Bone grafting for Right leg tibia and fibula fracture

[gurumath2001]

Hi All,

I met with an accident on 19th April 2010 and got my right leg tibia and fibula fractured.

After some initial checkup and x-rays, Doctors have performed Internal fixation surgery (Inserted a rod) into my leg.
Operation performed on the next day ie 20th April 2010.

After looking at post operative x-rays surgeon have suggested non weight bearing for 45 days and also informed that there's gap(1.3cm) in the fracture and it should unite in 3 months approximately.

After taking two x-rays, one after 45 days and another after 90 days, there was no change in the report.
Surgeon informed the fracture is into delayed union and may turn into non union and suggested to undergo one more surgery ie Bone grafting.

I have undergone 2nd surgery(Bone grafting) after 90 days of Nailing operation.

Spent 3 days in hospital and Using Walker to walk around and still not allowed to bear any weight on the injured leg.

One more x-ray taken after 45 days of bone grafting operation, surgeon said to bear 30-40% weight and i still have to use walker and informed to come after 45 days again.

The x-ray after 45 days of bone grafting doesn't show much changes as i have observed and Doctor is not giving me any frank opinion about details such as, 1>How long i have to use Walker and 2>How long does it normally take to heal/unite after bone grafting. Since every time the waiting period is increasing i m stuck up with walker and have no idea when this gonna end.

I am Doing the physio exercises as prescribed (toe and ankle movement) and bearing 30-40% weight on injured leg with the help of walker.

Kindly let me know the details like How long it'll take to unite/heal such fractures. When can i start walking using a single stick/ cane.

Will i be able to walk or run normally once the fracture gets united??

Your frank advice/opinion is appreciated

Thanks a lot in advance
gurumath2001

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[pudding_bowl]

Hi Guru,

I'm sorry it has taken me so long to reply, I was vacationing and working the United States and have been away from the forum for a very long time. Please update us on your progress at present?
Tell me do you smoke? - this is a high risk factor for delayed bone healing and is a major factor in non-unions. If you don't then that obviously isn't a factor here.
Based on your history it doesn't sound like you'v been very lucky after surgery, I would have expected these bones to have united after what is now about 6 months.
As far as I can tell you are doing the right things - Partial weight bearing will help to encourage bone growth... too much weight however will be detrimental. Bone union is tricky and can take a very long time, your surgeon is the best one to answer the question of how long it should take - I feel like you should have been seeing some union by now.
If the Bones unite then yes you should be walking normally and in time you may be able to run again - this will all depend on the rehabilitation of the ankle as to your progression towards running, but many people return to running after a healed fracture of the tib/fib.

I will leave it there for now, hopefully you can update on how you are feeling?

[gurumath2001]

Hi Pudding_bowl,

Thank you very much for responding to my query, hope your vacation was full of fun.

My present status is still the same, As i have Undergone Bone grafting surgery on 26th July so i'll be completing 3 months on this month 25th.
So I'll be meeting my surgeon on 25th of this month(October). I m keeping my fingers crossed to see some positive results this time. I am Still using Walker and bearing partial weight.

As you said, Smoking isn't a factor in my case as I do not smoke at all and no alcohol as well. So nothing much from me as of now. Will send you the x-rays after my meet with the surgeon on 25th. and I'll Keep you posted with the further updates..

Thank you again.. Have a good day

Regards,
gurumath2001.

[edgewise]

im in the same boat i had a climbing accident i fell 70 feet i broke both legs bad, broke my right arm and broke my back L-2, everything was going ok i have had 8 surgerys to save my life and limbs, I was in a coma for 4 days and in trauma intensive care for 9 weeks and 8 surgerys , i was sent home to heal up and do re hab i was doing ok but 4 weeks after getting out my right leg rebroke and hardware and bone gave way. now i have had number 2 bone graft and they took bone from my upper leg , they are trying to save my leg my next surgery is Dec 16 2010 if this surgery dont work they take the leg.
I have had so many surgerys and i still have 2 to go it really hurts to think im in and out of hospital and surgery after surgery its unreal.
well people what do you think my odds are of keeping my leg???

[dr.rana]

hi fellows. i am dr sohail rana .i have worked with russian orthopeadic surgeons .best in the world .They used Illizarove technique very very good for every problem of orthopeadic .in the world .if you have illizarove good suergeon you should consult them..I am
sorry about fracture problems.God bless you all.

[pudding_bowl]

Theres no way to tell edgewise... You really can't call it. You just gotta hope that you got a good surgeon... How'd you rebreak it?? Did you do something wrong or did your surgeon do a bad job :s Just saying maybe Dr. Rana is right that you'd benefit from a Ilizarov apparatus or Taylor Spatial Frame (Taylor Spatial Frame - Wikipedia, the free encyclopedia Ilizarov apparatus - Wikipedia, the free encyclopedia)... Discuss with your surgeon what he/she thinks is your best option. If your confident with your surgeon then thats awesome... if your not then find out if you can look elsewhere.

How'd you fall 70 foot. I climb... took a 18m the other day but was deep water soloing so only tore my superior labii frenulum because i looked down and had my mouth open when i hit the water.

Puddin'

[fracture]

HI,
This is Brijesh, From Bangalore, India. Have gone through the same accident. Fractured my shin bone on 4th September 2009.Internal fixation surgery(One nail fixed inside the bone with two screws just above ankle and two just below knee) was done on the 6th(after 36 hours).
followed all the doctoral advise with utmost care, Doctor failed to advice me the timeline for the nail removal timeline and got Dynamization done after 4 months(Hope it's not too late), went for routine xrays to find out the progress, All was well and the bone was healing and doctors decided to take the nail out in feb (one and half year after the accident), But was nt sure about the complete healing, Was advised for a CT Scan to get a clear picture, and was told that its a case of non union, Now Grafting is required. Please suggest:
1. Complications and healing period.
2. Dos and Donts
3. I am still a regular smoker and social drinker. Please suggest how much it delay or affect the healing.

PS: I have been walking a good 1-2 Kms daily for almost a year, And drive a car also. Is that fine to drive a Car.

[gurumath2001]

Hi All,

gurumath2001 here after long time..

Well, Let me share my recovery updates with all of you, i hope it helps to set positivity to those who are going through the phase i crossed..., I'll continue with my last update,

I met my surgeon on 25th OCT 2010 and he suggested to use walker with partial weight bearing and asked me to come back after 45 days again. I kept followup with him and i used walker till December end( total 5 months ) Finally, the day came when he allowed me to use single stick and bear full weight.

So i started walking with single stick from Jan-2011 and continued till mid of march ( almost 3 months ) and then i was asked to walk independently. though i was trying to walk normally, it was difficult to get that normal walking balance and i was limping. Limping gradually decreased as i started walking everyday and now i am walking normally.. however, its not the same as i used to walk before but its hard to recognize my walking error by general observation.

Above all, the best part is i am back to normal life and i am going to work independently, seems like life is back on track after almost 1 and half years and 2 major surgeries.

Hope my experience helps to those who are undergoing bone grafting surgery, My doc said that bone grafting is successful in almost all the cases and it surely forms union, only thing is, it might take longer than expected time frame.

My sincere THANKS to everyone who contributed to this thread and special thanks to Pudding_bowl for addressing my query - Thank you very much.


@Brijesh--->>

Hi Brijesh,

I am sorry to know about your non-union, My doc had referred me for Dynamization but after taking second opinion, i decided to go for Bone grafting directly to minimize the disability period and even the chances of union were pretty less for me after dynamization.

So, If you are undergoing bone grafting now, I think it'll surely form union. In my case, it took around six months and they said it was delayed union, so i think you should be fine in 3 months, however healing period varies from person to person. all i can say is to have patience and indulge in activities which keeps you happy..

As far as i know, there ain't any major complications, provided you follow doctor's instructions. I suggest you to minimize/quit smoking till you recover (read pudding_bowl's response to my query)

I'll leave it here.. you and edgewise can post updates.. I Wish you both a speedy recovery!



Thanks and Regards,
gurumath2001

[jamesklass]

however, its not the same as i used to walk before but its hard to recognize my walking error by general observation.