Broke My Leg, Concerned About Healing

Cyd Cyclone

I broke my leg on Tuesday afternoon, badly enough to need surgery. I had a spiral fracture of my fibula and broke the ankle end of the tibia off. I had surgery yesterday, and they put plates, pins, and screws in, including one through the ligament at the ankle that comes out in a few months. I'm at home now resting. Apparently I won't be able to walk on it for three months.

As I know I'm not the first person to break a leg, I come to you H/A with your combined wisdom, what should I expect from the recovery process? Are there certain things I should be doing to help with recovery, or certain things to avoid?

dispatch.o

It will itch, if it hurts if you do something, don't do that thing and give your doctor a call. Your muscles will atrophy and your tendons and ligaments will probably tighten and you need to do your prescribed rehab. The biggest mistake people make is skipping rehab, that shit actually matters and normally a good physical therapist isn't some ex-jock who majored in art studies or P.E. they are the ones best qualified to tell you what you should expect once that time comes.

This early on I'd say it's all sort of a maybe. You can expect a hideous ghoulish pale limb that may or may not have hair once your cast is off. It will itch. Mobility and all that good stuff, range of motion etc really depends on how it heals and it's way too early to know. You will probably have to do stretches and such every morning for the rest of your life to get your ankle and foot to loosen up, though.

Ponge

I broke my leg/ankle in almost exactly the same places last September after a bad tackle playing football. Immediately after the surgery it hurt like hell, and it itched a bit but I had the cast replaced like 3 times as they checked on it's healing, so it helped to get some air to it (god it stank). Which was good, because the first cast had moved slightly and my skin was rubbing against the cast, rather than the padding which caused mega blisters.

It's going to suck. If you're on crutches then get a decent pair, or get some proper hand grips because your hands are going to blister up and hurt like hell. Don't use the under-armpit ones if you can avoid it, I've heard they can pinch a nerve under your arm if used for extended periods. I had to go back to work after 2 weeks because I ran out of sick-pay, and commuting in and out of central London every day on crutches really sucked, but after a month or so I was moving about okay. The first couple of weeks I had to stop every hundred metres or so due to exhaustion, but you get used to it.

My orthopaedic surgeon was really big on movement, and getting the muscles going. I moved the ankle around in the cast as much as I could as soon as I could (without overdoing it, or stopping if it EVER hurt more than an ache) and managed to avoid having to wear the 'space boot' once the cast was eventually removed. I didn't have issues with my ligament though, so that might not be the best course of action for you, check with your doctor.

Really the biggest pain in the ass is washing/showering. I had to hang my leg out of the bath and just take things really easy for a while. You can buy bags and things to put the cast in while you wash, but I just used bin-liners.

I had some of the metal-work removed (a large screw that went across my ankle that was apparently liable to snap, so it's easier to get it out). That was a simple 20 minute surgery with little to no recovery time (I took a day off work but in all honesty I probably could have gone in).

Any other questions just let me know man.

Mad Jazz

dispatch.o wrote: »

Your muscles will atrophy and your tendons and ligaments will probably tighten and you need to do your prescribed rehab. The biggest mistake people make is skipping rehab, that shit actually matters and normally a good physical therapist isn't some ex-jock who majored in art studies or P.E. they are the ones best qualified to tell you what you should expect once that time comes.

This, a thousand times this. PT is incredibly important for an injury like this, and you'll have to do it for a long time (probably long after you actually stop going to rehab appointments). Your therapist will most likely give you some exercises to do at home every day. Do them. If you don't, your recovery time will be longer, I promise.

The other big thing is pain management; broken bones hurt like a motherfucker, especially when you have to have surgery to fix them. Make sure you stay in front of the pain, because it takes a lot less medication to keep things under control than it does to break through when you're already hurting. If you have concerns about regularly taking narcotics for a couple of weeks as you recover from the surgery (a very common concern, btw), talk to your ortho and get set up with some other main management regimen. He/she should have no problem working with you to come up with a plan you're comfortable with.

Magic Pink

dispatch.o wrote: »

The biggest mistake people make is skipping rehab, that shit actually matters and normally a good physical therapist isn't some ex-jock who majored in art studies or P.E.

Every time I've had physical therapy it's been this exact shit and ended up being a huge waste of time and money. It's very very common; recognize it if it starts happening and dump the therapist and get a new one ASAP. Key phrase to watch for "I don't know why this isn't working".

Cyd Cyclone

Thanks for the advice so far, I should mention that I am in Canada, so if I do have trouble with the PT, I hear it's easy to get a different one. I'm likely working with the department at the hospital, some of whom I met yesterday, and they all were actual nurses as well as PTs.

I'm definitely taking the Tylenol 3 they sent home with me, as otherwise I wouldn't be able to sleep. Luckily, they didn't send anything stronger or more addictive, so I'm not too worried. I've been taking ibuprofen for the swelling, so that helps. I wasn't expecting how painful crutches turned out to be. I've got sore spots on my hands and ribs where the top of the crutches rest, and my hip from holding up my bad leg. When I heard that I wasn't likely to do any work for the first 2 weeks, even light office work, I didn't believe them, but now I sure do!

Siska

Keep an eye out for increasingly flushed looking skin in the next few weeks. Especially if you have any skin breakage on the front of your leg where there is little muscle and fat. Infection is common in the shin area because of poor circulation.

bowen

And MRSA is really common in hospital settings. Well, strep too, necrotizing fasciitis is nothing to laugh about.

Cyd Cyclone

They gave me a rundown of what to look for, like lose of feeling in toes, burning sensation, pain in the back of the leg, and unusual pain. The flushed skin is a little difficult to check for, cause they covered my leg in red antiseptic, but it's starting to wear off. Luckily I didn't break the skin when I initially broke it, so I guess I dodged part of that bullet.

Edit: I also don't have a hard cast, but a fiber glass splint wrapped with cotton and tensor bandages, so I'll be able to notice any sudden swelling.

bowen

It can be introduced during surgery.

Basically for NF, the biggest thing to look out for is "an unusual amount of pain in the area" Though with a spiral fracture that's kind of hard to judge.

Just be aware!

Cyd Cyclone

They mentioned that something like that could be introduced during surgery, but that they didn't have any current outbreak reports. I'm keeping an eye out, but I'm remaining hopeful I won't have to deal with it. I've also got a bit if a sore throat, but they said it's likely due to the anesthetic airway thingy. If it gets worse, I'm definitely contacting them.

El Mucho

Pain management is important for the first couple weeks. Make sure you keep on top of the pain. If you let it slip you are in for a few hours of excruciating pain until you get back on top of it.

I have had ACL re-construction twice, and the first week I was taking those tylenol 3's as often as the bottle said. Wake yourself up if you know the 4 or 6 hours will be in the middle of the night and take another pill. Also for tylenol 3's get some stool softeners and drink lots of water your poops will be like rocks and it will feel like pine cones coming out.

Once the pain started to subside, I used extra strength tylenol to supplement the t3s.

Darkewolfe

Just plan to be doing some of the exercises you get in physical therapy for the rest of of your life. Build that exercise into your routine. Part of you is always going to be weaker than it should be, and you need to plan to strengthen support muscles to account for it.

LewieP's Mummy

I broke my left leg a number of years ago. I learnt:
Take good painkillers. Don't wait until you're in pain to take them, take them at set times so you stay topped up.
Do all the physio they give you and more besides.
Buy some decent gel cycle gloves to cushion your hands, they will hurt lots and blister if you don't.

Cyd Cyclone

So far I've been taking the T3s every 4 hours or so, with Ibuprofen every 8ish, when my hip really hurts usually. I'm not going to worry about switching to Extra Strength Tylenol for at least a week.

I really appreciate all the advice so far. It's nice to know that things aren't going to suck this much forever.

Raif Severance

Just to echo what previous people have said, PT!!!! I've had 3 surgeries on my knee for a torn ACL and the most important thing I learned is that you need to do the PT. I never thought I would be back to my pre-injury strength but it is possible if you work on it.

Did your physician tell you to take the ibuprofen or is that something you are doing yourself? The reason I ask is because when I broke my collar bone/ribs my Ortho doctor me to avoid ibuprofen in the beginning because while it is an anti-inflammatory it also prevents some of the beneficial effects which can delay bone healing. If your Doc told you to take it then I would go with their advice.

The last thing I will mention is that there is 300mg of acetaminophen in T3 and 500mg in extra strength Tylenol. Just remember that you usually want to stay under around 3000mg a day of Tylenol (for short-term use under 4000mg may be okay but there's controversy about that). Tylenol 3 is a pretty weak pain reliever relatively so if you are still having extreme pain have them give you something stronger. Codeine has little to no analgesic effect until it gets turned into morphine in your body so you are basically taking morphine with a delayed onset. Some people make this conversion really slowly and find little relief with T3 so just be aware of that.

Good luck on your recovery!

The Ender

Jesus. What the Hell happened, if you don't mind me asking?

Do everything your doctor says, and don't try to 'man up' or be a hero. If the instructions are to stay off of it, stay off of it. I know quite a few people that screwed-up proper bone healing because they just refused to take it easy.

Cyd Cyclone

I fell on some ice. My left foot slipped, then must have hit traction or something while I was falling backwards. The worst thing is that I felt the bone snap. After that it's a bit hazy.

Raif, I was given ibuprofen in the hospital, and told to continue it for swelling, but only every second or third dose of the T3s. I'll keep in mind not to over do it on the ibuprofens. Thanks for the dosage info on the Tylenol, I wasn't aware of it, I'll definitely make sure not to go past the max dosage.

Overall, the leg pain has been ok, as long as I'm proactive with taking the meds. I woke up a little late last night for the dose, and it felt like I had seriously sprained it or something.

I didn't quite believe them when they told me I wouldn't be able to do light office work during the first two weeks, but I get super tired just getting up and going to the bathroom. I've got my appointment to take the staples out two weeks from Tuesday, so hopefully things will be looking better from then on.

Shutdown

What's your living arangements like? It's obvious but you'll need a gopher for a while - even someone around the house.

If you're living by yourself, see if you can move back to family or have a buddy move in for a month.

Cyd Cyclone

By way of an update:
Oh god I can feel the metal in my leg! Why did I try to push the meds from every 4 hours to every 6!

ceres

Because you hate advice!

...At least that's what I assume.

I hope you feel better soon, that is going to be a shitty way to spend your Spring.

Cyd Cyclone

It was more a case that it hadn't let that bad when I let the dose slip to every 5 hours, so I thought I'd take the risk. It was not a risk worth taking. It's not so much that it hurts more, but feeling the screw going through my ankle is extremely unpleasant.

I will never disregard dosage advice again!

The Ender

Cyd Cyclone wrote: »

By way of an update:
Oh god I can feel the metal in my leg! Why did I try to push the meds from every 4 hours to every 6!

The Ender wrote:

Do everything your doctor says

That sucks dude; I know it can be a hassle to adhere to a med schedule (some of the stuff I'm taking for my left eye right now upsets my stomach, and it's easy to forget the damn drops), but our bodies don't like it when we cheat.

Cyd Cyclone

I was adhering. He told me to push it to every 6 hours after a few days and see how I felt.

Chakotay

After removing the cast, you have to go to rehab to strengthen your leg. I also experienced having my foot cast but your experience is totally different from mine. Just a heads up, that leg of yours would be prone to injuries in the future. I'm experiencing reoccurring sprains and still needs to go to the PT for leg strengthening.