Compound tibia/fibula fracture not healinggreenspun.com : LUSENET : About Joints : One Thread
Hello, I was seriously injured in a car wreck on December 15, 2003. I was hit head on by a drunk driver and I got airlifted to a hospital about 40 miles away. I was in ICU for 4 days. I recovered from most of my injuries except for my right leg. I had a compound tibia/fibula fracture. My bone splintered apart. I had bone 10 - 15 bone fragments in surrounding tissues in my leg. The tibia came out of my leg about 6 inches. They did emergency surgery on my leg where they implanted a IM Rod and several nails. I wasn't able to walk on it for the first 2 months. After that I was able to start some weight bearing. I started getting around a lot better with crutches. Then in July of 2004 I was able to walk with just a cane. The only problem was the tibia would not heal at the fracture sight and my nails were working their way out of my IM Rod. So on September 24, 2004 I went back into the hospital for another surgery. At that time they removed the rod and replaced it with a larger one along with larger nails. While they had my leg opened they compressed the bone together at the fracture sight as good as they could get it and they also cut my fibula where all the blood flow would go through my tibia with hopes that it would heal. Well now it's been 4 months since that surgery and the fracture sight doesn't look any better than it did before this last surgery. I still have a gap where the bone fractured and came out of my leg. Now my Surgeon is talking about taking the last resort which would be bone grafting. Has anyone here ever been through bone grafting? I've tried everything. I use a bone stimulator 2 times a day, I take plenty of calcium and vitamins, I walk as much as I can, but the pain gets very unbearable after about 1/2 mile of walking. I hate going through anymore surgeries. I told my surgeon I would not go through anymore until I graduate college which will be in March. I just need to know if bone grafting is a bad as it sounds. He said he would take the bone from my hip to use in my leg. It's been over a year now and I hate to keep going backwards instead of forwards.
-- Chastity Barnes (email@example.com), January 27, 2005
Hi Chastity. I feel for you. In August of 2004, I fell from a ladder and fractured and dislocated my right ankle, rupturing the syndesmotic complex, and fracturing the fibula. I had a plate and screws in my fibula, syndesmotic screws, and screws in the medial maleolus. I was also non-weight bearing for 2 months, until the syndesmotic screws were removed. After extensive physical therapy, I was still walking with a pronounced limp. As it turns out, the fibula developed a non-union.
I was not so lucky to have tried a bone stimulator because the plate on my fibula broke where the non-union was. I had to go right to a bone graft. That is where I am now. I am 2 weeks post op and I feel pretty good. My surgeon took out the plate/screws and put a rod in my fibula. Took bone from my hip (ileac crest) and grafted it onto my fibula. Don't let anyone fool you, it does feel like taking a step back, but I took that step because after 6 months, I just want this over with. I spent 3 nights in the hospital with a wonderful, self controlled morphine pump. It was hard to go home and be non- weight bearing again. That's where I am, except I can use my leg for balance only.
Although I cried for about 2 weeks straight before the surgery...and frankly about 10 days straight afterward, I feel good about this decision. What I was most afraid of was the taking of the bone graft from my hip. I am a nurse and worked with teenagers who have had spine surgery for scoliosis. With a 2 foot incision in their backs, all they complained about was the pain in their hip. Don't let me kid you, the hip surgery does hurt a bit, but it wasn't as bad as I anticipated it would be and the pain can be controlled. Just make sure that you have a morphine PCA (patient controlled analgesia) with settings based on your needs as well as a trapeze bar above your bed. A bedside commode is a good idea as well...no bedpans to stess the hip or getting out of bed and across the room to the bathroom. Once out of the hospital it was tender, mostly due to the staples, but once they came out, it feels okay. Mostly no pain, occasional throbbing only and it is not bad. What helps is the fact that I had to be non-weight bearing on my leg again. It helps because I did not have to bear weight on the side where the graft was taken. The weight bearing puts stess on the hip and was the primary cause for the spine patients pain.
The worst part is taking the time out of my life for this. That's why the tears. I really couldn't bear it anymore, but being 2 weeks on the other side of this, I am glad that I did it. I got it over with instead of prolonging the inevitable. When this is over, I want it to be over. Right now I am at home. My surgeon wants to wait another week before I can go back to work (desk work only). I am using a walker around the house(I am sick of crutches)and am getting around fine. Good luck to you. Let me know how it goes.
-- (RebeccaCorbin@hotmail.com), February 12, 2005.
Hello Rebecca, Thanks for the information. It makes me feel a little better about the grafting. My biggest problem with all of this is I have made it through numerous injuries over the last 14 months. I've got over all the injuries I had except this one. I was out of work for 8 months following the wreck. Now I have been back at work for 6 months. It's been hard because I suffered from a severe head injury in which my short term memory was taken away. So I had to learn to write tasks down all the time so I don't forget to do them. I started back to college. I'm able to drive and have some independence again. I hate the thought of having to go back to being homebound, and depending on my husband and son to do everything for me again. There are times I think it would be better to just live with a limp the rest of my life. There may still be hope that I won't have to go through the graft. I started having severe pain right below my knee last week and I saw my surgeon about it. X-ray revealed that I had a screw right below my knee loose that is more than likely hitting a nerve when I walk. The X-ray also showed some bone growth at the fracture site. He wants to go ahead and remove the screw but I can't afford to miss anymore college right now. I've almost made it to the finish line and I can't stop now. So I told him I would live with the pain until March. He said if the bone growth continues to improve in March he will just remove the screw and give my tibia a few more months to heal and see what happens. I've learned not to get my hopes up at all. I've been told stuff like this before only to get my hopes up to early. I prepare for the worst and hope for the best. I hope you contine to improve and get back on your feet again real soon!!! I was told it could take 6 months to recover after a bone graft. Is that what you were told also?? Well good luck and I hope you feel better soon.
-- Chastity Barnes (firstname.lastname@example.org), February 13, 2005.
hello, i have no answers but thought i'd let you know i'm in a very simular position. i too was in a car crash, and amoung many other injuries, had an open fracture on tib and fib. i found out the other day that after 3 months with an extenal fixator the bone isn't healing. my consultant is now disscussing with his colegues what the next step is, and has suggested bone graft. i'm also very concerned and worried, this will be my 6th operation since the accident. what makes it worse is that i messed up my other leg aswell so am still bed/wheelchair bound.
not sure this will help your situation but thought i'd let you know your not alone.
hope you make a speedy and full recovery.
-- jamie pettitt (email@example.com), March 03, 2005.
I am now recovering from a IM Nail insertion and bone graft due to a non-union double compound fracture in the tibia/fibula. I was hit 8/29/04 by a car while riding my bicycle. I fractured the right femur in 8 places, and the double compound on the left tibia/fibula. Two nails were installed in the femur, and that is 100%. After 6 months of "healing" on the tibia, it was still non-union.A a plate was installed in the ER due to the loss of bone, and the complications of a nail insertion. I tried a bone stimulator for 75 days, 10 hours per day, and had no luck. My ortho doc recommended a specialist in St. Louis, MO named Dr. J. Tracy Watson, who performs synthetic bone grafts. I had the procedure 3/1/05, as well as insertion of a nail in the tibia. There was some complications of the nail insertion, as the tibia was missing so much bone from the accident. Glad to say, it was installed, and the graft was successful. I hope to be off the crutches in about 2 weeks, back in PT for more rehab. The surgery was painful, but nowhere as painful as a regular bone graft, where theyremove the bone itself. Dr. Watson extracted platlets and other "stuff" from the pelvis, mixed it into a cocktail for the fraft, and viola! The nail will be weight sharing, and barring infection, I should be good to go within 6 weeks. The swelling so far has been minimal (20%) and I have been off the leg about 22 hours per day, keeping it elevated.
-- s james driscoll (firstname.lastname@example.org), March 09, 2005.