Spiral fracture of distal tibia and fibula (42-A1.2)

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Hope everyone is healing up. I am a 29 yr old male who avidily races motocross. On May 9, my right foot was caught in a rut as I was rounding a corner in a race. The break occured between the end of my knee braces and my ankle braces. I ended up with a spiral fracture of my distal tibia and also a fibula fracture (42-A1.2 classification).

On May 10, my first surgery was the placement of a spanning external fixator and a four-compartment fasciotomy for elevated compartement pressures. May 12 - taken to OR for irrigation and debridement of right leg fasciotomy wounds with delayed closure or right medial wound. VAC placement put in place. May 14, further irrigation and debridement of fasciotomy wounds with removal of external fixator and intramedullary rod fixation of right tibia fracture. May 16, closure of fasciotomy wounds successfull without skin graft.

I was treated at the Mayo Clinic in Rochester, MN. The surgeons were very experienced with this type of break but took quite some time to decide on the best approach. The two approaches they were looking at were the rod fixation vs a plate a screws. The rod fixation was decided on because of the decreased risk of infection as compared to the plate approach.

It is early on, but it looks very straight from the X-rays. I was told not to bear any weight on the injury and will see the doc in a few weeks.

A few questions: 1) Is it common for a spiral tibia fracture to slip or the screws to bend when bearing weight? If others have had similar injuries, how long before weight bearing took place?

2) What percentage of rods are taken out after the bone heals? How long should I expect the rod to be in place before it could potentially be taken out? The surgeons highly recommended takening the rod out if further physical activity was going to be done (i.e. motocross). If the rod were to bend and it was fixated with screws, there could potentially be serious complications.

3) My ankle is still very sore. About 10 years ago I incurred a talus fracture of my right ankle. Since that time, the flexiblity of that ankle has been substantially less. With this tib/fib injury, it appears the flexibility has even gotten a little worse. It is early on in this healing process and the decreased flexiblity may be due to swelling. Just wanted to know if there were cases where ankle flexibilty was also decreased with a tib/fib fracture.

Thanks. And happy healing to you all.

-- Michael Shimpa (michael_shimpa@yahoo.com), May 27, 2004


Michael just hang in their. I,m also a MX racer out of OK. In april I also spiral fractured my TIB. and FIB. Over shot a double at muddy state race, rear wheel slipped out on landing and dug my right foot into a rut. Same place as you right below the knee brace. They installed a rod and screws. (1) I was weight beiring after 3 weeks. full beiring after 6 - 7 weeks. DR. assured me that i couldn,t harm them just weight beiring. Just no twisting motions! (2) Mine are staying in unless they cause me problems. (3) You shouldn,t loose flex in your ankle, just get it mobile. Start training on a bike it should loosen it up and work the swelling out. I started riding as soon as i was down to one crutch. After two weeks i got rid of that crutch. I started 5 miles than 10 now i ride 25 twice a week. 2 weeks ago was my last x rays and i was 50% healed so i climbed Pikes Peak 2 days later, 14110 feet. This kind of exercise forces the blood in to the breaks for faster healing. It just takes time and a little pain. This is my second broke leg ,one blown out knee, 4 herniated discs, 1 severly torn ankle, crushed nose, 2 concustions, and lost count on all my stitches but MAN I'M HAVING FUN!!!! Keep it pinned JASON.

-- (JASONRACEN@COX.NET), July 05, 2004.

I recently suffered my very first fracture of my life, and I am a 44 year old woman. I was not doing "extreme sports" or in a car accident, I was a volunteer EMT responding to the scene of an mva early in the morning. We respond to mva's with full turn out gear. I am also a firefighter in town, and it was a big show, the passenger was in the vehicle and the fire department was busy getting out the hurst tools, I have no patience so I just opened the door and with my partner cracked the door back as far as possible. Then I went around the other side of the vehicle, opened the door again (try before you pry - but we do love our tools) and climbed into the vehicle. There was black smoke pouring out of the vents and partner and I picked up the pace and manually extricated the man. After getting the patient out of the car, I walked around the front of the vehicle and tripped. These things happen so quickly, I recall taking a step and my left foot not following, I twisted and broke my fall with my left hand. My brother firefighter said he saw me step on a headlight - honestly, I don't remember which it is, except that it hurt, lots, frighteningly. So the rescuer became the more injured of the patients. I had no idea of the extent of my injury, except that I knew as I was going down that it was broken. Another town's ambulance was called to the scene and took me to the closest hospital, in spite of my request to go to a trauma center (gee). When my heavy boot was finally removed, the extent of the break and dislocation was horrifying. Both the distal tibia and distal fibula had spiral fractures plus splintering of the distral fibula and complete dislocation. No eruption through the skin, but it was only a matter of time, ergo the necessity of a quick set, which set was poorly executed and robbed me of blood flow and nerve impulse into the left foot. Within five minutes of the setting and the primary casting, the doctors were cutting off the cast and resetting my foot. I went into surgery at 8:35 pm the evening of August 10, 2004, the injury had occurred at 5:30 am. The longest day of my life. I had 14 screws and two plates implanted to repair the fracture. About 14 days later, the infection set in and I went back into surgery and the doctor did what is called a GPS (gravitational platlet separation) - he debrided the medial aspect of the wound, removed a screw whose head had infection on it, and poured a soup of my own white blood cells into the wound. Well, I am on the mend, lots of pain, lots of swelling and tons of loss of range in motion. The wound is still closing. The range of motion is at best 15% of what it was previously. I was non-weight bearing up until 14 days ago. Your question as to flexibility, well mine which was previously tremendous is almost non-existent. I am told I will regain flexibility, but not what percentage. A lot of the flexibility issue is due to swelling but also to scar tissue. Nothing but hard and painful work will regain your flexibility. I do understand that it is common to remove rods; however, my hardware is permanent. There is always the chance of screws loosening and you should pay close attention to the injured and rebuilt area. Weather change is usually a painful experience. I'm an EMT and I never heard of a spiral fracture, I thought it was the morphine and the doctors' where making it up, how could such a tremendous injury being incurred by a simple fall? Lots of denial too. Let me know how you progress. I miss my life. My therapist tells me I need a hobby. I had two hobbies, I was a volunteer firefighter and a volunteer ambulance corps person. Not now though. Can't imagine ever being able to do the things I used to do, but I am told those bones usually heal stronger than before their injury. There is hope, and I do believe I will come back to do the things I love doing. I hope you do well, and regain your ability to do the things you love doing too. Regards - Joanie

-- joan kuerzi (emtjoanie@aol.com), October 18, 2004.

its more of a question really, 2 weeks ago on holiday i broke my ankle a spiral fracture in my fibula ,and a small fractire in the tibia . they wont put a full plaster on cos of the swelling and its 50 50 if i will need an operation , i will find out on thurs.ive been trying to find info on my leg , mainly cos i am already fed up .could u please give me a bit of onfo .thankyou julie

-- julie lowe (lowejulie4@aol.com), October 19, 2004.

In February 1995 I was skating on an outdoor rink when my toe pick caught while turning causing my foot to stay straight and my leg to go in the opposite direction. The result....a spiral fracture of the tibia right above my skate boot and a fracture of the fibula near my knee. My leg hung down limp below the fracture site although I was lucky not to have an "open" fracture. That is, the bone did not pierce the skin. I needed surgery and they put in a tibia nail (a rod down the middle of the bone that runs the length of the bone) with screws just below the knee and above the ankle. I had quite a bit of swelling and had a lot of difficulty regaining mobility in my ankle, but with time and lots of physio I recovered fully. My knee suffered some nerve damage and was "pins and needles" for about a year. This also subsided after a couple of years. In March of 1997, I had the hardware removed because I wanted to ski and was paranoid about falls. This was a fairly simple procedure and I was fully mobile within two weeks. The only remaining symptoms are the scars from the surgery and lately I have noticed a lump of bone near the site where the screws were above my ankle. This lump aches, especially when the weather is wet so I had it X-rayed yesterday (which is why I'm on your site after all these years.) My GP assures me that this is like a bit of "scarring" on the bone from the screws so I am optimistic that all is well.

Anyway, good luck with your healing...been there.

-- Veronica Rachar (drachar@rogers.com), October 20, 2004.

Hey, I ride quad motocross and am recovering from a tib/fib fracture on my left leg. I was jumping a double and my foot slipped through the nerf bar netting and landed on the ground when I landed. I ended up having surgery with an IM rod in the tibia and 4 screws, two in the top and two in the bottom. This happened on Jan 8th so I am slowly recuperating. My doc said I could put weight on it if it doesn't hurt. I am on crutches and have a removable fracture cast. I have all of the mobility back in my knee but the swelling around my ankle is stopping me from full ROM with that joint. It doesn't hurt too bad now... but it has put a damper on my motocross. I was first in the Women's Division for a winter series. Happy Healing to all, Taylor

-- Taylor Ellis (ellis@inna.net), January 22, 2005.

I went skiing 3 weeks ago in Flagstaff, AZ and my ski caught up in my other one. The boot didn't release, so my leg twisted and I got a spiral fracture in my tibia and broke fibula also. They also put a rod from knee to ankle, with one screw below knee and three above my ankle. I'm getting married in 4 weeks, but the doctor is hopeful that it will be strong enough by then that I can be weight bearing and walk down the aisle without crutches. Right now, I'm not allowed to put any weight on it, though. There is one piece that butterflied off and so it's not attached well. I'm hoping to be able to hobble down the aisle un-assisted by crutches. At least my dress will cover the Hanger boot.


-- Kristi Swisher (kristi_ready2go@yahoo.com), February 05, 2005.

Greetings fellow fracture sufferers! I broke my Fib & spiral fractured my Tib on January 8th, 2005 after my 20" folding bicycle folded on me as I was riding up an incline. My leg got caught between the frame of the bike as I went down and it snapped like a twig. Didn't really know I broke anything until I tried to get up and noticed my left foot was 90 degrees from my leg and almost upside down. I'm not a doctor, but I knew it wasn't supposed to look like that! Six days in the hospital and a couple of hours of surgery later, I'm still healing. I had a 10" plate attatched to the Tib and 4" plate attached to the Fib, along with 14 screws. My leg looks like the inside of an Erector Set! Just had my 8 week checkup and got mixed results after seeing the x-rays. The Fib is healed, but the Tib showed hardly any union thusfar. Dr. said it takes a long time to heal a Tib fracture, especially a spiral. Have to stay off it for another 4 weeks, then we'll see what's doing in there. Ankle motion hasn't been affected too much, but the swelling is intense. My foot & ankle looks like the Hindenburg before the explosion! Y'all hang in there, and as they say, time heals all wounds, especially fractures.

--Gene Kasson (gkasson@sbcglobal.net)

-- Gene Kasson (gkasson@sbcglobal.net), March 13, 2005.

Hello, Looks like we are all healing!! It seems like it takes forever. I want to get back to life!!! Im 21, went skiing, and I fractured my Tib & Fib on 2/26, had surgery on 3/1. (Been skiing since I was 6, i think im done now though, hehehe). I was released from the hospital 3/3. Not too bad. I have a rod in my tib and I believe I only have 2 screws @ my ankle. I have a long incision vertical on my knee, and a tiny one on my ankle. I was put in what I think was a splint for my first week, then last week, i was put into the "Cam Boot". I am supposed to take it off when im sleeping, and laying down. Anyone have any advise on the boot? Should I keep it on as much as possible?? or keep it off?? How long is it normal to be non weight bearing?? I have a bit of numbness on my scar on my knee, its a little bit tingly. Did anyone have that sensation?? I hope its normal. Any speedy recovery tips?? I hope my bones are 'fusing'!!!!!!!!!! Thanks , and good luck to all!!!

-- Vanessa (VanessaHagicostas@yahoo.com), March 14, 2005.

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