Recovery Timeline for Tibial Comminuted Fractures: What to Expect

The recovery timeline for a comminuted fracture of the tibia?

Hello, Doctor! I was involved in a car accident on March 10 of this year, resulting in a comminuted fracture of my right tibia.
The following day, I underwent internal fixation surgery using intramedullary nails and bone grafting.
After being discharged and having my stitches removed, I developed an unexplained infection nearly three weeks later, which caused the wound to open and discharge a significant amount of serous fluid.
Upon returning for a follow-up on April 1, my doctor performed a debridement surgery and removed the original intramedullary nails.
I was then hospitalized for recovery using an external fixator and underwent a course of antibiotics.
Approximately twenty days later, I was discharged home.
I would like to ask the doctor: 1.
How long will it take before I can walk without crutches? 2.
If a comminuted fracture is not internally fixed, will it take longer to heal? 3.
How long should I wear the external fixator? On May 10, during my follow-up appointment, my doctor mentioned that the bone is starting to heal! He advised me that I could remove the external fixator at home and to practice putting weight on my leg with crutches, gradually increasing the load.
However, I have noticed that occasionally, in certain positions, I feel like the bone is shifting, and I experience some pain in my calf.
Should I be concerned about this, and should I stop practicing weight-bearing? Thank you!

A Guo, 40~49 year old female. Ask Date: 2021/05/15

Dr. Chen Yongxue reply Orthopedics

1.
Fracture healing takes at least 6 weeks.
Severe comminuted fractures or those with infection may experience delays.
2.
Internal fixation can provide support for the fracture, and fractures generally heal well; however, if there is an infection, the hardware must be removed to control the infection.
3.
Please consult your attending physician for further advice.
Thank you.

Reply Date: 2021/05/15

More Info

Recovering from a tibial comminuted fracture can be a complex and lengthy process, especially given the complications you've experienced, such as infection and the need for multiple surgeries. Here’s a detailed overview of what you can expect in terms of recovery timelines and considerations.

1. Timeline for Walking Without Crutches
The timeline for walking without crutches varies significantly based on the severity of the fracture, the presence of complications (like infection), and the individual’s overall health. Generally, for a tibial comminuted fracture, patients may begin to bear weight on the affected leg around 6 to 12 weeks post-injury, depending on the healing progress observed in follow-up X-rays. Since your doctor has noted that your bone is starting to heal, you may be able to gradually reduce your reliance on crutches over the next few weeks. However, it’s crucial to follow your doctor's advice and not rush the process, as premature weight-bearing can lead to complications.

2. Impact of Not Using Internal Fixation
Not using internal fixation (like plates or screws) for a comminuted fracture can indeed prolong the recovery process. Internal fixation provides stability to the fracture site, allowing for earlier weight-bearing and rehabilitation. Without it, the body may take longer to heal as the fracture fragments need to stabilize on their own. In your case, since you initially had internal fixation but later had it removed due to infection, the recovery timeline may be extended. It’s essential to monitor the healing process closely with your healthcare provider.

3. Duration for Wearing a Splint
The duration for wearing a splint can vary based on the healing status of your fracture. Typically, a splint may be required for several weeks to months, depending on how well the bone is healing. Since your doctor has indicated that the bone is starting to heal, you may be able to transition away from the splint gradually. However, it’s advisable to follow your doctor’s recommendations regarding when and how to remove the splint, as they will have the best understanding of your specific situation.

4. Concerns About Pain and Sensation
Experiencing pain or a sensation of movement in the bone while trying to bear weight can be concerning. It’s essential to listen to your body; if you feel pain, especially sharp or significant discomfort, it may indicate that you are putting too much stress on the healing bone. It’s advisable to reduce your activity level and consult your doctor about these sensations. They may want to perform imaging studies to ensure that the fracture is healing correctly and that there are no complications.

Additional Considerations
- Physical Therapy: Engaging in physical therapy can be beneficial once your doctor gives the green light. A physical therapist can guide you through safe exercises to strengthen the muscles around your knee and improve your range of motion without jeopardizing the healing process.

- Infection Management: Since you experienced an infection, it’s crucial to monitor the surgical site for any signs of re-infection, such as increased redness, swelling, or discharge. If you notice any concerning symptoms, contact your healthcare provider immediately.

- Nutrition and Bone Health: Ensure you are consuming a diet rich in calcium and vitamin D to support bone healing. Staying hydrated and maintaining a balanced diet can also aid in your recovery.

- Follow-Up Appointments: Regular follow-up appointments with your orthopedic surgeon are essential to monitor the healing process and make necessary adjustments to your rehabilitation plan.

In summary, while the recovery from a tibial comminuted fracture can be lengthy and fraught with challenges, adhering to your doctor’s recommendations, engaging in appropriate rehabilitation, and being mindful of your body’s signals will significantly aid your recovery. Always prioritize communication with your healthcare team to ensure the best outcomes.

Similar Q&A

Recovery Timeline for Open and Comminuted Fractures: What to Expect

Doctor, I had a severe car accident on October 2nd, and I currently have comminuted fractures in my right thigh, knee, and lower leg, along with an open fracture. I need to avoid putting weight on it for three months. I would like to know how long it might take to walk normally a...

Dr. Li Yongheng reply Orthopedics
Hello, generally speaking, comminuted and open fractures of the thigh, knee, and calf tend to have a slower recovery process, and rehabilitation may take longer and be more challenging. You may need to discuss with your attending physician whether you must wait three months befor...

Rehabilitation Timeline After Tibial Fracture: What to Expect

Hello, doctor. I sustained a fracture of the upper end of the left tibia due to a car accident on February 21. I have been in a cast for 5 weeks and am scheduled to return for a follow-up appointment to remove the cast on April 6. I would like to know how long it will take for re...

Dr. Shi Guozheng reply Orthopedics
Fractures typically take about three months to heal. If the fracture is not severe, the healing time may be shorter, around six weeks. Initially, weight-bearing is allowed, but only with about a quarter of the body weight. Crutches should be used for assistance, and follow-up app...

Healing Time and Mobility After Left Tibia Fracture: What to Expect

How long does it take for a comminuted fracture of the tibia in the left lower leg to heal? Can the left lower leg with a comminuted fracture of the tibia bend?

Dr. Chen Yongxue reply Orthopedics
Hello, fractures need to be stabilized and weight-bearing should be avoided for about six weeks. There are various methods of fixation, including casts, nails, and plates, as well as external fixation, each suitable for different situations. Bone healing requires healthy soft tis...

Understanding Recovery from Tibial Comminuted Fractures After an Accident

Hello, doctor. I had a car accident on February 3rd and suffered a comminuted fracture in my lower leg. Could you please tell me when I will be able to fully bear weight on my leg? It still feels numb and tingly. Thank you very much.

Dr. Shi Guozheng reply Orthopedics
Typically, the degree of fracture healing must be assessed to determine when it is safe to bear weight. Therefore, follow-up X-rays are required, which may take at least three to six months.