Question for Dr. Mark on Tib/Fib break with xrays...
Posted 10 September 2006 - 04:27 PM
Here are the facts: I'm 25 year old male self employed need to be on my feet for work. 163lbs athletic build.
Yesterday I broke my tibia and fibula and was ambulanced to Umass Hospital in Worcester Mass. I was given a ton of morphine and pain killers. Here is how the day went.
Injury happened at 11am.
Ambulanced to hospital arrived at 12pm.
Put in a splint for xrays that happened at 2pm
Finally met with orthopedic at 6pm where they said they are going to give me two medicines. One sedates me, the other is a stronger pain killer than the Morphine.
They put this full cast on and set the bones and said it probly will need surgery check back in a week.
Thats where I am lost. I was really expecting surgery right away and in this full cast I can still feel the bones moving My question for you is what should I do next about treatment? This cast weighs a ton and I am stuck in my bed and cant not move. It is also not constructed right where my leg needs to be at the right angle to avoid pressure points in the cast. It's still extremely painful. I was given perkasets but it is not enough if I have to move.
I live 1.5 hours from the hospital I was brought to. What do you think is the best way to treat this and what should I do tomorrow to get immediate treatment? Was hoping to visit my local orthopedic
I do not have xrays from after they set it. But these are the before
Posted 10 September 2006 - 04:46 PM
Afterward, you could start immediately walking on it without a cast as well as work the range of motion of the ankle and foot.
It should be healed by four months, and you could ride about a month later.
Posted 10 September 2006 - 07:09 PM
best of luck to you
Some xrays if you want.
Posted 11 September 2006 - 04:44 PM
Dr. Mark hit it on the head....get your leg fixed man....whew....
Posted 11 September 2006 - 05:08 PM
Posted 11 September 2006 - 05:26 PM
1. Took new xrays... obviously it wasn’t set in that cast.
2. Put a new cast on before surgery. The new one is below my knee and much more comfortable. It was a fun adventure with his cute assistant holding my heal up as I ground my teeth on the table. Hurt like hell.
3. Debated the options... They are getting me in for surgery on Thursday. He's moving people around and getting me in (I'd find someone else if they didn’t)
Dr. Mark they left me with two options. One the rod as you said. But he really wants to go for a plate and screws. IF he feels that if they get in there and the plate wont work they are going to switch and end up putting the rod in. I wish I could provide you with his EXACT reasoning but I do not have it verbatim as to why he wants to go plate and screws first. What do you think?
Posted 11 September 2006 - 05:29 PM
If you doc can't rod it, change out the doc.
Posted 11 September 2006 - 05:35 PM
Also what gets done to hold the fib back in place?
Posted 11 September 2006 - 05:50 PM
The fibula can just be ignored in this fracture. It doesn't need anything.
Posted 30 October 2006 - 06:01 PM
Sept 9, 2006 Broke the tib/fib and the xrays that you see above when it was NOT set were taken.
Sept 11, 2006 Met with my orthopedic back in CT and they took xrays, put on a new cast and got me in for surgery on Thursday. The 5 days from the break to surgery were some of the worst days of my life dealing with the bones shifting in the damn cast everytime I moved my leg.
Sept 14, 2006 Surgery at 9am a plate was put on the tib/fib. When I woke up from surgery around 12:30 noon I felt great. Wanted to go home. Watched the nationals on OLN at 6pm and was released at 7. Was soo glad not to have to spend the night in the hospital and got a good nights rest.
Sept 15, 2006. Not as smooth a day from the day of surgery. Could not stand up for longer than 2 minutes due to the blood rushing into my foot it felt like it was going to exploid. The best part though was no more bones shifting and I was in a splint wraped in a bandage. Also somewhat of a throbbing pain coming from the bone but bearable.
Sept 17, 2006 Finally left the house after being in bed for 2 straight days. Went down to the local track got some fresh air but still hurt like hell to stand up I HAD to keep it elevated. I was also catching a cold…. Which made for another week of hell. Especially dealing with running my business.
Sept 25, 2006 Met with doctors 11 days after surgery. Had the staples removed (was cake didn’t even feel it and had some sitches out. Just a pinch hurt way more than staples and actually the cut they stitched was seeping a little where the stapled part healed way faster. Was moved into an aircast (hard boot that is removable) Still very swullen and still had to keep it elevated
Oct 2, 2006 Still getting better. Easier to get around I can stand up now without having to elevate the leg due to the rushing of blood. Still leg and foot turns blue in the shower ect… Started going to the gym 3 days a week
Oct 16, 2006 Back to doctors. New x-rays asked about working out on my trainer. Doctor gave the ok but said go easy. That day I couldn’t get over 50 cadence and put my mountain biking shoes on instead of roadbiking shoes cause I couldn’t fit due to the swelling
October 23 2006 Finally could it in road shoes and reach a 70 cadence for 15minutes Range of motion now with the ankle is getting better. I can not bring it up all the way but can almost point it down all the way.
October 29 2006 , Finally reached 85 cadence for 30 minutes at a 130hr I cant really work myself much harder or my ankle hurts
October 30 2006 (6.5 weeks since surgery) Here are some pictures went to the doctors said I could be partial weight bearing. I have been able to use my foot really for the past 5 days to balance myself when standing on two legs. I can also be a little less careful with my leg in the air cast when like getting in and out of cars. Also I don’t like sleeping with the aircast on and I can do so now pain free.
My worries: 1. the swelling? Do you think its normal 2. The healing of the fib. What’s going on! Is it healing properly??
Posted 30 October 2006 - 06:06 PM
I would get you a TED stocking to help compress the veins and return blood to the heart.
When you are not walking, you should be elevating the foot, and I think that you can start taking weight on it.
Posted 30 October 2006 - 06:48 PM
Posted 31 October 2006 - 10:41 AM
Posted 09 November 2006 - 06:23 PM
When standing it hurts enough where I lose focus and I can feel my pulse at my ankle and it hurts to put 50% of my weight on it. Also lost range of motion. It hurts like hell to move my foot up
Any advice on what to do? Go in to the doctors? (I'm one week out from an appointment) Ice it? Elevate it? thanks for any input. I'm devastated.
Posted 08 December 2006 - 01:35 PM
So here we are...
November 5: Able to put 50% weight on it. still on crutches
November 8th: Fell out of the aircast on it. really bad sprain. reswelled up. Not able to put weight on it. No longer able to push a clutch in on a car without tons of sharp pain
November 20: Able to drive a manual car again. Back where I was before falling on it. Doctor said I can put all my weight on it.
November 22: Able to walk in aircast. It felt like walking on your wrists and hurts to put weight on it. Can only go about 300ft a day on it before being back on the crutches. Started physical therapy
November 28: Able to walk now in the aircast without the use of crutches. This is 12 weeks after the injury.
December 4: Able to walk without the air cast for half the day
December 6: Able to walk without the aircast all day with a limp
right now it's still swollen but better than those pictures I posted. I feel pretty good on it but can not put all my weight on the ball of my foot. It just hurts really bad if I try but is getting better each day.
dont break your leg....
Ohh this is interesting too some of the bills. Why do they tell you how much it costs after? if you dont have insurance this could set you back for YEARS. Thank god I have insurance.
Ambulance ride (30 miles) 850 dollars
Emergency room that day: 2300 orthopedic
Each visit to orthopedic (they bill 300 but don’t get it I think they are getting 200)
Xrays: 35 a picture (seems like only thing that’s reasonable)
Surgery: The hospital bill for the DAY (I didn’t spend the night) for the plate and 12 screws to be installed was $12,882. Are you serious?!?!!?
physical therapy: 80 a visit for 8 visits
So right now I think its somewhere around 17,000 dollars
Posted 08 December 2006 - 03:25 PM
Posted 09 December 2006 - 02:32 PM
Hospital bill for three days $37,000
Doctors bill for surgery $3,100
Two cat scans at $1,400 each
Phsical therapy 3 times a week. Pool and land for 2 months $3,500
Phsical therapy is a joke. I do my own therapy now. 24hr fitness $55.00 a month
Posted 11 December 2006 - 08:05 PM