Complications After Open Fracture Surgery: A Patient's Journey

Open comminuted fracture of the tibia?

Hello Doctor, I was in a car accident on February 26, 2020, which caused a bone to puncture my skin, resulting in an open wound.
I underwent surgery at that time and received a blood transfusion.
Over a year later, the wound has been peeling, and applying lotion has not improved the condition.

1.
Is this normal? My entire lower leg is very sensitive to touch, and it feels uncomfortable; I can also feel the metal implant.
I consulted a doctor who mentioned that I am too thin for the implant to be removed, and he does not recommend taking it out (it's a self-funded titanium alloy).

2.
I would like to understand why this is happening.

3.
Sometimes my foot feels sore, and I experience weakness when walking.
After sitting for a long time, my left foot goes numb.
Is this normal?
4.
I thought that after more than a year, I could enjoy a few drinks, but whenever I drink alcohol, the wound becomes hot, red, and extremely painful.
I cannot put weight on it at all; only elevating it alleviates the pain.
I would like to know what the issue might be.
Due to the pandemic, I am hesitant to visit the hospital frequently, and I hope you can take the time to answer my questions.
Thank you for your help.

Xiao Qing, 20~29 year old female. Ask Date: 2021/05/21

Dr. Wang Shouji reply Orthopedics

Hello, if the fracture has already healed, removing the metal screws should not be an issue.
However, if there was a wound at the time of the fracture, it is important to rule out any infection at the wound or fracture site.
During the pandemic, it is recommended to apply heat therapy, engage in strength training, and perform exercises involving stepping and flexing the knee and ankle joints to see if some issues can be resolved.
Changhua Hospital cares about your health.
Sincerely, Wang Shou-ji.

Reply Date: 2021/05/21

More Info

Open fractures, particularly those that require surgical intervention, can lead to a variety of complications and long-term effects on recovery. Your concerns about the ongoing issues following your open fracture surgery are valid and deserve thorough exploration.

1. Skin Issues and Sensitivity: The persistent peeling of the skin and discomfort in the area surrounding the surgical site can be attributed to several factors. After an open fracture, the skin and underlying tissues undergo significant trauma, which can lead to changes in skin texture and sensitivity. The use of titanium alloy for internal fixation can also contribute to discomfort, especially if the surrounding soft tissues are sensitive or if there is nerve involvement. It is not uncommon for patients to experience altered sensations in the area, which can include numbness, tingling, or heightened sensitivity. If the skin condition does not improve with topical treatments, it may be beneficial to consult a dermatologist or a wound care specialist to explore other options.

2. Muscle Weakness and Pain: The feelings of weakness, pain, and occasional numbness in your leg can be attributed to several factors, including disuse atrophy, nerve irritation, or even complex regional pain syndrome (CRPS), which can occur after significant trauma. After a long period of immobilization, muscles can weaken, leading to difficulties in movement and stability. It is essential to engage in a structured rehabilitation program that focuses on gradually increasing strength and mobility. Physical therapy can help address these issues and improve your overall function.

3. Alcohol Consumption and Pain: The reaction of your leg to alcohol consumption, where you experience increased pain and swelling, is concerning. Alcohol can have various effects on the body, including vasodilation (widening of blood vessels), which can exacerbate swelling and inflammation in an already compromised area. Additionally, alcohol can interfere with the healing process and may affect pain perception. It is advisable to limit alcohol intake, especially in the context of recovery from a significant injury.

4. Long-term Recovery: Recovery from an open fracture, especially one that is complicated by the need for surgical intervention, can be a lengthy process. Healing times can vary significantly based on the severity of the fracture, the presence of any complications (such as infection), and the overall health of the patient. It is not unusual for patients to experience ongoing discomfort and functional limitations for months or even years after the initial injury. Regular follow-ups with your orthopedic surgeon are crucial to monitor healing and address any emerging issues.

In summary, your experience is not uncommon for individuals recovering from open fractures. The combination of surgical intervention, potential nerve involvement, and the psychological impact of the injury can all contribute to the symptoms you are experiencing. It is essential to maintain open communication with your healthcare providers, including orthopedic surgeons and physical therapists, to ensure a comprehensive approach to your recovery. They can provide tailored advice and interventions to help you regain function and manage pain effectively.

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