Incarcerated Tibial Nail (Rod)

[FollowMe]

I broke by Tib back in February, 2005. (Really shitty year to do that -- you may recall the Sierras were in mid-winter condition by Halloween.) This injury pretty much ended my ski life. Otherwise I'm very healthy so in the scheme of things this is pretty minor. It's impacted my ability to do other things as well, like running, and even walking can be painful at times. I've attributed this to the nail (rod) and I finally made the decision to get it taken out this year.

Unfortunately, the surgery to remove the nail was unsuccessful. (The doctor worked on it for over an hour, using the slap hammer, and all known tricks with the exception of breaking the leg.) Basically, the bone has grown around the nail in such a way that its become entrenched. Otherwise, it was a relatively straight forward surgery w/ a 6 day recovery and full weight bearing immediately. I'd encourage people to talk to their doctors about this procedure if your nail is bothering you.

My next option is to go back under the knife, where the surgeon would cut "bone windows" at various points in the tibia to loosen the grip and pull it out. It's a 6 week recovery time w/ crutches. I do a ton of travel for work and this would impact my sales budget for the year. Yea, I know, it's not all about the money but fellow salesmen feel my pain here.

Has anyone been through this type of surgery ("bone windows" or other) to dislodge a nail/rod? I'd be interested to hear you thoughts. I'm leaning towards it already, but will talk to another doc or two and give it a lot more thought.

[jerlane]

Before you put yourself through another (bigger) surgery I'd make sure the rod is the source of your trouble. I'm curious what makes you so certain that's the problem? Have you had a bone scan that showed a reaction around it? I assume there's no question that the fracture healed properly in the first place. The last thing you want to do is go through all of this and still problems.

[Todds]

I knew someone that had a bad break in his tib/fib and had a rod installed in the tibia. I'm not sure if it is the same as yours. He had problems for years. Had pain, couldn't run, etc... Went to lots of doctors/experts. Everyone said he was mechanically good. At some point he talked to a really good personal trainer who said the problem was bad rehab. The problem was that he was walking wrong. He wasn't doing a proper heal to toe roll when walking and ball to heal when stepping off a curb. He was flat footing the injured leg. I don't know if it got to 100% but he got a lot better.

[LightRanger]

How far down from your tibial plateau is it?

Just curious.

Hoping I don't have issues with mine. I haven't been healthy enough since my fracture (other complications) to really test it.

[drmark]

If the rod is incarcerated then the fracture is damm well healed.
If the doc cant get it out, then it is NOT irritating the soft tissues, for it it was prominently placed, there wouldn't be such a problem getting it out.
(although the easily removable screws near the knee can be the source of the problem)

In short, there is just about no medical indication in this case for having the rod taken out, and another source of knee pain (most likely patella tendonosis (better known at tendonitis) is present.