Recovery Timeline and Long-Term Effects of Open Tibia and Fibula Fractures

Q: Recovery Timeline and Long-Term Effects of Open Tibia and Fibula Fractures

Mr. <br>Abo： Hello, regarding the issue you raised, it is difficult to determine the severity of the injury based solely on your description, and it is also not possible to predict the healing process accurately. <br>It is recommended that you consult the hospital where the surge

Open fractures of the tibia and fibula, and when one can resume walking, as well as the potential for long-term complications?

I would like to ask the doctor about my condition.
I suffered an open fracture of the left tibia and fibula due to a car accident, and I also underwent a skin graft because a large area of flesh near my left ankle was missing and bleeding profusely.
I fell into a ditch, so I was hospitalized for nearly a month to care for the wound.
Once the wound improved, I had internal fixation for the fracture, with a plate inserted in the tibia and a nail in the fibula, both of which were out-of-pocket expenses.

1.
Given my injuries, how long will it take for me to walk normally again? Last week, during my follow-up appointment, the doctor said I could lightly place my foot on the floor but should not put too much weight on my left foot.
Is it okay if I sit in a chair and slightly apply pressure on my left foot while resting it on a slipper? Will this hinder the recovery of my left foot?
2.
Currently, I cannot bend my left foot to a 90-degree angle, and when it is flat, it droops significantly more than my normal right foot.
My ankle has remained swollen since the surgery; could this be the reason my left foot cannot bend like a normal foot? Or is it because the fibula has not healed properly yet, preventing my foot from achieving the normal 90-degree angle?
3.
How long will it take for me to recover enough to walk again, given my injuries? I understand that bone healing takes about three months, and the doctor mentioned that blood vessels also take around three months to heal.
Since my follow-up appointments are spaced 1.5 months apart, I wanted to seek professional advice online regarding these questions.

4.
After my internal fixation surgery, I have been gently placing my foot on the floor to stimulate faster healing.
Although the bone is growing, it seems to be slow, and while I can accept the current progress, I worry about the bone not healing properly while I sleep.
The doctor mentioned that my recovery might be slower than average, but I hope to regain the ability to walk soon so I can attend classes without burdening my family for transportation.
Will there be any long-term complications or permanent damage that I will have to deal with for the rest of my life?

Abo, 20~29 year old female. Ask Date: 2020/02/18

Dr. Xie Hongjia reply Orthopedics

Mr.
Abo: Hello, regarding the issue you raised, it is difficult to determine the severity of the injury based solely on your description, and it is also not possible to predict the healing process accurately.
It is recommended that you consult the hospital where the surgery was performed.
The Hualien Hospital of the Ministry of Health and Welfare cares about your health.

Reply Date: 2020/02/18

More Info

Recovering from an open tibia and fibula fracture, especially after a traumatic event like a car accident, can be a complex and lengthy process. Your situation involves not only the fractures but also a significant soft tissue injury that required skin grafting, which adds another layer of complexity to your recovery. Here’s a comprehensive overview of what you can expect in terms of recovery timelines, potential long-term effects, and advice on managing your rehabilitation.

Recovery Timeline
1. Initial Healing Phase: After an open fracture, the first concern is the healing of the soft tissue and the prevention of infection. Given that you had a skin graft, this phase is crucial. Typically, soft tissue injuries can take anywhere from 2 to 6 weeks to heal adequately, depending on the severity and the care taken during recovery.

2. Bone Healing: For the tibia and fibula, bone healing can take approximately 3 to 6 months. However, since you mentioned that your bones are healing slowly, it’s essential to follow your orthopedic surgeon's advice closely. Regular follow-ups and X-rays will help monitor the healing process.

3. Weight Bearing: You mentioned that your doctor advised you to start placing light weight on your foot. This is a positive sign, as it indicates that your doctor believes your fracture is stable enough to begin gentle weight-bearing activities. However, it’s crucial to adhere to the guidelines provided by your healthcare team. Lightly resting your foot on the ground while seated is generally acceptable, but avoid putting significant weight on it until cleared by your doctor.

4. Physical Therapy: Engaging in physical therapy is vital for regaining strength and mobility. Typically, physical therapy may begin once the doctor feels the fracture is stable. This can be anywhere from a few weeks to a couple of months post-surgery. The goal will be to gradually increase your range of motion, strength, and function in the affected leg.

Long-Term Effects
1. Range of Motion: It’s common for patients with tibia and fibula fractures to experience stiffness in the ankle and knee joints, especially if they have been immobilized for an extended period. The swelling you’re experiencing could be due to a combination of factors, including the healing process and the immobilization of the joint. Regular physical therapy will be essential to regain full range of motion.

2. Chronic Pain and Discomfort: Some patients may experience chronic pain or discomfort in the affected area long after the fracture has healed. This can be due to nerve damage, scar tissue formation, or changes in the bone structure. Discuss any persistent pain with your doctor, as they may recommend pain management strategies or further evaluation.

3. Potential for Complications: Open fractures carry a higher risk of complications, such as infection or delayed healing. Additionally, there may be a risk of post-traumatic arthritis in the ankle joint, especially if the fracture involved the joint surface. Regular follow-ups with your orthopedic surgeon will help monitor for these potential issues.

4. Psychological Impact: The trauma of the accident and the subsequent recovery can also have psychological effects. It’s not uncommon for individuals to experience anxiety or depression during the recovery process. Seeking support from mental health professionals or support groups can be beneficial.

Conclusion
In summary, your recovery from an open tibia and fibula fracture will take time and patience. While the initial healing of the soft tissue may take a few weeks, complete recovery of bone strength and function can take several months. Adhering to your doctor’s advice, engaging in physical therapy, and monitoring your progress will be crucial in achieving the best possible outcome.
Always communicate openly with your healthcare team about your concerns, and don’t hesitate to ask questions regarding your recovery process. Each individual’s healing journey is unique, and your medical team is there to support you through it.

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