Complications After Open Fracture Surgery: What to Expect - Orthopedics

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Understanding complications after an open fracture surgery, especially in the context of a severe injury like yours, is crucial for both recovery and long-term function. Open fractures, particularly those that are comminuted (where the bone is shattered into multiple pieces), pose significant challenges in terms of healing and rehabilitation.
From your description, it seems that you have undergone a series of interventions due to the complexity of your injury. Initially, external fixation was used, which is a common approach for managing open fractures, especially when there is a risk of infection or when the fracture is unstable. The fact that your bone did not heal properly after five months is not uncommon in cases of severe open fractures. The subsequent surgery to use artificial bone grafts and internal fixation indicates that your medical team is taking the necessary steps to promote healing.

Regarding the alignment of your bone, it is important to understand that some degree of angulation or curvature can be acceptable, especially if it does not significantly affect function. The two-centimeter standard mentioned by other doctors is a guideline that many orthopedic surgeons use to determine whether a deformity is clinically significant. If the angulation is within this range and does not cause pain or functional impairment, it may not require further surgical intervention.
However, if you are experiencing a noticeable limp or if your gait is affected, this could be due to several factors. It might be related to muscle weakness, joint stiffness, or even compensatory mechanisms that your body has adopted due to the injury. The fact that you are using crutches and have limited ankle mobility could also contribute to an uneven gait. It is essential to assess whether your walking difficulties stem from the bone alignment or from other factors such as muscle atrophy or joint stiffness.

As for the concern about the bone becoming more bent over time, this is generally not the case. Once the bone has healed, it is unlikely to change shape significantly. However, if there is ongoing pain or functional limitations, it may be worth discussing with your orthopedic surgeon whether further intervention is necessary.
In terms of your ankle mobility and the possibility of nerve compression due to the hardware, this is a valid concern. If the internal fixation devices are causing discomfort or limiting your range of motion, it may be necessary to evaluate the position of the hardware. Sometimes, hardware removal is indicated if it is causing significant issues, but this decision should be made based on a thorough clinical evaluation and imaging studies.

In summary, while some degree of angulation may be acceptable, your symptoms of limping and limited ankle movement warrant further investigation. It is crucial to maintain open communication with your healthcare providers, seek second opinions if necessary, and consider physical therapy to address any functional deficits. Rehabilitation plays a vital role in recovery, and a tailored program can help improve strength, flexibility, and overall function.