Post-Surgery Recovery Tips for Tibial Fractures: What to Expect

Post-operative care for tibial fractures?

On July 19, I was involved in a car accident that resulted in a comminuted fracture of the left femur, with the fracture extending approximately 30 centimeters from above the knee joint to below the hip joint.
I also sustained a fracture of the right ankle joint and a fracture of the right knee joint (the doctor mentioned that surgery is not necessary for this).
I returned for a follow-up appointment two weeks later to have the stitches removed, and the doctor said the wound is healing well.
The orthopedic surgeon advised that I could start practicing walking with a walker, but the rehabilitation doctor disagreed, stating that based on the previous X-rays, the bones have not healed sufficiently in less than three weeks, and both legs are fractured, making them unsuitable for bearing weight.
What should I do? Currently, I can bend my knees to an angle of less than 50 degrees, but I still experience pain, and there is a grinding sound with some catching sensation.
Is this normal? Is it normal for the pain to increase at night when the temperature drops? What can I do to recover more quickly? I live in an old apartment and am currently residing in a nursing home; I want to learn how to climb stairs as soon as possible.
Is it possible to learn to go upstairs in two weeks? How long will it take before I can stop using a walker or wheelchair?

Hsu Yu-Ling, 30~39 year old female. Ask Date: 2023/08/11

Dr. Shi Guozheng reply Orthopedics

The duration for which a walker is needed depends on the healing status of the bone, which should be assessed through follow-up X-rays.
If it is not a comminuted fracture, typically, one can start walking within three months, but a walker will still be necessary.
To safely discontinue the walker or crutches, it is important to wait until the bone has fully healed.

Reply Date: 2023/08/11

More Info

Recovering from tibial fractures, especially after significant trauma like a car accident, can be a challenging process. It’s essential to understand what to expect during your recovery and how to manage your rehabilitation effectively. Here are some insights and tips based on your situation.

Understanding Your Condition
You mentioned suffering from a comminuted fracture of the tibia, which is a severe type of fracture where the bone is broken into several pieces. This type of injury often requires a longer healing time due to the complexity of the fracture and the potential for complications. Additionally, you have fractures in both legs, which complicates your recovery further.

What to Expect Post-Surgery
1. Pain and Discomfort: It is normal to experience pain, especially in the early stages of recovery. The pain you feel, particularly when bending your knees or during movement, can be attributed to several factors, including inflammation, muscle stiffness, and the healing process of the bones. The "grinding" or "cracking" sounds you hear could be due to the movement of tendons or ligaments over the healing bone, which is also common.

2. Swelling and Bruising: Expect some swelling and bruising around the fracture sites. This is part of the healing process, but if the swelling increases significantly or is accompanied by severe pain, it may indicate complications such as infection or improper healing.

3. Temperature Sensitivity: It’s not unusual for pain to intensify with changes in temperature, particularly in the evenings or during colder weather. This can be due to increased sensitivity in the injured area or changes in blood flow.

Rehabilitation and Mobility
1. Weight Bearing: Your orthopedic doctor has advised against weight-bearing activities at this stage, which is prudent given the nature of your fractures. It’s crucial to follow this advice to avoid further injury. The rehabilitation doctor’s caution is based on the X-ray findings, indicating that your bones have not yet healed sufficiently to support weight.

2. Assistive Devices: Using a walker or crutches is essential for your safety and to prevent undue stress on your healing bones. It’s advisable to continue using these devices until your doctor confirms that you can safely bear weight.

3. Physical Therapy: Engaging in physical therapy is vital. A physical therapist can guide you through exercises that promote flexibility and strength without putting too much strain on your fractures. They can also help you with range-of-motion exercises to improve your knee flexion, which is currently limited.

4. Gradual Progression: Learning to navigate stairs and increasing your mobility will take time. It’s essential to set realistic goals. While you may hope to learn to go up and down stairs in two weeks, this will depend on your healing progress and the advice of your healthcare team.

Tips for Faster Recovery
1. Follow Medical Advice: Adhere strictly to your doctors' recommendations regarding weight-bearing and rehabilitation exercises. Regular follow-ups are crucial to monitor your healing progress.

2. Pain Management: Use prescribed pain medications as directed. Ice packs can help reduce swelling and alleviate pain.
3. Nutrition: Ensure you are consuming a balanced diet rich in calcium and vitamin D to support bone healing. Foods like dairy products, leafy greens, and fortified foods can be beneficial.

4. Stay Active Within Limits: Engage in gentle movements as advised by your physical therapist. Avoid prolonged immobility, as this can lead to stiffness and muscle atrophy.

5. Mental Health: Recovery can be mentally taxing. Stay connected with friends and family for support, and consider speaking with a mental health professional if you feel overwhelmed.

Conclusion
Recovery from tibial fractures is a gradual process that requires patience and adherence to medical advice. While it may feel frustrating at times, focusing on small, achievable goals can help you stay motivated. Always communicate openly with your healthcare team about your progress and any concerns you may have. With time and proper care, you will regain your mobility and strength.

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