I broke my tibia riding in the woods 5 weeks ago. The Doc said I didn't need a rod and it seems to be healing fine. I'm wondering if there are any vitamins or foods that will help the process. I am supposed to be exercising it by putting 50% weight on it....  I think working out with every other part of my body will help with the blood flow and speed up healing.  Any tips?

Drink a lot of milk, and get a calcium/magnesium and a vitamin D supplements. Avoid soft drinks. Drink lots of water.

That one needs to be rodded.  People don't accept crooked legs like they did in the 1920s.  Its crooked.  I can tell even from that liffle picture.
Finding a competent doctor is never easy.

Actually it's been 6 weeks since I broke it, so a rod isn't an option at this point is it? I hope my doctor isn't discounting the pressure generated from riding a dirt bike or snowboarding on a slightly crooked bone.

There is no problem fixing that crooked bone.  Your current doctor has all readly let you know what tools are in his box.  Find someone with a larger tool box, or come visit me.

This doctor came highly recommended and seems to be very respected among the other doctors in the area. He said he'd love to nail it, but thought it might be worth it taking a little longer to heal in the long run without a rod. He said it was right on the acceptable margin.  Won't the bone fill in a bit once pressure is put on it?  I'm wondering what could aid that process. Also, are there any other options beside a rod down the middle?

My eyes are no sharper than anyone else's. Look at the frontal view.  Its crooked and when it heals you will have a crooked leg and be mad at the world.  I don't care if Jesus Christ, Himself, reccommned the doctor.

Your options are rod, plate, or cooked leg.  
Well at least with the crooked leg, you will have a leg to stand on in court later on.

Maybe I will go see another doctor. I'd hate to start all over again. I did see another ortho surgeon 3 weeks ago while I was away on vacation and he said the same thing--that he wouldn't have put a rod in it. He said the bone would really thicken up in that area and then remodel itself over time and you would hardly be able to see there was a break there.  I don't want a crooked leg, but even more so, I don't want a weaker leg.  I'll go check with another doc this week and let you know what he says.  Thanks for the input.

DrMark said:

Word - I broke my tib (and fib) in 06 and it looked pretty much like yours and was rodded. Don't know how old you are, but I was 50 and that is way to young to start walking bowlegged.
Get a second opinion or get your butt to Houston NOW.

Just my opinion, i know you have 5 weeks invested in "letting it heal naturally", but i would chalk that up to a learning experience and get it plated/rodded straight.
Again, just my opinion.
I lost almost 4 weeks waiting for a crooked collarbone to heal "naturally" and then got it plated and am very happy.  I consider it a learning experience.  I got it plated locally, so at least it is straight, although the dr. is not confident to accelerate recovery times.  And next time i am flying to Houston so that my recovery time is less

well the earliest appointment I could get was in two weeks. That will be 8 weeks since the break. I guess at that time we will see what it looks like healing-wise and also what it looks like from the outside. I don't mind if the bone has a little jog in it so long as it is just as strong as the other one. If it is bad enough to see from the outside, I think I will opt to have surgery and make it straight. The last time I had the cast off, 3 weeks ago, from the outside, my leg looked perfectly straight.

X-rays don't lie.
Swelling can alter the outward appearence to the casual observer.

yes, it was swollen in that pic. Dr. mark, I can accept a slight jog in my shin bone.... I won't accept it if it is a visibly deformed leg, (I guess we'll see in couple of weeks) but will it be as strong as my other leg? I am very active and play every sport, snowboarding, etc... I've been a serious woods rider all my life--I'm 54 years old, 5'10" 180#.  Your thoughts?

In 1940 people accepted crooked bones.  In 2009, people don't accept that anymore. What century do you live in?

Forget it Doc. I'm asking questions about bone healing and strength and your smug reply is "what century do I live in?"  I'm looking for a doctor that will actually answer questions.  So you think I shouldn't wait a week to get my cast off... just fly down to your gig?  Are you that desperate for business? Thanks for your genuine concern... it's heartening.

Get over you denial. I answered your same question in five responses all ready. You posted on the website where I am the local expert.  As I am sure you know, I have way more business than I can handle.

Now you can hear it again. The bone is crooked.  Its either healing crooked, or just staying crooked and not healing, and I have no dog in this race.

You said you are over 50 years old.  Same as me.  You should be happy that you only have a broken tibia.  I got, and I am sure you got, friends who are all ready dead from heart attacks and the like.   Find a competent doctor, to drop a rod down the medullary canal, and you will be walking without crutches in two to four weeks and back to your old life.

You didn't answer my question. I asked about the healing process and what I could do to assist it. I asked if the bone would be as strong as my other one even if it had a slight jog from the break...  Like I said, forget it. Your thing is "it's crooked" ok, gotcha.. it is. I am not in denial. My doctors and I will assess it all in one week.  Can you accept the fact that other doctors might have a different opinion than you?  I got a second opinion from another highly respected ortho doctor and he said the same thing... not to rod it.  I'm not even saying they are right.... all I'm asking is about my current condition and issues dealing with it.

You think it should be rodded. They don't. I'm going to wait a week and see.  In the meantime, the health fitness expert keeps telling me "it's crooked" - beyond that--nothing.  Let's drop it.

Dr. Mark, Dr. Sarmiento would probably have alot to say about your comments. His experience certainly demands some respect and admiration. Most patients these days would end up with an IM rod, but hopefully this patient had a discussion with his surgeon and after being given all the information on treatment options and expected outcomes he chose which way he wanted to go.  I hope this guy does well and will never have to suffer the knee pain that a significant percentage of patients get after tibial nails.

Dr. Sarmiento practiced in an era when rods were not in general use and he accepted 10 degrees of angulation.  See below.

Look at the AP view of that little X-ray.  The bone is allready in about 10 degrees of varus, and the fibula is INTACT.  That is a very dangerous situation, as the intact fibula puts a further varus stress on the healing tibia.

Not this this constitutes medical evidence, but a jury of 12 in Harris County, Texas in the Year of Our Lord, 2007 found my former partner guilty of medical malpractice for allowing a tibia to heal with 10 degrees of varus, even after documenting the usual pros and cons of the treatment.  It seems that the patient forgot.  When the  poop hits the fan, all patients forget.  (While I problably dont agree with you Orthopaedic surgeon family members on much, I am sure they have also learned this hard lesson). The award was $100,000.  

The question is who's opinion is more important?  Dr. Sarmiento, a great man that I know personally, or 12 anonymous Harris County, Texas, bus drivers and school lunch ladies?  I am sorry to say, but the school lunch ladies' opinion counts more in my local area.  Knee pain is out there.  A crooked bone is never judged as acceptable in an otherwise healthy person.


In my practice, I am malunion and lawsuit adverse.  If a guy has a crooked long bone, and doesn't want it fixed, I am pleased to let the guy down the street take the risks.

Honestly, I can see both sides of this. I simply think it's worth waiting a week to take a very close look at the latest X-rays and the leg itself. And in consultation with the doctors, decide the next step.  Here is an X-ray of a perfectly straight tibia, and the full length of mine.