Well. I'm scheduled to visit a new ortho. Definitely going to discuss removal of the rod. Thanks guys!!! Feeling far more optimistic!
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Well. I'm scheduled to visit a new ortho. Definitely going to discuss removal of the rod. Thanks guys!!! Feeling far more optimistic!
Good luck.
Ok I have had my rod in my right leg roughly 5.5 years and I think it time to loose the rod. I have had 2 CT scans and got a second opinion as first doc said let's try to remove the bottom screws to relieve the pain. The second ortho said he would want no skiing for 3 months but can bike and run no prob.
I'm gonna push this sucker done ASAP so I can get some late turns in...
Wish me luck~
WB
I bet you'll be skiing in sooner than three months if the only procedure you're having done is pulling the rod. Your patellar tendon will be sore like it was when they put it in. Other than that, it's wound care for 2-2.5ish weeks and getting the sutures out. I'd think 4-6 weeks...
I waited three months when I had mine taken out. I had some serious structural issues as well though (non union, bone grafts) and it was only in there for 1.5 years.
I assume you can be up on it right away just don't get crazy. How long were you on crutches? I hope not long - I hate those things. I just broke the news to my ski patrol coordinator.. yeah they weren't stoked- I'm the newb that's gets the not so great tasks on the hill. ;)Quote:
Originally Posted by LightRanger
Been almost four years and I've had multiple procedures with crutches (five since early 2009), so it's hard to remember. I also had a z-plasty at the midfoot for my Checkrein Deformity I developed, so more than just getting the rod pulled. Surgery was December 2012 and I remember skiing in March, but if I recall correctly it was due to the foot surgery more than the rod removal. Thinking... 2-3 weeks for crutches? But again, I had sutures in my instep too. No difference in weight bearing for rod removal, it's really just the wounds and sensitive patellar tendon.
Ok thanks Yeah that what a figured on the crutches Attachment 191154. I suppose the good news is that I already got the ankle screws removed 3 months ago. So that part is doneAttachment 191155Quote:
Originally Posted by LightRanger
@WB
Woah cowboy!
I've written up my story from this past year, but am somewhat apprehensive to post it.
TLDR version;
I skied after a very substantial Tib/Fib [Compound,displaced, comminuted, spiral - but not open - Tib nailed w/ 8mm nail. Fib left alone] after 11 weeks. [I'm in my late 40's and reasonably fit and healthy - so it's not some 23yo miracle recovery story either.] The big bummer is it was the first full week of the season here.
I skied really gently for the first 4-5 weeks, and as pain really went away kept turning up the volume. As spinal tap says - "it goes to eleven!" And while I know I was pushing about as hard as it would be possible to do, I don't think I was totally foolish, and simply lucky, either. [I also know that virtually every situation has items that make it unique. So, my (or anyone else's) experience may not apply to you.]
In any case, I salvaged a good portion of the season. I can't imagine, if you can recover from the patellar [or barring other unusual issues] that you can't ski about as soon as it's not too painful - for simply nail removal.
:)
-Greg
Oh, I'll add this: The neoprene patellar tendon straps were totally like magic for me. Massive reduction in patellar pain. [They're used for Osgood-Schlatter disease.]
They're cheap - like $20-25 on Amazon, or cheap knock-offs on ebay for half that.
Did I mention - they were totally like magic. I was completely blown away. Seriously. Like 80% pain reduction. If someone had claimed that kind of result before hand, I'd have said they were smoking the good stuff - 'cause that just seemed so unlikely. [As far as I can tell, there's no good idea in the medical literature as to why they work either. Perhaps some change in the angle of attack/pull on the tendon is the most likely I've seen.]
Anyway - for super cheap, it's worth it to try. Heck, I'll send you mine, if you like.
-Greg
Thanks for all the good intel Greg. Ok I'm gonna check out that strap action. I definitely amQuote:
Originally Posted by gregorys
Motivated to back on the slopes.... Epic pass and a new demo pair of On3ps that I need check out.
I pushed to get the surgery done ASAP and the Ortho was cool with that action.
Thanks again
Brandon
I am a 46 year old male recovering from a tib/fib spiral fracture in March. I ski 40-50 days a year when healthy. I have been crushing myself in the gym and riding my bike since early July. I would put my recovery at 75-80% of where I was pre-injury. I have a tibial rod and I have had the top screw closest to the knee joint removed. I do not have pain to the touch in the break area. Getting close to the start of the season and I have all sorts of questions....
Tele or Alpine? I do both and my initial thought is tele. Is there a downside to this?
Do I need to get new liners for my boots?
Will my leg get cold?
What can I expect my limitations to be once I am on the snow? Powder? Bumps? Jumps?
Finally, my doc, an experienced ortho with skiers, feels that I will ski pain free and said only one in ten patients have the rod removed. The consensus on this board sounds overwhelmingly in favor of rod removal.
Any opinions are welcome.
Feeling nervous!
-COMMISH
Yo dude,Quote:
Originally Posted by COMMISH
My thoughts:
1. Tele or alpine shouldn't matter if it doesn't hurt. My injury was based on a tele non-release at frightening speed at Squaw, so I switched to alpine. Happy. Plus I doubt I'd tele effectively with the residual Checkrein Deformity and lack of toe flexion that I have.
2. Liners depend on how it healed and if your leg shape is the same. I like Intuitions, but it may not matter in your situation.
3. I doubt your leg will get cold if it didn't get cold before. IM rod should not affect that.
4. Not sure until you try it. I had significant pain at the fracture site and couldn't ski (due to excruciating pain, not physical inability due to it) until I got it out. Others have had totally different experiences and have no limitations at all. Most of the time I did not have pain to the touch at the break area either, for what it's worth.
5. Like the last response, it seems to depend. I saw something like four+ different orthos over the years for my issues and it was split down the middle on getting it out. But I couldn't even snowboard until I got it out because it was so painful, so it was ultimately an easy choice for me and I wish I had gotten it out sooner. The relief for me was immediate. Was in for close to four years before I got it removed.
Keep us posted on progress. Sounds like you're well on your way. :smile:
You've seen my post up above, I assume?
First, just because it works for me doesn't mean it does for you. If you [or I] are "unusual" that's just fine. People are who they are and have the limitations they do. Don't settle for "average." Beta like mine is useful in helping you decide what to look out for - but it's only a weak substitute for your own experience. You may find your experience is way different than most everyone else's. Just because the average shoe size is, say 8, doesn't mean you should hell-or-highwater make yourself fit 8's. [Seems obvious, but it's something to keep in mind.]
>Tele or Alpine.
IMO Alpine. Tele is, IMO, more likely to re-stress the spiral fracture. As noted by LR, if it's truly healed, it shouldn't matter any more than it did the first time. [I assume it's no-release tele stuff - unless you've got the Voile plates. That might change the calculus for me a bit.]
Turn the DIN's down. I'm a type III+ skier, and I was skiing for the remainder of the year last year as 1 DIN *under* a Type I [for my BSL, Weight, Age]. I'll probably ski this year as Type I until I really start having problems with pre-release and then I'll go up [very slowly and carefully] as needed. Since I skied really hard the last month last year, I'm having a hard time seeing that I'll ever go back to the same DIN I was using before, as I don't think I need it for retention, and the substantial additional risk probably isn't worth the few times I'll release when I shouldn't. [This is a work in progress, so it's always possible I'll come back after this next year and I'll be back at III+ DIN again - but I doubt it.]
I don't need to be as careful this year, as I'll be a full year out and less likely to re-injure it than I was at 11 weeks post-op when I started skiing last year. But in any case, I don't think I need the higher DIN.
>Do I need to get new liners for my boots?
>Will my leg get cold?
Pop 'em on and see. I sure didn't.
I inline skate on a super rigid carbon-fiber/fiberglass boot with very little padding anywhere. While the screws at my ankle are right near the top of the boot, I'm not having problems with them, really at all.
None of my screws hurt much at all. Of course, being an inline speed skater in rigid boots gets you used to some discomfort - but I don't think that's the reason I'm not having issues. I just think my screws don't bother me. [One in my knee seems to irritate the tendon that passes over it, but it's a pretty small issue. At this point, I can't see spending the cash to remove the screws.
I'm in the PNW, so really cold ski days are rare, but I've not noticed any issues or differences. Coldness doesn't seem to impact the bone or hardware. [I've not been out in anything below 15-20F or so who knows if -15F might make a vast difference.]
As noted none of the screws or the rod appear to be any significant issue. It's always hard to tell, but I think I get modest twinges of bone pain. [Or it seems like bone pain.] It's not at all certain those would be better without the rod and screws. The vast majority of the time no issues.
So, as noted - I started skiing at 11 weeks post-op.
I had my first double-eject at 12 weeks, I think. Was skiing groomers, and just caught an edge in some soft new snow at the edge of the run. I was really apprehensive when I went to get back on my feet. I was totally amazed at no pain at all. Just went and clicked back in. [Remember I'm skiing at DIN Type I--]
Over the next month, I ski a bit harder each day. Right at 15-16 weeks or so, I go back to skiing nearly as hard as I ever did. But pain was way down before I would turn up the volume more. [I never, ever, skied with any drugs on board. Not even advil. If it was going to hurt, I wanted to know. I might pop two advil at the end of the day, but not before.] And if it did start hurting - especially bone pain, I'd turn it down, or go home.
You'll be a full 6-8 months. If your xrays show good solid bone, I think you're good.
As for rod removal. Simply see how it feels. Clearly some here have been really miserable. I'm way on the other end of the spectrum.
I'd watch this before I considered it: [Warning - not for the squeamish! Think tongs and hammer. It's a IM nail removal video. Poor guy on the table. His leg is not going to feel great tomorrow. It's 2:30+m of full on hammering to remove the IM nail.] Ugh!
https://www.youtube.com/watch?v=HiC8Iue5iMg
As an epilogue. I did re-crack the top portion of the "butterfly" you often get in a spiral fracture. I did it the last day of the season, while cruising through the terrain park hitting the edges of the smaller kickers. But I think I caused a small hair-line fracture a couple of days before, while picking up a very heavy desk. It felt really odd as I picked up the desk, but no pain or anything else - so I thought I imagined it. I skied off the mountain, essentially, on one leg and limped home. The next few days were pretty lousy, but in 3-4 days pain was way down again.
I was gimped for 2-3 weeks, but didn't do any substantial damage to worry about. A follow up in the last few weeks indicates full bone healing and I was told "go enjoy life." [I did miss a couple of months of skating at the beginning of the summer. But having a couple of months of skiing to use as "payment" seemed like a trade I'd make all over again, in a heartbeat.]
I couldn't ask for more, really. All said, it could have been and/or be so much worse.
HTH
-Greg
LightRanger and gregorys, Wow. Thanks for the prompt response and thoughtful feedback. This is really solid info. I should add that I am headed to Winter Park on 11/18. I don't expect much terrain to be open, but it will be my first time on snow post-injury. Also, this is where my cold concern comes from. I ski Tahoe and WP and the temperature variation between the two regions can be fairly extreme. I think my takeaways are to turn my DIN lower to start and see if my gear works (boots, etc). I am going to start with my alpine set up.
I will absolutely report back.
Thanks again!
COMMISH
This is an interesting discussion about DIN release values - and is part of why I, generally, think I'll live with lower release values.
http://www.vermontskisafety.com/vsrfaq5.php
The TLDR; version is: I think I, in the past, selected a DIN purely on what a chart said. But I think the vast majority of the time, I really don't need that kind of retention. (This based on skiing at what I previously would have considered a "ridiculous" release value - thinking I'd blow out all the damn time. Imagine my surprise when I didn't.)
That paired with my Tib/Fib fracture got me more interested in safe bindings/release values. I'd already gotten some Knee Bindings [don't tell anyone, I'll lose all my cred as a skier!] too, but still haven't mounted them yet.
I was also Tele until about 18 months ago, and I decided to go to Alpine because I was skiing so fast on newer tele gear I borrowed from friends. [I'd mostly stopped skiing for a number of years, other than a little skiing when I was climbing volcanoes here in the NW. So, my tele gear, which was releasable, was super old.] Yet my tib+fib was on Alpine gear. So, go figure.
Perhaps this is all tilting at windmills, but I'd just like to avoid an[other] injury if I can.
-Greg
Ok my nail is coming out this coming Thursday and yes I've watched and shared that video several times- scares the sheet outa me. So I will update you all on the process/recovery.
Ok now to Commish:
I have have had my nail in since Feb 2011. Skiing deep in West Bowel Squaw. All was good until about 8 months ago including lots a skiing and tahoe paddle boarding - 14 miles races...etc.. so this removal to me is a big deal cause all was good until recent. I am having sharp pain at the break area and then it radiates out. I have gotten a second ortho opinion and he said all is healed based on 2 CT scans 6 mos apart.
Have s good one~ you'll hear from me in the near term.
Brandon
Regarding the video above. That is not typical. Video demonstrating a atypical situation of incarcerated nail. Just FYI so dudes are not getting scared. Nail comes out much easier typically and does not usually require the windquist universal nail extractor. Simple slide hammer and it comes out. Good luck with surgery.
Brandon-
Good luck with the removal. I will also keep all in the loop on my progress. As I mentioned, I am back on my boards in 13 days. We shall see how it goes.
-COMMISH
Ok had the nail and screws out Thursday afternoon and as of today I'm able to walk ...sort of hobble without crutches. And I am not on the hydrocodone at this point. The dance between pain control and expelling waste becomes tricky- focusing on the waste this morning
Attachment 192388
Took off all the gauze and wrap today
Yeah, I hear hydrocodone does that to some people. I never had the problem. [Oh, I _could_ tell there was a difference, but it wasn't much of an issue.] But then again, I only took a 15mg dose for a day or two, then 10mg for another day or two, and then 5mg for perhaps another week.
I actually felt tramadol was pretty good at 25mg, along with 200mg advil. HC was good for pretty intense pain [often at night/evening], but tramadol was great once I was out of the most intense pain.
I hear colace helps substantially.
And don'cha love that edema!?
"Yeah, my legs always look like the Michelin man's!" :)
So I realize I'm bumping an old thread, but I figured I might as well add my own experience.
I fractured my tibia in a classic boot-top manner on Dec. 25, 2014. The ortho-on-call declared that I needed surgery, and he installed an IM nail (rod) and three screws that night.
https://scontent-sea1-1.xx.fbcdn.net...1d&oe=59B64FA5
(10 days post-op)
I was "weight bearing as tolerated" even before being released from the hospital, and I think it was about three weeks before I was hobbling around on one crutch and four before I could limp my way to work, two short blocks away. I was cleared for cycling, snowshoeing and hiking in early March, did a bit of low-angle skiing on three-pin gear mid-March, and had my first lift-served "turns" in early April (about two weeks before being cleared to do so). I did develop a bit of arthritis in my left knee, and my PT and I both suspect that is likely a side effect of the surgical procedure rather than a direct result of the original injury.
I will say this: if you sustain this sort of injury, I'd strongly recommend getting to see a physical therapist as soon as possible. I had to ask, "Can I start PT now?", and the surgeon looked at me a little funny and then said if I wanted to, he'd write the referral. I assume he'd planned to suggest it at the next follow-up appointment, another month later; as it was, I'd lost a lot of strength in both legs, and I wish I'd started seeing the PT sooner if only to work on preserving fitness in non-injured parts of my body.
I still have the hardware installed and am generally loathe to go in for surgery of any sort without a damn good reason. It doesn't bother me at all, and I'm back to skiing frequently and often skiing fairly hard (albeit with lower DIN settings on all but my GS skis). My understanding is that the risk of leaving the rod in is that if I should manage to break the same tibia again, it would imply also having bent the rod...and then they'd need to remove the bent rod from the broken leg, which sounds incredibly unpleasant.
Also, I was initially worried about the calcium lump at the injury site causing boot-fitting issues, but by the time the following lift-served season rolled around, I was back to about the same cuff tightness on both boots, and it doesn't seem to have had any significant impact on alignment.
https://www.facebook.com/peter.nicke...94042302785405
dunno if you can see this but i'm pretty sure its rod removal not knee surgery