 Poster: A snowHead
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My husband broke his leg in 2 places skiing 2 weeks ago. He has a titanium plate for the ankle break and 8 screws.
He's got a cast at the moment. I was wondering (I know you can only give a rough idea):
Will he get a boot at some point instead of a cast?
How long will he need crutches for?
Any tips on getting back to strength?
Will he need the plate out later on?
Thanks!
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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He will likely go from a cast to a boot after a few weeks - time frame may be consultant dependant.
Likely to need crutches in some form Non Weight bearing, Partial Weight bearing for 6-12 weeks.
The plate and screws will stay in unless they cause major problems.
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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@RosieL, make sure he asks his surgeon any questions that he has. Tips for strength are physio physio and more physio as soon as full weight bearing. Check your travel insurance...mine has £500 for physio and I used that in less than 3 months. In the meantime he should get an NHS physio referral...he needs to be doing non weight bearing exercises now to try and arrest the atrophy
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You need to Login to know who's really who.
You need to Login to know who's really who.
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Thanks that's great- I've passed all that on.
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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| RosieL wrote: |
My husband broke his leg in 2 places skiing 2 weeks ago. He has a titanium plate for the ankle break and 8 screws.
He's got a cast at the moment. I was wondering (I know you can only give a rough idea):
Will he get a boot at some point instead of a cast?
How long will he need crutches for?
Any tips on getting back to strength?
Will he need the plate out later on?
Thanks! |
Sorry to hear that.
The cast/boot/ left free options are driven by the stability of the fracture, the state if the soft tissues, personal preference of the surgeon and cost ( the boots are expensive) . So best talk to the surgeon who did the op.
Ditto crutches and weight bearing.
Not much rehab possible until cast/ boot off.
Plates do need to come out sometimes. My preference is to leave them if they aren't causing problems.
You can get more detail on whether plates should be removed here on my blog http://www.wimbledonclinics.co.uk/blog-is-it-bad-to-leave-metalwork-in-the-body-february/
If you want more info come back to me
Jonathan Bell
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You'll need to Register first of course.
You'll need to Register first of course.
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@Jonathan Bell,
Not even my injury but feel privileged to read such a comprehensive and knowledgeable reply.
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Thanks Jonathan - that's really helpful.
Unfortunately the surgery was done it Italy and there was a major language barrier! My husband is going to our local fracture clinic tomorrow so he'll be assessed there. He has private medical care too so we can use that if we need to, for extra physio etc...
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@RosieL, excellent. The UK consultant will be able to answer all questions and refer to physio. I found it helpful to write all my questions down to take to the fracture clinic
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You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
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| RosieL wrote: |
Thanks Jonathan - that's really helpful.
Unfortunately the surgery was done it Italy and there was a major language barrier! My husband is going to our local fracture clinic tomorrow so he'll be assessed there. He has private medical care too so we can use that if we need to, for extra physio etc... |
Transfer your whole care across if you don't get time in fracture clinic. When I used to do fracture clinics we were given 5 minutes per patient.
If you let me know where you are I may be able to rec a physio.
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| Hywel wrote: |
@Jonathan Bell,
Not even my injury but feel privileged to read such a comprehensive and knowledgeable reply. |
My pleasure. I've started to write s few blog pieces on my own site where the same question keeps coming up or a longer reply would be helpful . Removal of metal is a common one
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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@RosieL, Nightmare..... I know nothing about these things whatsoever, but wasn't a nail an option as happened to me? Jonathan Bell, if I may ask, could you shed any light the "general criterion" for nailing or 'casting'?
Thankfully the plate and screws are absolutely fine in ski boots, which I was a bit worried about.
my mess...
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And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
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Thank you all. He had a really good appointment at the clinic today (we're in Edinburgh). He had his stitches out and got a new cast. They were really happy with the job the Italian surgeon had done. All looking good. Apparently all the nails/screws were put in because the ankle bone split quite a long way up- ouch!
He's to marginally weight bear and can drive (great news in practical terms!) He'll start physio soon I think.
Thanks again!
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Oh and Allanm - holy s**t!!!
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You know it makes sense.
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@RosieL, Oh that's encouraging..but I really hope you are going to say it's his left leg and he drives an automatic!
and don't worry about @allanm, he's been skiing today....but yes, holy s**t!
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Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
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^^ RosieL, In the big scheme of things it wasn't that bad, we do sport, it goes wrong from time to time, such is life you have to cope.
But, for me, I was driving (an auto) pretty much from day one, (partially) weight bearing in a handful of weeks, and the whole time no cast. IIRC, pretty well not problem in about 10 weeks - **although** I didn't have real confidence for the best part of a year to do any sort of sport (waterskiing).
Jonathan Bell, Your website is great, very informative specifically the "Who should remove metalwork?". I've other problems now, but was thinking about the possibility of removal, it will stay, it isn't causing me any problems.
@holidayloverxx Yes, these things are sent to try us, great day today.
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Poster: A snowHead
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My advice to ROSIEL's husband (ROSIEL, too) - beyond my heartfelt compassion (I was there as a kid - 11 months on crutches, 16 months before I was cleared once and for all..........) is to take it easy. Too many try too soon to do too much. Do just the opposite.
By the way ROSIEL............., what precipitated this? Slow twisting fall in oatmeal? Was binding properly set and too, what was the condition of the boot(s)? Am also curious about the brand of binding.
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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Thanks again. Yes it was his left foot and yes it's an automatic!😀
I'm probably not as sympathetic as j could be as I'm working long hours and we have 3 children. Hey ho!
The fall was a weird one. Great conditions and on a blue. He got caught up between 2 people skiing too close to him and couldn't get a turn in. I think he looked over his shoulder and his skis crossed. He's a pretty proficient skier so it was bad luck.
I did ask about his ski (I wasn't there). I don't think it came off. His boot was fine. It did make me wonder about the bindings. Ski hire shop was chaotic and they didn't ask about our levels. He is a pretty good skier so I guess he'd have the binding on fairly high? Definitely one to pay more attention to next time....
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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| allanm wrote: |
@RosieL, Nightmare..... I know nothing about these things whatsoever, but wasn't a nail an option as happened to me? Jonathan Bell, if I may ask, could you shed any light the "general criterion" for nailing or 'casting'?
Thankfully the plate and screws are absolutely fine in ski boots, which I was a bit worried about.
my mess... |
Casting is increasingly historic and requires alot of input with frequent visits.
There are disadvantages mainly around the fracture healing with incorrect position( Angle of healing, shortening , displacement)
You also can't get the nearby joints moving early so you may get permanent stiffness.
Fixation allows accuracy of holding the fracture, early rehab and possibly weightbearing.
It allows earlier return to work etc in many cases. There are some disadvantages in that you risk complications from surgery , in particular the risk of infection.
Techniques for fixation have improved over the last 30 years. There are now possibly too many fractures fixed.
Jonathan Bell
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You need to Login to know who's really who.
You need to Login to know who's really who.
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@Jonathan Bell, Thanks for that ^, but what I was kind of fishing for was the **possible** reasons why I was nailed, and @RosieL's OH was put in a cast, as far as I'm concerned the nail was great, no 'rehab' whatsoever, once weight bearing we just increased slowly back to normal (IIRC < 3 months), I have no ill effects at all now (apart from the final set wasn't millimeter perfect)... but no ones gonna notice (;>)
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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| allanm wrote: |
| @Jonathan Bell, Thanks for that ^, but what I was kind of fishing for was the **possible** reasons why I was nailed, and @RosieL's OH was put in a cast, as far as I'm concerned the nail was great, no 'rehab' whatsoever, once weight bearing we just increased slowly back to normal (IIRC < 3 months), I have no ill effects at all now (apart from the final set wasn't millimeter perfect)... but no ones gonna notice (;>) |
What was the fracture? Nails are used for lots of different types of fracture in many bones.
Some bones lend themselves better to being stabilised with a nail. Typically the most suitable are large, fairly straight with a wide marrow cavity.
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You'll need to Register first of course.
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^^ I was talking about Tib & fib.. as in "My mess" two posts up.
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| allanm wrote: |
| @Jonathan Bell, Thanks for that ^, but what I was kind of fishing for was the **possible** reasons why I was nailed, and @RosieL's OH was put in a cast, as far as I'm concerned the nail was great, no 'rehab' whatsoever, once weight bearing we just increased slowly back to normal (IIRC < 3 months), I have no ill effects at all now (apart from the final set wasn't millimeter perfect)... but no ones gonna notice (;>) |
Apologies i have only just spotted the xrays.
Fractures are classified as this helps with descriptions.
The fibula fractures in both ankle and tibial shaft fractures.
In essence you had a fracture of the tibia not an ankle fracture
Usually the fibula fracture associated with a tibial fracture is left to its own devices as it heals without upsetting the ankle. Your fibula fracture was quite close to the ankle and displaced so it was fixed. Plates work best on the fibula though there are thin nails that can be used.
You can plate a tibia but it involves disturbing the soft tissues around the tibia which can interfere with the blood supply to the bone. Good blood supply equals healing reduced blood supply equals delayed healing. Tibial intramedullary nails have many advantages over plates ( they are safer to put into very swollen bruised legs, you can weight bear much earlier, inserting them actually stimulate healing, healing rates are very high and they rarely require removal unlike plates). Your fracture may have benefitted from rehab especially if you still have some restriction of ankle dorsiflexion ( bending foot up towards the head).
Jonathan Bell
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Thanks for that @Jonathan Bell.
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