18 weeks post-op, cleared for impact
Hi, all! It's good to be back on the forum. Just spent an hour catching back up with the thread and [virtually] meeting the newer members.
At my prior 12 week x-ray, the TPF looked good, but the bottom of the spiral tibia fracture didn't show much progress. So I have been FWB with no impact activity the last six weeks, applying ultrasound, mineral water, chicken soup, PT, and prayer (in no particular order). I kept working with the leg somewhat past the pain threshold, but short of sharp pain. That caused visible swelling and a bit of discoloration around that part of the tibia, for the first time in a while, which must have indicated healing.
I just had a new x-ray taken Saturday, though a comedy of errors and delays at the facility prevented me from getting the CD until Monday. It looked to my uneducated eye like the tibia now has a good, bony callous. I uploaded the files and sent an email to my OS in Salt Lake. He was great as always, getting back to me a day later, agreeing that we have good bone formation and clearing me to gradually start impact activities. The man is a gem among trauma surgeons, and I'm much indebted to him both for the quality of his work in the OR and the ease of working with him on followup.
Based on the new instructions from the OS, today was my first PT session with impact exercises, as well ones that put higher stress on the knee. I'm doing well with sets of 15 small, two-footed jumps and wall-sits of about a minute duration. After several weeks of doing ankle lifts of various kinds, my calf is nearly recovered. But the quad has a long way to go. It's much less defined than my good leg, and I can't do any one-legged squats on the injured side. So that, and continued balance/proprioception will be the focus of my next few weeks. I'm trying to get as far as possible before leaving July 8 with my 15 year-old son for a week vacation in Northern California and Yosemite.
Good to see that people are looking at http://tpf.wikia.com
Please don't just read it, but also pitch in and add content. There's an enormous amount of experience and wisdom in this thread. We just have to work at distilling it into the wiki, so those who come after us won't have to wade through dozens of pages from years back to extract it all. I feel that I owe a great debt to those who've provided all the information, sympathy, and encouragement. This is a debt we pay forward!
Best to all,
Chris
--
skiing Snowbird, fx TP, fib, spiral tib 02/09
surgery ORIF 2 plates, 18 screws 02/10
compartment syndrome / fasciotomy 02/12
PWB 6 weeks
FWB 10 weeks
Exogen ultrasound weeks 14+
impact 18 weeks
Ultrasound bone growth stimulation
Quote:
Originally Posted by
East Mtn
Exogen ultrasound weeks 14+
This is probably worth some explanation. At 12 weeks, with my tibial shaft showing little evidence of healing at the bottom of the spiral fracture, I started looking into home-use bone growth stimulators. There are three basic types: microcurrent (electrical), pulsed electromagnetic, and ultrasonic. I asked my OS, and he was generally skeptical of them, because evidence of their effectiveness is usually confounded with other measures also being taken when bone fails to heal (nonunion).
However, there does seem to be good evidence for ultrasound, including placebo-controlled studies in rabbits, rats, and humans (which would avoid confounding by other measures). The best evidence I've read is that it can heal fresh fractures about 30-40% faster and resolves 85% of nonunions. It can be used from the side opposite a metal plate.
The only available home unit in the US is the Exogen 4000+, which costs up to $2,000 new from the manufacturer. However, there is a secondary market on Ebay, where they typically go for $100-200 lightly used. I lost a few auctions and then won one for $150. If you are in a hurry, you may have to bid more. When the time comes, I can probably resell it for about as much. There is an excellent Buyers Guide available at http://reviews.ebay.com/Exogen-4000-...00000019355500
However, contrary to what that guide states, replacement batteries are easily available (just Google it). The unit is designed to give a year's worth of daily treatments (365) before the battery needs to be replaced. Don't expect the manufacturer to help, as they will only provide support to the original purchaser.
The unit itself is small and easily transported. It uses about the same type and intensity of ultrasound as fetal imaging.
No sure way to know if it is helping in my case, but in retrospect I wish I had bought and used one the first week.
What a great site..........
Hey Guys what a great site..Really helpful members and good information.
A little about my injury...April 28th 2012 5 mins to go in my rugby game, got tackled, guy wrapped his legs around mine and pretty much tipped me over sideways, heard a loud pop and pretty much instant pain, couldnt stand up so was carried to the sideline. Drove myself (gotta be thankful for automatic cars) to the emergency clinic where an Xray showed a TPF.. Up to the hospital where tests confirmed a comminuted depression spilt lateral TPF that traverses tibia from the anterior to posterior cortex. Both ACL and PCL stretched and also an acute lateral meniscal tear.
3 Days later i had surgery fitted with a plate and 6 screws, then home 2 days later with a non moveable brace and crutches and 6 week NWB. As you all know the time goes pretty slowly during those first NWB weeks, but i must admit it wasnt as painful as i had expected and was pretty much off my pain killers in the first week. My hardest part was finding a comfortable position to sleep in, also doing the everyday things like showering and using the toilet was a nightmare.
May 17 back to the hospital for follow up where i was placed in a ROM brace that was set to 90. The joy of being able to bend my knee was amazing never thought id be so happy with the simple things. Did lots of Excercises i found on the internet to try and keep strength in my thigh and calf, and also lots of swimming which seemed to have been pretty successful.
June 14 Back to the hospital for follow up Xrays, surgeon is very happy with how things are going so has cleared me for PWB. To be honest im pretty much walking around the house now without the use of my crutches, just trying to build up strength and ROM im my leg.
Im back to the Hospital July 3rd for hopefully final clearance then starting PT. And then back to work part time 7th of July and fulltime 30th July (i work as a chef so its going to be a little tricky)
So thats my story, i know i got off pretty easy compared to alot of people of here.....Anyway thanks for reading and good luck with everybodies recovery