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

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

Hello： 1. <br>Rehabilitation for fractures is highly individualized and there is no standardized protocol. <br>Generally, it follows the recommendations of the surgeon who performed the operation or is assessed by a rehabilitation physician from the same hospital. <br>2. <br>Musc

Postoperative care following an open fracture of the distal right tibia and fibula?

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 post-surgery (on February 7th), the doctor advised me to try gently putting weight on my foot.
Now, a month later, the area of the open wound is still somewhat swollen, and my ankle has not completely reduced in swelling.
When I sit with my feet on the ground for a while, I start to feel numbness.
I can stand with both feet parallel (which is about 50% weight-bearing), but I still need a cane to walk and am hesitant to put weight on my right foot.
I have a few questions:
1.
Is my progress too slow or too fast? Would practicing walking in a wheeled chair be beneficial?
2.
Since my next follow-up appointment is a month away (on March 7th), the rehabilitation exercises I am doing are the pump exercises, joint movements, and ankle strengthening exercises recommended by the rehabilitation department.
Is this sufficient? My right leg still appears noticeably thinner.

3.
During a previous outpatient visit, the orthopedic surgeon mentioned that I might not necessarily need to see a rehabilitation specialist for therapy.
Would it still be advisable to consult a rehabilitation specialist for a quicker recovery?
4.
Regarding the timeline for recovery, which will be achieved sooner: walking with crutches or being able to drive? Thank you.

Yu, 40~49 year old female. Ask Date: 2022/02/23

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 an injury is a normal phenomenon, and engaging in strength training exercises will gradually help restore muscle mass.
3.
The field of rehabilitation has its own expertise, and I personally recommend consulting with a physical therapist to learn self-rehabilitation techniques before transitioning to independent training.
4.
There is no one-size-fits-all answer; it depends on the type of fracture, the condition of the wound, and the surgical situation.
Wishing you a speedy recovery.

Reply Date: 2022/02/23

More Info

Post-operative recovery from a right distal tibia-fibula fracture can be a complex process, and it's important to approach it with patience and adherence to medical advice. Based on your description, it seems you are making progress, but there are several factors to consider regarding your recovery timeline and rehabilitation.

1. Progress Assessment: The timeline for recovery can vary significantly from person to person, depending on factors such as age, overall health, the severity of the fracture, and adherence to rehabilitation protocols. The fact that you are able to bear some weight (50% on the affected leg) is a positive sign, but the lingering swelling and numbness indicate that your body is still healing. It is not uncommon for swelling to persist for several weeks after surgery, especially in cases of open fractures. If you find that sitting with your foot on the ground causes numbness, it may be due to nerve compression or circulation issues, which should be monitored closely.

2. Rehabilitation Exercises: The exercises you mentioned—pumping movements, joint mobility exercises, and muscle strengthening for the leg—are essential components of rehabilitation. These exercises help maintain range of motion and prevent stiffness, which is crucial for recovery. However, if you feel that your progress is slow or if you have concerns about the effectiveness of your current regimen, it may be beneficial to consult with a physical therapist. They can provide a tailored rehabilitation program that addresses your specific needs and can help you progress safely.

3. Physical Therapy: While your orthopedic surgeon mentioned that formal physical therapy might not be necessary, many patients find that working with a physical therapist can significantly enhance their recovery. A therapist can provide hands-on treatment, advanced exercises, and guidance on proper techniques to ensure you are not overexerting yourself or risking further injury. If you feel that your recovery is not progressing as expected, seeking physical therapy could be a wise decision.

4. Timeline for Walking and Driving: The timeline for transitioning from using crutches to walking independently and then to driving can vary. Generally, patients can expect to start walking without assistance within a few weeks to a few months post-surgery, depending on their healing progress. Driving typically requires that you can safely operate the vehicle without pain or impairment, which often means being able to bear full weight on the affected leg and having sufficient range of motion. In many cases, patients can expect to drive within 6-8 weeks post-surgery, but this can vary based on individual circumstances.

In summary, your recovery progress seems to be on track, but it is essential to continue monitoring your symptoms and communicate any concerns with your healthcare provider. Engaging in a structured rehabilitation program, whether through formal physical therapy or guided home exercises, can enhance your recovery. Remember to listen to your body, avoid pushing through pain, and follow your doctor's recommendations regarding weight-bearing activities and mobility. Regular follow-ups with your orthopedic surgeon will also help ensure that your recovery is proceeding as expected.

Similar Q&A

Challenges in Healing Open and Comminuted Tibial Fractures: Surgical Options Explained

Hello Dr. Wang, I was involved in a car accident on November 26, 2019, which resulted in an open and comminuted fracture of my right tibia. On December 2, 2019, Dr. A performed intramedullary nailing surgery. It has now been over two years, and the fracture site has still not hea...

Dr. Wang Shouji reply Orthopedics
Hello, 1. Generally, it is not necessary to remove the intramedullary nail; using a steel plate for fixation carries a higher risk of plate fracture if healing does not occur. 2. It is important to assess the overall volume of the defect; if the volume is significant, there is...

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...

Understanding Open Fractures: Recovery Challenges After a Tibia and Fibula Injury

Hello Doctor: I have an open comminuted fracture of the tibia and fibula in my right lower leg due to a car accident, which was surgically repaired on November 8 of this year with internal fixation using plates and screws. However, due to the presence of a traumatic wound, I have...

Dr. Li Wenlin reply Orthopedics
1. If the wound is not healing well, a splint can be used to support the area for easier wound management, although it is not as effective as a cylindrical cast for stabilization. 2. The treatment should be based on X-ray findings, as the distal tibia near the ankle joint may b...

Knee Pain After Tibia and Fibula Fracture Surgery: What to Do?

Hello Doctor: I suffered a tibia and fibula fracture in my right lower leg due to a car accident. On May 9, 2016, I underwent intramedullary nailing surgery, which involved a large incision above the knee to insert a rod, and there are surgical wounds with screws on both the inne...

Dr. Hong Ximing reply Orthopedics
The intramedullary nail fixation has been in place for over a year, and the fracture should have healed. If there is any pain or discomfort, you may return for a follow-up appointment to discuss the removal of the nail with your attending physician.