around where the break is i can feel a little bit of room in there, is this bad? pretty much what is causing this clicking and rubbing, which i hope goes away soon because i know on next Monday my next visit if i tell my doctor this, i just know hes going to push me towards surgery.
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replied July 13th, 2011
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Ricky,

The clicking is the actual two bone ends moving a little. This is okay. The movement actually helps stimulate the body to lay down more callus, to stop the moving. Some people who have IM nails put down still have a little clicking at the beginning. It will go away very soon.

The cast will get a little loose as the swelling goes down. That is one reason why cast treatment requires a lot closer follow-up than surgery. (And why some surgeons prefer to do surgery, they don't have to see the patient as often.)

The reason for the elevation is to reduce edema in the soft tissues. If the edema gets too massive, it can actually decrease the venous blood return, causing stasis of the blood (toes turn purple). The arterial supply will continue to pump blood, it is the low pressure venous side that gets affected.

The blood supply to the bones comes from two places. The periosteum is a fascial sleeve around the bone, which brings in most of the blood supply. The other is endosteal, where fairly large blood vessels penetrate the bone and run along the inside marrow cavity of the bone. The soft tissue edema can put pressure on the blood vessels, sometimes decreasing the flow to the bones. So, by elevating the leg, you decrease the edema and thus the pressure on the blood vessels.


The surgeon will usually takes some x-rays, and from them, he can tell how well the cast is fitting and if it is holding the bone the way it should be. Sometimes, during the first 4 to 6 weeks, the cast may be changed several times, due to swelling, how the bone is healing, atrophy of the muscles, etc. So, it is okay if the cast is changed, it doesn't mean anything is wrong. Just that the environment around the break has changed, so the cast may need changed.


Good luck. Hope you do well.
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replied July 31st, 2011
Just wanted to give an update, for those in the future who may come across this. Today marks about 5 weeks. I just had my full leg cast cut off 5 days ago. They removed the entire thing and put on a new cast that is now below my knee. I honestly had no trouble moving my knee as soon as the full cast was removed. I would lay on my bed and rest my leg down and bring my knee up to my chest and then back down slowly till straight,i did this here and there during the day and it helped alot. i had a little pain if left in one position to long but after one day i don't feel much stiffness of the knee anymore. My leg is noticeably smaller but not as bad as i thought. So after they placed the new cast on we did xrays, and they showed the bone still out of place. its a spiral break so it comes to a point at both ends and they were moved just a tad bit more out of place once the new cast was on. They had me place my foot on a stand that allowed me to have a 90 degree angle to my ankle. It was slightly painful and im thinking that this was the reason my bones moved a bit. Now i for sure feel new cracking and moving sensation in my bones. Im not sure if this is normal at 5 weeks but im hoping it goes away before my next visit, which is in about 4 weeks. My Dr said from there if we are looking good i can have another cast put on so i can start to apply some weight gradually or we can move to the air boot. I feel some discomfort still and pains here and there mainly right in the morning and sometimes during the day, i also haven't taken meds in about a week so its not to bad. My only concerns still is just the cracking and rubbing of my bones at the break. Now that i no longer have the full cast i feel them more and in different areas depending on how im laying. I was wondering if i should also have my leg elevated at all times, and while im sleeping? Im hoping the cracking goes away so i can accept that my bone is actually healing. Your help has been great and i will continue with updates. Thank You
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replied July 31st, 2011
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Ricky,

Actually, the bones have already started to heal, otherwise, you would still have a lot of pain around the fracture site. And, the micromotion at the fracture site should stimulate bone healing, as the body doesn't like it, and lays down callus to stop the motion.

The fragments being a little off isn't a problem, as long as the overall alignment is okay. Even when an IM nail is used, it is not uncommon for the fragments to be slightly off, especially with spiral fractures.

It's great that you were able to get the knee motion going without any trouble. As for the ankle, it has to be at 90 degrees, or you will develop an Achilles tendon contracture. By getting the ankle up to 90 degrees, you will also be ready to go to a walking cast soon.

Good luck. Hope everything continues to progress well.
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replied September 21st, 2011
Spiral fracture of tibia and fibia
Hi, sorry to bother, but you seem to know a lot. I had a spiral multople fractures to my tibia abd fibia on 2nd august. Had an op on 9 th aug. Have a rod and four screws placed. Just started my physio yesterday. I was made to stand on my feet with my full weight, but without walking. And now i am in agony. I can fill the pain on the fracture area on my fibia. Called my surgeon and he told me not to put more than ten kg. I passed the info to my physiotherapist and he reduced the weight. But i am afraid that the damage is already done. The second x ray pictures taken before my first physio session yesterday did show no improvement since the operation. I am worries...
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replied July 20th, 2011
Hey ricky its a slow process broke my tibia at the ankle joint . Had a plate and 10 screws and put in a cast to the bottom of the knee. That stayed on for 12 weeks, then put into a moonboot had another operation to remove 2 protruding screws. Week 16 allowed to put 50% weight bearing, week 18 75% weight bearing week 20 100% weight bearing. Fantastic l thought but with a inactive ankle for so long learning to walk and weight bear is difficult and painfull. I have pyhsio twice a week and hydrotherapy twice a week and the specialist are saying maybe another few months, regards Gary Aust.
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replied March 3rd, 2012
how do i deal with this mentally
hi my names jason, i was attacked and mugged in spain on 29th jan 2012, the w****R jumped up and down on my leg, breaking the tibia and fibula, i had surgery, while i was awake(epidural) they drilled into my knee, then hammered a very long rod to my anke, im in a full leg cast, and finding it sooooo hard, really clausrtophobic if that makes sense, i feel like im being burried alive, panic attacks everyday, i just want to go back to the way i was, i used to be happy, once upon a time, i hope the fu**er who attacked me gets what he deserves, !**@!.jase
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replied March 4th, 2012
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Jason,

I almost didn't find your post. It is often difficult to find the posts placed in the middle of a long thread. You might want to either place your post at the end or start a whole new thread of your own, so that your message is not overlooked.

Welcome to eHealth. Hope you find some good information.


As to your comment about feeling claustrophobia in the long leg cylindrical cast, don't think that you are alone, or that it is crazy.

It is a known fact in the orthopedic community that patients can become very claustrophobic when placed in a nonremovable, cylindrical cast. Even a small cast around the wrist can cause the feeling.

Some patients go on to full blown panic attacks.

In some cases, patients have required medication for anxiety and panic attacks, if they had to have the cast on.

If it is possible, most of the time, the patient is changed to a removable splint. But, that is determined by the fracture and how it is healing.


So, if you are actually having a very difficult time with the anxiety and panic attacks from being in the cast, speak with your orthopedic surgeon.

You have an intramedullary (IM) nail with interlocking screws in the tibia. With an IM nail in the tibia, unless you have other injuries, or the tibia fracture was just so comminuted that it has absolutely no intrinsic stability, you should be able to go to a short leg cast, or maybe even a fracture brace (sometimes called a fracture boot).

Using a LLC in addition to an IM nail is a little overkill. Often called using both a belt and suspenders, do you really need both?


So, speak with your surgeon to see if you can get out of the LLC and at least down to a SLC, but if possible down to a removable fracture brace.

Now, you may have to remain limited weight bearing for a while, until there is some callus formation around the fracture site, to support the fracture. The IM nail is just holding the bone in adequate alignment. It is not strong enough to take your body weight.

You will have to work with your surgeon on this.


The other option, which is not really ideal, is to go on medication for the treatment of anxiety. This medicine can make your motor skills a little off and when you are in a cast, on crutches, that could lead to several nasty falls. So, surgeons try to stay away from these medicines, unless the patient is basically bed bound.



So, again, speak with your surgeon. This is not a crazy idea. If you surgeon blows you off, talk to someone else. This is a know complication of cast treatment. There was an article in the Journal of Hand Surgery, Am. “Intolerance of short arm cast wear by patients with claustrophobia: case report.” I’m sorry that I could not find the exact volume or year. There are actually several articles like that out there, in several different journals.

But, you yourself can do quite a bit of help for yourself.

Do not sit around the house and have no one over. If you are able to get up and going, even if it is in a wheelchair, get your friends to help, and go and have a good time out on the town. Isolation makes it 100 times worse.

If you cannot go out, then have some of your friends come over to help with your place and invite some more friends for later. Socialization is very important.

Just do not get too over the top and hurt yourself.



So, speak to your surgeon about what options you have. But, don’t let him/her just blow you off. This is a real problem, published in their journals. So, it needs to be dealt with.

Good luck. Hope you find a solution that fits you.
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replied April 28th, 2012
Oh god I am so sorry.....hope you got well?
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replied April 28th, 2012
walking cast with broken Fibular.
wow you are in my shoes.....I feel the exact same way....I am wearing a walking cast now, I try to stay off of it a bit.....been wearing it two weeks now. God I need to get off of it I hate the way it rocks...makes me so unsteady feeling when I walk...I have to hold on to stuff as I walkaround the house! I'm to go see the doc in three weeks, its been two weeks, so I'll see whats is what I have a broken Fibular.....wish me luck!
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replied November 1st, 2011
Tib fib fracture
I broke my tib fib clean through on the lower part of my shin 5 months ago. I was told it would be healed before football season. I still cannot run 100% and missed the whole season because of it. They put a foot long rod down the center on my shin and 2 screws. I had the screw down by my ankle removed and still get very sore. I regularly work out, run, ect And I feelM like I have plateued at 70%. Help me
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replied November 1st, 2011
Especially eHealthy
Matt,

You are barely out of the usualy time to union to tibia fractures.

Time to union;
- low energy frx: 10-13 weeks;
- high energy frx: 13-20 weeks;
- open frx: 16-26 weeks

The above times are just for union, that does not include the time for rehabilitation.


And you have to remember, that you do not injure just the bone, but all of the soft tissues around the fracture site. The periosteum is ripped apart, the muscles pulled away from the bone, and all the other soft tissue in the leg is stretched and twisted at the time of injury. The sharp ends of the fractured bone can cut into the soft tissues like a knife.

All of the soft tissues have to heal and they heal with scar tissue. That scar tissue has to mature, soften, and stretch out. If can sometimes take as much 12 to 18 months for the scar to completely mature.


Rehabilitation is often the hardest and longest part of a healing tibia fracture. It may be that you are expecting a bit too much, a bit too fast.

It sounds like your bone has united well, so that part is partially hehind you. But, the bone will still continue to remodel for several months yet. And the soft tissue is still healing.

You have had the nail dynamized already (removing one screw). So, it in now just a matter of continuing to do more and more sport specific rehabilitation.


In some patients, once the bone and soft tissues have completely healed, but there is still discomfort with activity, which seems to be related to the nail, its removal may help. This is especially true if the bending modulus of the nail is different than that of the patient's bone. Usually the nails (especially the titamium ones) have the same bending modulus of bone, but in some patients their bone is slightly different than that of the nail. And that causes pain with activities, especially those that cause microbending of the tibia.


But, removal of the nail is usually not done for a minimum of 12, preferably 18 months after injury, to make sure the bone has completely healed.

Speak with your surgeon about the continued discomfort. Also remember, it is very common to have plateaus in therapy, and they just have to be worked through. Speak with your therapist about the plateau, to see if he/she has suggestions for training changes.

Good luck.
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replied April 12th, 2012
femur fraction
Hi Gaelic and everyone. My name is Sally and I broke me femur bone in 2 places on 2/2/12 car accident. Had surgery 4 screws and rod. Today is 4/12 and per dr I am only able to put 30% of my weight on my leg. When I am in a position for too long it feels like I am sitting on nerves. I still have pain thru. out the day and night but not as bad as the begin.. My knee is still swollen and tender. I am having lower back/hip pain. My leg feels heavy and stiff. My dr have not recommended pt yet. The dr also left bone fragments in my leg. He said it will desolve on its own but it feels hard. Can you please tell me if this is normal and what time frame would it take to feel normal again? Thanks in advance.
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replied July 10th, 2011
Tib and Fib Break
My daughter (16) just broke her tib and fib on Thursday morning and had surgery Thursday night. We had no option, there was a rod in place and screws. Can't really tell much because its so soon, but she has been up walking with crutches, the pain is off and on, but not as bad as I thought. She sees the surgeon again on Monday for an eval. Good luck! The rod was used to ensure thebone healed straight, he didn't want to take anychances and have to go back in.
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replied July 18th, 2011
Recovering Tib/Fib Soccer Athlete
My son is 18 broke his tib/fib in a soccer game on May 24, 2011. He was the goalie and took a guy one v one. The ER doctors called it a Joe Theismann and the video is similiar. He had surgery on May 26 with a rod and 2 screws placed in. He's been in physical therapy starting his 4th week and sports performance on his 2nd week for core and upper body, and back at the gym 5 days a week for light cardio (bike/core). He is walking on his own not running and was excited to hop on 2 feet the other day. He has a college soccer scholarship for the fall...the doctors and PT have mixed reviews on his return date to the field. We're finding that if he looks back one week at a time he can see his the gains.. The emotions and lack of confidence have been more taxing than the physical rehab. Our problem has been a HUGE pressure sore that developed on his heel that he recieved while sitting in the split for 2 days that hasn't healed. We go in this week to find out if they will do a skin graph.
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replied November 1st, 2011
can you update? My son 16 just had rod put in the tib this weekend from football injury....these articles are scaring me, it sounds like lots of people are experiencing much longer recovery then I anticipated.
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replied November 1st, 2011
Especially eHealthy
Sheri,

If you thought that your son was going to be playing football this month, then yes, it is going to be longer than you expected. Tibia fractures are significant injuries.

Your son has youth on his side. All patients and fractures heal at their own rate and time, though.

But, in general, tibia fractures:

Time to Bony Union;
- low energy frx: 10-13 weeks;
- high energy frx: 13-20 weeks;
- open frx: 16-26 weeks
- type 3B & 3C open frx requires 30 to 50 weeks for consolidation;

- distal tibial fractures may be more prone to non union than proximal fractures due to absence of muscular soft tissue envelope;

- in the report by Anne Skoog et al., the authors studied 64 consecutive patients with a tibial shaft fracture; it showed 12 months after the injury, 44 percent had not regained full function of the injured leg, although all but two of the patients had returned to preinjury working and recreational status;



The above time frames are for bony union, and do not include the time required for rehabilitation of the limb, which will take much longer.

That is not to say thay your son is going to be laid up on the couch for several months. Depending upon how stable the construct of the fracture and hardware is, he will be able to start weight bearing fairly quickly.

Since he is not tied up in a cast, he will have the opportunity to work on knee and ankle range of motion. He will be able to do nonimpact activities quite quickly.

He should always follow the surgeon's instructions closely. The surgeon knows how strong the construct is that is holding the bones together. He/she will tell your son when to start weight bearing and how much.

It is important to do the weight bearing when the surgeon allows it. The stress across the fracture site will help to heal the bone. Bones will respond to the stresses applied to them - Wolff's Law.


So, yes, it is going to take some time for the bone to heal and the muscles and other soft tissues to get back into shape. But, with the IM nail, it is much easier, because stiffness of the joints can be avoided.


Speak with your son's surgeon, if you have specific questions about his care and timeline for progression in therapy.

Don't worry too much. He will get over this and go on with life. Good luck.
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replied November 27th, 2011
Sounds like you did your research. Can anyone give me an idea on the pain level and length of pain and swelling? I know everyone is different but I haven't heard too many people talk about extreme pain for long periods of time and my son had surgery a week ago and is still in such extreme pain and taking (in my opinion) high dose medication. Thank you for your input.
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replied November 27th, 2011
Especially eHealthy
aliciak,

You are correct in everyone's pain tolerance is different, but a patient should not have excruciating pain several days after surgery. The day after the procedure is the worst, and then the pain should steadily decrease. By a week out, most patients are taking narcotic pain medication, once in a while. Usually just before a therapy session or at bed time for sleep.

If your son still is taking the same amount of medicine that he was the day after surgery, his surgeon should be contacted, because he should not be in that amount of pain.

Reasons for the pain have to be explored. Is the dressing too tight, is there an abnormal amount of post-op swelling, etc. Too much activity with the foot hanging down is a big problem at this stage. If a patient is in enough pain to require high doses of narcotic (opioid) medication, he/she should be laying down with the foot elevated above the heart, not out and about with the foot hanging down. It is a little early for an infection to be a problem, but that would still be in the differential. At this stage the usual problem has to do with swelling and tight dressings.


Once all physical reasons for the continued pain have been checked, and everything is okay, then you would have to start looking in to alternative pain management techniques to lessen the dependency on narcotic pain medicine. Some patients get in a routine of taking the medicine and are hesitant to decrease it, fearing that they will be in pain.

But, there are other things that can be done to lessen pain, mainly by distraction. Meditation, listening to music, reading, working on art projects, writing letters/journal, etc all do well for this. Keeping the foot elevated above the heart will reduce swelling and a throbbing type of discomfort.


So, if he is still requiring large and continued doses of opioid pain medication, his surgeon should be contacted. At a week out, most patient are starting to wean down their need for medicine. Thus, physical reasons for the pain have to be ruled out first.

Good luck.
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replied September 16th, 2013
just depends on on him, how bad he wants to recovery
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replied July 18th, 2011
I found this site and found that your situation is a little simular to mine ,and answered a lot of my own questions . I broke my fib. and tib.in 8 places and crushed part of my ankle on May 16 2011 .I had fallen off my transport truck while tarping a load of lumber .I knew as soon as I hit ,that I had broken my left leg but didn't realize the extent . I was taken to a hospital in southern VA were they had done X-Rays ,and that's when I found out the extent . I was then transfered to a great hospital in Winston Salem NC where they put an external fixation on. When I came to after the operation my leg was so swelled that I couldn't even see my knee . I was in that hospital for 4 days . Very good hospital . They told me the reason for the fixtation was to keep to keep my leg and foot in place ,and to help stop my bones from fusing together and that it would be at least a week before they could operate . Now since this was a compensation claim and that I am a Canadian (please don't hold it against me lol) I had to come home , and since my boss had to bring a driver down to get my truck that was fine .
Once home ,it took me almost a week to see a surgeon. Now ,I'm told that he is one of the best in our area ,.I had my surgery on June 03 , and released from the hospital on June 05 . I had a plaster and cloth cast on the 1st 2weeks , then went back for my post op. visit and to have most of the stitches removed and they put a fiberglass cast on .
I went through the same as you Rick , unable to do a whole lot . But I did find ways to do things as time went by because my wife has Fibermyalgia a can't do much . I don't go back to see the surgeon until July 28 . My main concern is the amount of swelling that occures after this much time , even yesterday ,it kept swelling to the point the there was no movement at all in my cast , man , did it ever keep getting tight , and I wasn't doing a whole lot , had to lie down and elevate my leg each time and even took an oxy once to help with the pain .
Also ,I was told NO weight bearing on that leg for 12 to 14 weeks after the surgery , Is that normal .
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replied December 11th, 2011
How are you healing
I am still in the soft cast. Will be going Friday for the hard cast. I already have a hard cast on the right foot. How did your recovery work out? How are you doing?
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replied December 11th, 2011
Especially eHealthy
Laidup,

Welcome to eHealth.

I doubt if bigtruck will respond, the above post was almost 6 months ago, and his one and only posting.

Tib-fib fractures can take quite a while to unite, and the soft tissues recovery is even longer. But, it sounds like you are on your way.

Hope you heal well and your recovery is uneventful.

Good luck.
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replied March 25th, 2012
Tib Fib spiral fracture?
Hey there. Would love to hear how this turned out. I have a fib/tib spiral fracture close to my ankle. The OS thought it would be best casted and not surgically fixed due to the potential for complications with surgery.

Any updates?
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replied March 25th, 2012
Hey there. Would love to hear how this turned out. I have a fib/tib spiral fracture close to my ankle. The OS thought it would be best casted and not surgically fixed due to the potential for complications with surgery.

Any updates?
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replied January 28th, 2013
I recently on December 11,2012 had a motorcycle accident leading to a broken tibia and fibula as well as a broken ankle. In order to fix my tibia I had surgery which put a metal rod down the middle of my tibia. so far it's been 7 weeks and the bones haven't even started healing back together. Doctors tell me it will end up taking 6 months for a full recovery to be able to even walk again. It all depends on the person and the break which will decide how long till you are up and running again. I'm 19 young very healthy in shape don't smoke or drink but it's still taking a long time to heal. Best of luck on the road to recovery and always stay strong Smile

But in most cases 12 weeks is what is needed.
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replied September 26th, 2013
Hello All

I need a bit of reassurance I had a double spiral fracture of tib and fib back (5 breaks in total) in april. I had an IM rod and screws fitted and have been going back to different consultants over the last 6 months. I have been told to be fully weight bearing, non weight bearing and partially weight bearing by 3 consultants. I gave up and just do little often. I have returned to cycling etc. I have been walking without sticks for about 2 months now and this week the Dr has told me that there is little signs of the bone healing and it will be a long slow process. I still get lots of pain and weakness and a very pronounced limp, but other days can feel very strong and walk fairly normally. Is this normal? I was very active fire fighter and medic prior to the accident but now I drive a desk!! and the whole situation is starting to make me depressed. I am 6'2" 240 lbs and have been reduced to tears on many occasions. I dont know how much longer I can continue to keep having to ask others for help. Its usually me people come to. How long before things usually start to look better.
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replied January 25th, 2010
broken leg
i broke my tibia n fibula playing fastball i now have a plate n 6 screws in my leg, i too am very athletic, its been six months since i broke it but not playing any sports. i want to play this summer, will they take out my plates n srews? in some cases they do, but what are the other options why they dont. i try do exercises but i didnt get a cast just a brace. why is that?...ever since i started working on it, its feels funny n tighter n heavier, n i cant bend it all the way to my but anymore, just half way, that was before i started my leg exercises....anyone have any answers for me??...would greatly appreciate any information, thank you
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replied February 16th, 2010
my tibia n fibula
i have almost the same break i just have more screw and plates i was told the metal will stay in as long your bone and metal conjoint together, they do not put case or braces on because of the metal pieces has put thing back together ,you just have to stay off until you giving the okay from the DOC as for the funny n tighter n heavier will last up to two year ,it been 14month for me the doctor told me with the last xray that everything was heal which was dec 10,2009 to gone on with my life as before, just no skiing or running but everything else was ok to do with inreason hope this help a little
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replied April 21st, 2010
tibia and fibula break
i broke my tibia and fibula just 2 weeks ago doing gymnastics.
i feel off the beam (1.25m) and on the way down my leg wacked on the metal bar underneath. it was not padded!!
I have been in a thigh high cast for this 2 weeks and i have an x ray next week, and if my body is helping my leg heal well i will have a knee high cast:).
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replied May 25th, 2010
Fibula only
Cracked my fibula by the ankle playing football. Wore a cast for six weeks to reset my ankle. Then a boot for 2 weeks (didnt actually wear the boot.). I was walking after six weeks and running after 7. Lots of tightness at the ankle, but pretty sure it was due to the cast. Need to start full running in 2 weeks but there is still pain. Doctor says to be careful, so apparently there is still somewhat of a risk to over-doing it. Pain is usually your bodys way of saying stop.
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replied June 9th, 2010
Tibia and Fibula break
broke my tibia and fibula playing Roller Derby Apr 10th
I have a rod and three screws in my shin and the fibula was just set. I left the hospital with a boot...It has been 2 months and at home I do not wear the boot, I started wearing my shoes to get my foot use to it again and also riding a stationary bike.. the PA said I could do anything that did not hurt or put weight on it.. the stationary bike has helped with flexibility in my knee and ankle...Ready to get back on my WHEELS!!!
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replied July 19th, 2011
Tib/fib sprial fracture from roller derby
How long before you got back to derby? I had a spiral fracture to my tib & fib on June 30th. I had a rod, clamp and screws to set. It is now July 18th and was told on July 28th, they would xray and see if I was healing and then could start putting some weight on that leg?? What was your experience? I want to be back to skating!
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replied June 13th, 2010
Broken Leg
so snapped my tib and fib. had full length cast for 10 weeks. a cast at my knee for 5 weeks and now they are telling me i have to have a boot for 3 months! im a level 9 gymnast, do you know when i can get back?
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replied July 10th, 2011
Since it sbeen a year, how lng it it take to heal. My daughter is a level 5 Cheerleader on two teams. Sh eis 16 and I am very concerned about her healing and when she will be able to tumble and how much will she lose.
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replied August 9th, 2010
Broken Tib
Snapped my tib on 5th May 2010, i too had a full leg cast for 8 weeks, then a half leg one up to the knee which was changed twice, i now have to have another cats which will be between my knee and ankle which will give me more movement and hopefully walk without crutches!
I'm desperate to get back running and get in the gym but nothing seems to be working, feel more frustated with docs as they keep changing their minds.
Will it ever heal fully?
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replied September 3rd, 2010
In January 2003 I snapped by tib & fib playing hockey, totally separating the bone. Have an 8" plate and 9 screws put in. I was 43 at the time. Had the cast on with no weight bearing for 10 weeks. Felt great after. Played golf 6 weeks later and started hockey again at the end of summer. Went skiing and snowboarding for the first time ever 6 months ago with my kids. No problems. I avoid kicking a soccer ball hard as that has some discomfort.
I have no plans to get the hardware removed. Must not be 100% as occasionally I'll have some mild area swelling with tenderness to the touch.
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replied September 14th, 2010
Broke tib and fib
I broke my tib and fib last year,and i can do everything that i use to do.I did NOT want any pin's or plates,I asked about those,and doc;s said that it would be better with out as long as it heals, and that I would be in a cast a longer time.I said ok no plates or pins.They say after it heals it will be stronger then the other leg because of the extra cal. around the bone.I do notice that that leg were the breaks were is fater/ lager in size,Not much,but you can see the difference. Im 61 yrs old and in good condition.
It just takes time.
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replied November 6th, 2010
Broken tibula and fibula
I am athletic and very active, I broke both the tibula nd the fib. A tit. rod and srews were put in. It has been almost 1 month no weight 2 more togo. The break was not clean, twisted then snapped. I am wondering if anyone out there is running with the same injury and rod? How long is the recovery period? Are you back to the same activities as before the injury? Or at what percentage? How long did it take to regain full strength? it is possible?-right?
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replied April 6th, 2011
Hi,

I had a similar injury in Jan. 2010. I was running on ice and fell; broke 2 bones in my tibia and broke fibula as well, near the ankle. Had tit. rod and screws put in. It is a long process. Be patient. 14 months later, I am starting to run consistently but am still experiencing tightness and inflexibility in that ankle area. Everybody tells me it will eventually be 100%. Can't run as fast as I would like now because I just don't have flexibility.
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replied December 9th, 2010
My broke leg - healing progress
els327 - I'm 47 and did lots of biking and running. Broke my leg (tibia, fibula and ankle) figure skating 11-1, surgery 11-2 (rod and screws). Cam boot for 9 weeks, but weight bearing after 2 weeks and working up to half my weight (85 pounds) at the 9 weeks. Returned to work (desk job) after 2 weeks. Doc says it'll take 1 to 2 years to get full movement of knee and ankle and at least 1 year befor running or skating again..
As of 12-9 I can put 55 pounds on the leg wearing the cam boot with comfort, move my ankle ~50% and knee ~30%.
Only my knee has pain if I move it more than ~30%.
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replied December 12th, 2010
Tibula and Fibula (spiral break)
I had a spiral break of the fib n tib on my left leg. I had surgery done where they placed a rod and 3 screws in my lower leg and a boot. This happened on 11/03/2010 surgery was done on 11/04. My 2 wks visit was on 11/16 my dr said that my bones were setting up fine and that i could start putting 30% of my weight on the leg. But keep the boot on at all times. i can sleep without it. i am rotating my my ankle at about 40% and bending my knee at about 50%. i can walk on it a little without crutches or walker with boot on. I go back on 12/16 for my 6 weeks visit....How much longe???? It is much more painful at the knee where he cut it open to insert the rod
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replied January 21st, 2011
i broke my tib in sept 2010 i now have a plate an 11 screws i had no cast no brace my doc told me my cast was the plate an screws i have being walking on it since nov 18 with the help of a cane, and still i am walking with a bad limp will i ever be able to walk normal again?? i broke it due to a car wreck it was broke in 10 places.. and yes it is still very painful!!
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replied January 21st, 2011
i broke my tib in sept 2010 i now have a plate an 11 screws i had no cast no brace my doc told me my cast was the plate an screws i have being walking on it since nov 18 with the help of a cane, and still i am walking with a bad limp will i ever be able to walk normal again?? i broke it due to a car wreck it was broke in 10 places.. and yes it is still very painful!!
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replied February 1st, 2011
I broke my fibula & tibula playing soccer..it's been a month,& I have rod & 3 screws....I don't use a cast or a brace...dr.said he will take out my rod until my bone hills.I'm only 16 years old & well that's why he's going to take it out..
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replied February 6th, 2011
broken tibia recovery
I broke my tib and fib 11/28/2008 car accident. compound fracture fixed with IM rod and four screws. I was 43 years old at the time, I just had the bottom two screws removed 10/29/2010 to ease the pain in my ankle. still a lot of pain walking and I still can't run. I can ride a bike with no problems and very little pain. everyone heals differently so it's hard to judge a recovery reading these post. I reccomend plenty of exercise, even if it does not involve your injured leg. (gotta keep the blood moving) watch your diet, and definetly if you smoke, STOP!! keep a good attitude, being miserable won't help anyone. good luck all.
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replied February 7th, 2011
I fractured my tibia on 12/10/10 during a soccer scrimmage i had a rod and 4 screws placed in my right leg im 15 years old and its almost been 2 months sense the incident and i didn't have a cast they said i would be walking 2 weeks after surgery and my recovery time was 8 weeks well its about to be 8 weeks and i cant run without having a horrible limp or do a full squat and my track season starts in 12days hopefully ill be able to run before that or atleast before district
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replied February 16th, 2011
broken tib and fib
i broke my tib n fib in dec 2010, got a pin put in and bolts. cast on for 10 days then go it off and was given crutchies n told to start putting weight on it and keep it elevated. tht was nearly three months ago. i am now walking without crutchies, still have slight pain in my ankle and slight pain when i walk. been off work 3 months,starting physio next week. i can rotate my ankle and bend my leg. i have been swimming and going for little walks. still gets swollen and tender but its a big improvement. couldnt even walk a month ago. scars from the surgery arent very nice but doc said they r nice and neat and should fade pretty nicely.keep positive and keep doing little exercises and resting.x but iam jst wondering, will i be left with a limp? the surgeon said i wont but i am worried!! will i ever b bk to normal?
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