Tibia and Fibula Fractures: Recovery and Concerns

Q: Tibia and Fibula Fractures: Recovery and Concerns

Hello： In response to your questions, first of all, congratulations. <br>Although the car accident resulted in a severe open fracture, based on your description, the physician handling your case has done an excellent job, and I believe there will be a good outcome. <br><br>Questi

Fracture of the tibia and fibula in the left lower leg?

Hello Dr.
Lee,
Last December, I was involved in a car accident that resulted in fractures of my left tibia (broken in two places) and fibula.
It was an open fracture, and I underwent surgery on the same day using an external fixator.
Later, at my father's request, three days after the initial surgery, the method was changed to internal fixation, with the tibia being treated with a plate and screws, while the fibula was left untreated.
Twelve days later, the stitches were removed, and two days after that, I had a fiberglass cast applied.
I then returned to my home county for recovery.
I have several questions:
1.
My fiberglass cast was removed after 48 days (62 days post-surgery), and at that time, the bone had not yet healed.
Could this lead to bone displacement?
2.
When I returned to the hospital for a follow-up four months later, the doctor said the bone was healing, but very slowly.
He advised me to use two crutches and put weight on my foot to stimulate growth, even though the bone had not yet united.
Could this cause bone displacement?
3.
If the bone has not healed after six months, will I need another surgery? I am really afraid of undergoing another operation.
4.
Are there any lifestyle considerations I should be aware of? I am worried that I might be overlooking something that has led to my current situation (I do not smoke or drink alcohol).
5.
Are there any methods to promote faster healing? To add, my foot has not been painful at all.
When the cast was removed, the doctor was concerned I would experience pain and prescribed a topical pain relief medication, but I have not needed it.
Even when I put weight on my foot, there is no pain.
After my surgery, I consulted with two large hospitals, and both doctors said the bone surgery was performed very well.
I am almost 26 years old and have always been in good health; I haven't used my health insurance card for illness in several years.
During this fracture period, I have consistently consumed two glasses of milk daily, and my mother has almost daily prepared fish for me.
I feel like I have done everything I should, yet the healing is still very slow, which has led to extreme lack of confidence and a poor emotional state.
I have many questions, and I would greatly appreciate your help in answering them.
Thank you.

yang, 20~29 year old female. Ask Date: 2006/05/17

Dr. Li Wenlin reply Orthopedics

Hello: In response to your questions, first of all, congratulations.
Although the car accident resulted in a severe open fracture, based on your description, the physician handling your case has done an excellent job, and I believe there will be a good outcome.

Question 1: Prolonged immobilization in a cast can lead to muscle atrophy and joint stiffness.
Removing the cast after 62 days post-surgery is not too early.
Although there is still no significant bone growth at the fracture site, as long as you follow medical advice and use crutches correctly, you need not worry about displacement.
Question 2: Adhering to medical advice is crucial.
The surgeon will have the best understanding of your condition.
You mentioned that you can bear weight; if it is not painful, you may gradually increase to half of your body weight.
If your surgeon agrees, you can eventually progress to full weight-bearing.
Question 3: You are still young, and the chances of healing are high.
Try not to worry too much; being in a negative mood can actually hinder bone healing!
Question 4: What you can do personally includes maintaining a normal diet, having a regular lifestyle, and actively participating in rehabilitation.
Leave the rest to your physician to figure out.
Question 5: Accelerating bone healing is a common desire among all fracture patients.
With advancements in technology, there are indeed many new methods to promote fracture healing, such as autologous bone marrow injection, shockwave therapy, electrical stimulation, and autologous bone grafting, among others.
However, there is no need to rush; it is best to have a thorough discussion with your attending physician about the best course of action.
Wishing you a speedy recovery!

Reply Date: 2006/05/17

More Info

Hello! It sounds like you've been through a challenging experience with your tibia and fibula fractures, and it's completely understandable to have concerns about your recovery. Let's address your questions one by one.

1. Will the removal of the cast after 48 days without bone growth cause displacement?
It is common for fractures, especially open fractures, to take time to heal. If your doctor decided to remove the cast after 48 days, it likely means they assessed that your fracture was stable enough for that step. However, if the bones have not yet united, there is a risk of displacement if you put weight on the leg too soon. It’s crucial to follow your doctor’s advice regarding weight-bearing activities and to use crutches or a walker as recommended.

2. Will using crutches while the bone is still healing cause displacement?
Using crutches to relieve weight from the affected leg is a standard practice to encourage healing without causing further injury. If your doctor has advised you to bear weight on the leg while using crutches, they likely believe that the fracture is stable enough to handle some stress. However, if you experience any unusual pain or instability, it’s essential to communicate this to your healthcare provider immediately.

3. What if the bone hasn’t healed after six months? Will I need another surgery?
If your fracture has not healed after six months, it may be classified as a nonunion. In such cases, further evaluation will be necessary. Your doctor may recommend additional imaging studies to assess the healing process. If the bone is not healing adequately, surgical options such as bone grafting or internal fixation may be considered. It’s understandable to be apprehensive about another surgery, but your doctor will guide you through the best options based on your specific situation.

4. What lifestyle factors should I be aware of during recovery?
While you mentioned that you do not smoke or drink alcohol, which is excellent, there are other factors to consider. Ensure you maintain a balanced diet rich in calcium and vitamin D, as these nutrients are vital for bone healing. Staying hydrated and engaging in gentle, doctor-approved exercises can also promote circulation and healing. Avoid high-impact activities until your doctor gives you the green light.

5. Are there ways to promote faster bone healing?
While you are already doing well by consuming calcium-rich foods like milk and fish, consider incorporating other nutrients that support bone health, such as magnesium and zinc. Some studies suggest that certain supplements, like vitamin D, may aid in bone healing, but it’s essential to consult your healthcare provider before starting any new supplements. Additionally, maintaining a healthy weight and avoiding stress on the fracture site will help.

It’s great to hear that you are not experiencing pain, as this can be a positive sign. However, the slow healing process can be frustrating. It’s essential to stay in close contact with your healthcare provider and follow their recommendations. If you feel uncertain or anxious, don’t hesitate to seek a second opinion or ask for more detailed explanations about your recovery plan.

Remember, recovery from fractures can take time, and everyone heals at their own pace. Stay positive, and keep focusing on your health and well-being. If you have any further questions or concerns, feel free to reach out. Wishing you a smooth recovery!

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