Rehabilitation Insights for Post-Tibia-Fibula Fracture Recovery

Rehabilitation status after tibiofibular fracture-dislocation?

Hello Doctor, it has been over five months since I fractured my left ankle fibula (with a plate on the outer side and screws on the inner side).
At the four-month mark, an X-ray confirmed that the bone had fully healed.
I have been walking and exercising for some time now.
I have a few symptoms I would like to ask about:
1.
When I squat down with my left heel on the ground, I feel a noticeable tightness and pressure in the back of my ankle, making it difficult to squat smoothly.

2.
On the inner posterior side near the screw, there is a very sore sensation when I press on it.
Sometimes when walking, if I step on a stone or uneven surface, the pressure point may compress the inner posterior side, causing a soreness that makes my foot involuntarily curl up.
What could be the reasons for these two issues? What methods can effectively resolve them? When I experience these symptoms, should I temporarily stop stretching and walking? If I continue to stretch, is there a possibility of the screws breaking? Additionally, since the doctor has confirmed that my bone has healed, am I suitable for a surgery to remove the screws?

Hank, 30~39 year old female. Ask Date: 2016/10/21

Dr. Shi Guozheng reply Orthopedics

It is normal to experience soreness after the healing of a fibula fracture.
Typically, fractures near the ankle take about six months to gradually recover, and it is also normal for joint mobility not to return to pre-injury levels.
Rehabilitation should be done gradually to improve function.
Removal of the plate usually requires waiting about a year to minimize the risk of re-fracture.

Reply Date: 2016/10/21

More Info

Rehabilitation after a tibia-fibula fracture can be a complex process, especially when there are residual symptoms like tightness, discomfort, or pain in the area surrounding the surgical site. Based on your description, it seems you are experiencing two primary issues: a tightness in the back of your ankle when squatting and discomfort near the area of the steel pin. Let's break down these concerns and explore potential solutions.

1. Tightness in the Back of the Ankle: The sensation of tightness or pressure when squatting could be attributed to several factors. After a fracture and subsequent surgery, the surrounding muscles, tendons, and ligaments may have undergone changes due to immobilization and disuse. Scar tissue formation can also contribute to a feeling of tightness. Additionally, the muscles in the calf may not be fully rehabilitated, leading to a lack of flexibility and strength when performing movements like squatting.

Recommendations:
- Stretching and Strengthening: Incorporate gentle stretching exercises targeting the calf muscles and Achilles tendon. Gradually increase the intensity of your stretches as your comfort allows. Strengthening exercises for the calf and surrounding muscles can also help improve overall function and reduce tightness.

- Physical Therapy: If you haven't already, consider working with a physical therapist who can provide tailored exercises and manual therapy techniques to address your specific issues. They can also help ensure that you are performing exercises correctly to avoid further injury.

2. Discomfort Near the Steel Pin: The sensation of soreness or discomfort near the area of the steel pin could be due to several reasons. It may be related to the hardware itself, inflammation in the surrounding tissues, or even sensitivity in the area as it continues to heal. The fact that you experience discomfort when walking on uneven surfaces suggests that the area may still be sensitive or that the muscles and tendons are compensating for the previous injury.

Recommendations:
- Activity Modification: If certain movements or activities exacerbate your discomfort, it may be wise to modify or temporarily avoid those activities until you can discuss them with your physician or physical therapist.
- Footwear: Ensure that you are wearing supportive footwear that can help absorb shock and provide stability when walking on uneven surfaces. This can help reduce discomfort and prevent further irritation.

3. Concerns About Stretching and Hardware Integrity: It is understandable to be concerned about the integrity of the steel pin while stretching or engaging in physical activity. However, if your doctor has confirmed that the bone has healed properly, the risk of the pin breaking due to stretching is minimal. That said, it is essential to listen to your body and avoid pushing through pain. If you feel significant discomfort during stretching or activity, it may be best to pause and consult with your healthcare provider.

4. Surgical Consideration for Hardware Removal: The decision to remove the steel pin should be made in consultation with your orthopedic surgeon. If your doctor has determined that the bone has healed and you are experiencing discomfort related to the hardware, they may recommend removal. However, this decision often depends on various factors, including the location of the hardware, the nature of your symptoms, and your overall recovery progress.

In summary, your rehabilitation journey is crucial for regaining full function and alleviating discomfort. Focus on gentle stretching, strengthening exercises, and consider seeking professional guidance from a physical therapist. Always communicate openly with your healthcare provider regarding your symptoms and any concerns about your recovery process. They can provide personalized recommendations and determine the best course of action for your situation.

Similar Q&A

Post-Operative Recovery Insights for Right Distal Tibia-Fibula Fracture

Hello Dr. Chen, I was involved in a car accident on January 19th, which resulted in an open fracture of the distal fibula on the right side. I underwent reduction and internal fixation surgery with a plate in the emergency department. During my follow-up appointment two weeks pos...

Dr. Chen Bochen reply Orthopedics
Hello: 1. Rehabilitation for fractures is highly individualized and there is no standardized protocol. Generally, it follows the recommendations of the surgeon who performed the operation or is assessed by a rehabilitation physician from the same hospital. 2. Muscle atrophy after...

Post-Surgery Recovery Challenges After Tibia and Fibula Fracture: Seeking Solutions

Hello, last July I suffered a fracture of the tibia and fibula in my lower leg, and underwent fracture reduction and fixation with a locking plate. The doctor recommended purchasing a pneumatic brace, but I have not actually worn it for walking. Four months post-surgery, the doct...

Dr. You Dianqi reply Orthopedics
If you experience any discomfort, it is recommended to consult your primary care physician for evaluation. Subsequent physical therapy can be pursued at the rehabilitation department outpatient clinic. Thank you.

Challenging Recovery from Distal Tibia-Fibula Fracture: Healing Strategies

On July 20, 2016, I was involved in a car accident that resulted in a comminuted fracture of the distal tibia and fibula. Traction was performed on the same day, and on July 29, I underwent external fixation surgery (due to trauma, I had to wait for the wound to heal). On August ...

Dr. Li Yongheng reply Orthopedics
Hello, you have sustained a distal tibiofibular comminuted fracture with poor healing, and you have undergone an autologous bone grafting procedure. If the fracture continues to heal poorly, you may require another autologous bone grafting surgery in the future. In addition to au...

Effective Rehabilitation Strategies for Knee Recovery After Tibia Fracture

I previously suffered a tibial fracture due to a car accident. I am now able to walk, but my knee still cannot fully extend like a normal leg. The doctor advised me to elevate my leg and apply pressure to the mid-thigh area to help straighten the knee. I have been doing this for ...

Dr. Shi Guozheng reply Orthopedics
Inability to fully extend the leg may be due to quadriceps weakness. After a fracture, immobilization with a cast or surgery can lead to disuse of the muscles for a period of time, resulting in muscle strength reduction. With active training or rehabilitation, it is usually possi...