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

Postoperative care for tibial and fibular fractures in the lower leg?

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 doctor informed me that I no longer needed to wear the brace for protection and could use a walker and crutches to practice walking.
Due to the slow healing of the bone, I have undergone shockwave therapy.
Currently, I can walk, but I have a noticeable limp, which has resulted in several complications: 1.
An inward posture, which easily leads to plantar fasciitis pain.
2.
Numbness from the ankle to the big toe, poor blood circulation, and the ankle and foot often appear dark and swollen.
The skin on my lower leg has become smooth and swollen, and when exerting myself, a particular area bulges out and appears bruised.
3.
Limited range of motion in the ankle joint, making it difficult to squat and walk up stairs.
The attending physician explained that as long as the bone heals, the other complications must be accepted and that the screws will be removed in 1-2 years.
I would like to ask how to address the swelling, numbness, and circulation issues, as well as the limited range of motion.
These problems are affecting my daily life.
Should I continue to see an orthopedic specialist, or would it be advisable to consult another specialty? Thank you!

Nina, 30~39 year old female. Ask Date: 2023/05/31

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.

Reply Date: 2023/05/31

More Info

Post-surgery recovery after a tibia and fibula fracture can indeed present a variety of challenges, especially when complications such as swelling, numbness, and limited range of motion arise. It’s essential to address these issues comprehensively to improve your quality of life and functional mobility.

Understanding Your Symptoms
1. Swelling and Bruising: The swelling in your ankle and foot, along with the discoloration, could be indicative of several factors, including poor circulation, inflammation, or even lymphatic issues. After a fracture, it’s common for the surrounding tissues to become inflamed as part of the healing process. However, persistent swelling and discoloration may require further evaluation.

2. Numbness and Circulation Issues: Numbness in the toes and poor circulation can be concerning. This could be due to nerve compression or damage during the injury or surgery, or it could be related to vascular issues. It’s crucial to monitor these symptoms, as they can affect your recovery and overall mobility.

3. Limited Range of Motion: The inability to squat or navigate stairs can significantly impact your daily activities. This limitation may stem from stiffness in the ankle joint, muscle tightness, or even compensatory movement patterns developed during your recovery.

Recommended Actions
1. Follow-Up with Orthopedic Specialist: Since you are experiencing significant symptoms, it is advisable to continue follow-ups with your orthopedic surgeon. They can assess the healing of the bone and determine if any further interventions are necessary. If the bone has healed but you are still experiencing issues, they may refer you to a physical therapist or a rehabilitation specialist.

2. Physical Therapy: Engaging in a structured physical therapy program can be highly beneficial. A physical therapist can provide targeted exercises to improve your range of motion, strengthen the muscles around your ankle, and enhance your overall mobility. They can also address any compensatory patterns that may have developed due to your injury.

3. Addressing Swelling and Circulation: To manage swelling, consider elevating your leg when resting, applying ice packs, and using compression garments if recommended by your healthcare provider. Gentle range-of-motion exercises can also promote circulation and reduce swelling. If numbness persists, it may warrant further investigation, potentially involving a neurologist.

4. Alternative Specialists: If your symptoms do not improve with orthopedic follow-up, consider consulting a vascular specialist to evaluate your blood flow and a neurologist for the numbness. Additionally, a podiatrist may provide insights into foot mechanics and help address any issues related to plantar fasciitis or other foot-related conditions.

5. Lifestyle Modifications: Incorporating low-impact activities, such as swimming or cycling, can help maintain fitness without putting excessive strain on your healing bones. Additionally, maintaining a healthy diet rich in anti-inflammatory foods can support your recovery.

6. Patience and Monitoring: Recovery from fractures can take time, and it’s essential to be patient with your body. Monitoring your symptoms and communicating openly with your healthcare team will be crucial in navigating your recovery journey.

Conclusion
In summary, while your orthopedic surgeon has indicated that the bone has healed, the ongoing symptoms you are experiencing warrant further evaluation and intervention. Engaging with physical therapy, monitoring your symptoms closely, and possibly consulting additional specialists will be key to addressing your concerns. Remember, recovery is a process, and with the right support and interventions, you can work towards regaining your mobility and reducing discomfort.

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