the medical details of my injury

[mx547]

the following is the medical description of my broken leg. i've been having problems with it healing (or not healing). after reading this, i see it's not so unusual. i'm a little more concerned now too. i shouldn't have looked at this. my injury is the type III. my treatment was/is the external fixation with limited internal fixation.

Tibial Plafond Fracture

Description:
Pilon fractures are a special subset of ankle fractures. They are intra-articular fractures of the distal tibia involving varying degrees of artcicular and metaphyseal injury. The word pilon comes from the french root meaning pestle or rammer conveying that the talus actually drives into the tibial articular surface. The distal tibia is also known as the plafond meaning roof (over the talus) and thus these fractures are also called Plafond Fractures. These are often devestating injuries.
Appropriate Care:
Type I- nondisplaced-minimally displaced respond well to closed therapy. Well padded splint, ice elevation non weight bearing. Can convert to a cast when swelling begins to subside.

Type II&III- (displaced with minimal comminution or displaced with marked comminutoin respectively). These require surgical intervention and are associated with poor results and mutliple complications. There is currently a debate wether open reduction with internal fixation or External Fixation +/- limited internal fixation. In various clinical series the reported frequencies osteomyelitis, amputuation, ostoearthrosis, and nonunion as high 20%, 6%,54%, and 18% respectively. The current trend appears to be toward external fixation with limited internal fixation because of its equivalent clinical results and lower complication rate. There is not complete concensus on this issue. With severe injuries there is a role for pimary arthrodesis though this is rare and again the orthopedic community appears to trending away from this management.

 

[jaliveto]

I'm one of those interested types. I see you are educating yourself about your injury and that's great. I broke 4 vertebrea in my neck 14 months ago. I did tons of searches on the internet about my injury. I had a non-displaced communted type II fracture of my 2nd vertebrea called the odontoid. Along with fracturing 3 other vertebreas. My first doctor was the head of neurosurgery at Shock Trauma which is a world class hospital. He kept telling me all along that everything would be okay but did not offer much information about my injury and how serious it was. The more research I did on my own, the more worried and stressed I got. This prompted me to switch to an orthopedic spine surgeon. This particular doctor was the type to sit me down and explain everything in detail and he shot straight from the hip. But what I found is that I worried way to much. ALot of what I found on my own was true but he was able to shed some light on things for me. In the end, I'm feeling great and I hope you will to. It takes time and lots of rehab.

I guess what I'm trying to tell you is that you should take your recovery seriously and it is great that you are educating yourself. But, remember we are not doctors and sometimes we can misinterpret things and a doctor can certainly clarify things for you. Ask alot of questions. Ask the hard questions. Don't let him beat around the bush with his answers. GET A SECOND OPINION if you can. It can't hurt. Good luck.

 

[jaliveto]

By the way two things I noticed and you may know this.
A displaced fracture is a fracture of a bone that has displaced(or come apart) usually more than 5 mm. This is how it was explained to me. So you can have a minimally displaced fracture all the way to a completely displaced fracture.
Also, when they refer to a fracture being comminuted, it generally means "shattered". Not necessarily shattered completely but maybe just at the two ends of the broken bone.

Are you seeing an orthopedic surgeon?

 

[tx246]

what has your research uncovered in the vascular arena? anything promising?

 

[jaliveto]

I know absolutely nothing in that area.

 

[mx547]

Originally posted by jaliveto

Are you seeing an orthopedic surgeon?

yeah, i broke it july 13. he put a screw in and installed an external fixator july 29. he took the fixator off october 8. i'm still wearing an ortho boot. my wound from the incision for the screw won't close. on december 12, i'm going to a plastic surgeon to have the screw removed and a skin graft done. he said, "you only get a couple shots at this, then you're looking at losing your foot." i guess i'm part of the "poor results and multiple complications" statistic. if you missed it, the following thread has an xray and a pic of my fixator pins.

http://www.dirtrider.net/forums3/showthread.php?threadid=64032

 

[jaliveto]

I checked out the X-ray. Don't stress, things have a way of working themselves out. Stay positive.

 

[jboomer]

I also had the Tibial Plafond Fracture. Broke it on Mothers Day (May of this year). Came up short on a jump. God, I was casted for 4 or 5 months (seems like a bad dream!). But, mine was only displaced a couple of milimeters. The doc said that if it was more than 5, then I would require surgery and the pins. But, he also said it would heal in a couple of months if I had the pins done, so... Yeah, just hang in there. It's a bad place to break the bone. The doc said I would never run again, without pain, and would probably require a cane, but I feel that I'm back to about 90%. I've lost about 25% range of motion in the ankle, but I only notice when I try and squat down (I can't squat and stand on the balls of my feet - ankle just won't bend that far.). Not pain anymore at all. Good luck to you.