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Thread: tibia pilon fracture
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02-08-2017, 12:59 PM #51Registered User
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02-17-2017, 11:12 PM #52Registered User
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Update- I'm now at 20 months post op and life is getting back to my "new normal". I started mountain biking heavily about 14 months and riding motocross again at 17 months. After the accident I swore I wouldn't hit any more triples but been hitting everything the past month and ankle is feeling pretty good (thanks to my kickass Racetech suspension). I use 1-2 rolls of athletic tape before I ride both for support and to keep down swelling and so far so good but I also feel like I'm playing a little Russian roulette. I started skiing 2 months ago and that definitely hurts some but a lot of that is the boot pressing into the 17 screws on my tib and fib. I still feel the ankle every step I take even walking but the pain is bareable. Dr says no to taking out any hardware as he thinks it will cause more harm than good plus I'm not sure I want to go back to no weight bearing for another 2-3 months to let the holes heal up.
When I push it my ankle gets angry and reminds me that an ankle fusion is likely unavoidable but I'm going to hold off as long as possible so that I don't have to quit skiing. It's been great being able to teach my kids to ski this year and we are going to take the winter off and move out to Colorado for 10 weeks so we can ski almost daily. It's funny how priorities change after something like this and I'm now very motivated to enjoy as much life as possible while my ankle is doing ok. My youngest is 8 so my goal is to hold off the fusion for at least 10 years so that we can recreate as much as possible while he's still at home. I'm very blessed to be doing as well as I am and I never thought my ankle would get this good (I'd say I'm about 66% of what it was) so those of you who are early on and going through the slow, painful, frustrating stage, it will get much better than where you are. The key for me was getting out and really pushing it. My biggest mistake was being non-weight bearing for almost 5 months. My PT said my Ortho was too conservative which really slowed my healing progress. It's a fine line but all I know is that every gain I got came after me pushing it beyond what my Dr suggested. If I could do it all over again I would have started putting light pressure on it at 8-10 weeks just to start introducing a little weight.
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03-06-2017, 05:16 PM #53Registered User
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My last follow up (not quite 9 weeks post-op) didn't go so well. Doc says not enough callous there, so continued NWB status. We'll look again in another 2 weeks, but he didn't sound too optimistic.
I was beyond disappointed to say the least. While I knew that would have been on the fast end of things, it still was a hard thing to hear after things had looked so good at my 6 week. Plus, the longer this goes on, the more problematic things like transportation places becomes. I can't perma-borrow an automatic, as it is I was scrambling after this last visit to find a vehicle to get me through until I can drive my manual (which may happen after this next visit whether or not I'm "released" for it). Getting too and from work is getting more and more expensive, mostly because there's no good reason for me not to be at the office other than costs of trying to get there!
So, I'm trying to play the balance game between what my doc is telling me in his conservative way versus what my body and leg are happy with. I've started putting a little weight on it when I'm standing around, around 25-30ish pounds, and my leg seems just fine with it. I'm not doing PWB technically, as I'm not using it to bear weight while moving, but on the flip side it seems happier and seems to actually LIKE being used a little bit. Plus, while the conservative approach may be the safer one, it also tends to drag out some recoveries...so I'm hoping to keep things moving in a positive direction.
In the meantime, trying to figure out some options assuming things don't look way better. Probably will end up picking up a light weight bike (I can manage a 300 with one leg) to commute on with my annual bonus which I'll hopefully see this month. That would at least levitate the stress of getting to and from work.Last edited by HoneyBadger302; 03-06-2017 at 06:00 PM.
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03-06-2017, 05:49 PM #54
hang in there, man. stay patient, work hard and you will be in a better spot before long.
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03-16-2017, 10:14 AM #55Registered User
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My 11 week post-op went better, and he released me for weight bearing. Of course, I'm still using a crutch, cane, or both crutches, but I can start using it as my leg allows. PT starts next week. He also released me for riding as long as I'm comfortable holding the bike up, so will try some small bikes over the weekend while I'm watching all my friends race and will try my street bike on Monday if the weekend goes good.
Will be back at the track on April 9, so have a few weeks to get some strength back in the leg before I'm trying to muscle the new race bike around a track. Definitely going to be painful getting these muscles going again, but at least it's forward progress instead of playing the waiting game.
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04-20-2017, 10:14 AM #56Registered User
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Hey everyone, really happy to have found this forum being that i have recently suffered the same horrible injury. As of 2/15/2017 i took a bad fall on my snowboard off a kicker at snowbasin which resulted in two broken ankles. After ski patrol rescued me, I immediately went to the emergency room and the following day booked a flight from utah back home to new jersey for insurance purposes. Once home, doctors said my right ankle suffered a pilon tibia fracture that would result in surgery and my left ankle had a small fracture that thankfully didn't need surgery but just a boot for 4 weeks (left ankle was only for touch and go purposes, not full weight baring). After 8 days of waiting for the swelling to reduce i went under the knife and had 1 plate and 10 screws inserted. The pain for the following 24 hours was the worst i have ever felt; I previously had a spinal fusion of my L3,L4,L5, S1 which also resulted in hardware and would say I have a high tolerance for pain. 3/13 I saw the surgeon again; he removed the air boot on my left foot, my hard cast on my right, as well as stitches, put my right foot in an air boot which I was still non weight baring, and wrote me a script for physical therapy 3 days a week. After this appointment they gave me crutches and i was out of the wheel chair and full weight baring on my left foot. 4/10/2017 was my most recent appointment with the surgeon in which he said the bone is healing very well, the hardware is all in place, my incisions look great and my ROM is much greater anticipated this early in the healing process. I had a series of questions for the doctor, majority of them were denied, such as driving, but i am allowed to wash but not fully submerse the right ankle in the shower so thats a plus. My next appointment is 5/1 so ill definitely post my follow up. From what the surgeon said at my last appointment, he believes theres a good chance ill be full weight baring as well as driving. Aside from my injuries, im a full time union electrician, (out on disability for 6 months) active body builder weighing anywhere between 220-240lbs with a barbell squat of 585lbs and deadlift of 585lbs. One day i hope to be able to squat just as heavy and workout just as hard prior my recent injury. On the plus side, I follow a healthy and regimented diet, drink plently of water to help flush any fluids, and take a variety of highly recommended, organic vitamins.
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04-20-2017, 11:31 AM #57Registered User
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merscamuch, sounds like you're doing quite well, keep working at it all and it'll pay off.
As for my status, welp, I was just in surgery this morning again - this time to flush, clean and get some cultures on an infection that tried to manifest over my tibia plate last week. Seems we caught it fast and he was able to leave the hardware in, so I'm still allowed full weight bearing - which is a relief with a race weekend coming up in 10 days!
Other than this complication though, things seem to have been coming along pretty well once I was moved to weight bearing status. Slow, but very steady progress.
Mentally I'm doing a million times better, and it's rather nice to sort of have life returning to normal-ish. FINALLY got to break in the new bike that I had bought (the day before breaking my leg)...
Maiden Voyage last Monday April 10th, 2017:
Graphics done, only other thing I want to do is powdercoat the rims white:
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04-20-2017, 03:14 PM #58Registered User
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thats a badass picture! glad to see the injury isnt preventing you from doing what you love. how did the doctor determine the need to perform another surgery? was there more pain during this time as well? i definitely got a laugh out of "it's rather nice to sort of have life returning to normal-ish." i cant wait to have that feeling again too
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04-20-2017, 03:54 PM #59Registered User
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Thanks
The pain with this one was pretty minor - the surgery was to flush the area, debribe any dead tissue, and if the infection location was getting under the plate, then he would have to remove the hardware as well. Thankfully the hardware was able to stay in, so pain right now is pretty minimal, pretty much just where he was working (although I haven't seen is since there's a pretty bulky bandage over it right now).
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05-02-2017, 01:30 PM #60Registered User
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so yesterday was 9.5 weeks from when i had surgery as well as the day the doctor cleared me to start walking. he recommended i use a boot until my physical therapist sees more strength developed but i for one know that using the boot prohibits any ROM in the ankle and strengthening of the calves so i will only be wearing it when im at the gym or go out in crowded places. today i washed my car and even drove it. its a six speed with big brakes so i have no issues stopping or clutching either. going down stairs or anything related to such movements is by far extremely difficult. im walking with a limp but once i start moving it gets better but its still noticable. lets see how i progress over the next 2 weeks in physical therapy. its hard to imagine at first but it really does get better !!!!
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05-02-2017, 01:53 PM #61Registered User
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Nice that you're able to get moving already, that's a pretty quick recovery from everything I keep hearing!
At this point, it seems like the infection is getting better/gone, but time will tell more on that one. In the meantime, I'm doing as much as possible to not let that slow me down too much. Stitches should come out later this week, right now that skin is still pretty sensitive to any stretching, so doing ROM stuff kind of hurts, but is what it is.
Still made it out for my races this past weekend - WAY off my pace (like 6-7 seconds slower than I was on my old bike), but, still had fun and my logic-brain is happy with everything I did (racer-brain is rather disappointed LOL). I can tell in the pics though that I was stiff on the bike - probably not trusting the leg and/or compensating for it....
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05-02-2017, 08:42 PM #62Registered User
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my surgeon said i was very ahead of schedule even for being a young man and doing nearly everything possible. being that youre full weight baring, how difficult is it for you to walk, perform daily tasks, etc...are you in PT? i also assume youre taking anti biotics to assure the infection doesnt come back?
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05-02-2017, 08:56 PM #63Registered User
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I can walk with a limp - at a slow pace it's hardly noticeable, if I try to walk my "normal" pace (which is pretty fast) it becomes pretty noticeable. Daily tasks are fine, sometimes need to "warm up" the leg/foot before moving, things are always more mobile after being active for a bit.
Still a long ways from running or anything along that line though
And yes, on antibiotics for 6 weeks to see if that clears it up....
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05-02-2017, 10:17 PM #64Registered User
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thats exactly how i feel. when im stationary for an extended period of time and start to walk i have a major limp regardless of pace, but once i get the blood flowing i can walk somewhat normal but still far from normal pace
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05-07-2017, 10:30 PM #65Minion
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Long term health of joint
Is anyone here diagnosed with pre arthritic changes in the joint because of degradation of the cartilage? I was, 2 years post my pilon fracture, hoping for some advice if anyone has experience with this...
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05-08-2017, 10:28 PM #66Registered User
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unfortunately i dont have any advice on such being that im still new to the injury
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05-25-2017, 09:15 AM #67Registered User
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i am 16 months post-injury. once my surgeon heard about my physical plans (getting back to running, skiing, etc) he said i should get all the hardware taken out (14 screws, 3 plates). i delayed because it was fall and i did not want to be recovering too much when the ski season started so kept everything in until mid-April. got everything out, sutures were taken out now 3 weeks ago and i can say- it is way better without hardware. the removal surgery was not fun- hurt a lot but i can already see better ROM and it just feels better, when i stand on that one foot, it does not build up into a dull pain anymore etc etc. there has been some debate on this thread if one should keep it in or take it out and i think surgeons have different opinions about this and i am sure it depends on specifics but given the option- get it out.
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05-25-2017, 10:16 PM #68Registered User
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this is excellent news. i see my surgeon again in almost another week and im definitely way ahead of schedule as far as progress goes but i have a feeling that this hardware is going to limit my range of motion as long as its in my foot. i absolutely want it removed one day. after your hardware was taken out, how long before you were full weight baring again? what is your activity level as well?
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05-27-2017, 05:02 AM #69Registered User
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Sorry to hear this. It's unfortunately a somewhat common outcome after pilon fractures, especially with more severe ones. Unlike the hip or knee, the majority of arthritis we see in the ankle is post-traumatic (i.e., due to an injury or a series of injuries such as repeated sprains). Happy to answer any questions you may have to the extent possible on a forum.
Originally Posted by jm2e:
To be a JONG is no curse in these unfortunate times. 'Tis better that than to be alone.
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06-02-2017, 04:24 PM #70Registered User
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hi, bett here. i know, i stink, havent been around. well, let's see. still going to gym 5x a week, and have pt (thank god for my union) once a week. pt thinks im awesome, dr thinks im awesome, however, the pain, even after having all 17 screws and 2 plates and i did manage to get them, almost gagging into the container- anyway, i've had a procedure with a nerve block in the dr's office, where he sort of wove a very thin and flexible needle in and out of the inner incision, in order to break up scar tissue. i managed to then race to the pt, who worked on it for about an hour and a half. meanwhile, i still have lots of stiffness (i assume that's just the way it's going to be), have difficulty with finding sneakers to wear that are not for the gym but just found a retro nike that's kind of like a stretchy sock and i can get it on myself, it barely touches the bottom of the incision. i feel like all i do is complain. and yes, still on oxy and oxycontin but the pain dr who i dislike lots, wants me in sone stupid (yes, stupid) study- it's a non fda drug at low dose-naltrexone low dose and of course i read just about everything about it. it's used for about 25 different cancers (all of this at a dose of about 50 mgs), MS, (all different kinds) , alcoholism and glory be, opiate addicts. and that's when i flipped out nearly scaring the PA who i see every 4 weeks. i NEVER took the dose prescribed-if they said take 2 long acting, i did, but the oxy -they prescribed 6 and i took 4. ok, about a week before the PA spoke of this drug, i, on my own, carefully, weaned much lower. still took the long acting, 15 mgs which is considered a low dose( someone i know takes 2 30mgs, which sounds enourmous to me, but I'm not a dr) -anyway, i now am taking one oxy, and 2 long acting, seeing the pain dr (who when i met him by accident at my grandson's flag football game, not only didnt he know me, when i pointed to my ankle and said "pilon fracture" he was kind enough to tell me in two years (which it is now) i would either need a fusion or an artificial ankle (they last about 10 years). in a matter of minutes i was hysterical, in my car, on the phone with my shrink friend . this was the conversation -"did he have your records in front of him ?" no. "did he see your X-ray?" no. so basically he just said this and drove me nuts which is why i hate him and when i told my ortho he said "do not listen to him,tho down the road, in 20 years you may need more but you may not". so in essence, im pretty nuts.
so now, i had a discussion with ortho and forgot to ask the name of the procedure but it is gel shots, natural (whatever that means) given 3 weeks in a row, in the office, in the front of the ankle. of course, since i forgot to ask the name of the procedure im now nuts till i call mon to make the appts.
all i know is that it's not covered, pharmacists have the balls (sorry if i offend anyone) to charge $800 but the drs got it in the office and it's all of $70 per shot. i mean, really? that's when i want to hate pharmaceutical companies and scream rape.
so my question is to all of you, have you heard of this? for some reason i dont think it's the stuff they do in the knee (rooster something?) but i will be back, promise , and tell you what it's called and does anyone else have the pain i still have after all this time. oh right, i am a woman, and not in my 30's. it happened when i was 68, which may make some of the difference because i was told, that men in their 30's usually get this type of break not women my age (one god damn step-taking care of my husband who had an ankle fusion, you cant make this up) .
ok, please someone answer and have something that wont make me jump thru the roof until monday. thanks again and i m sorry i havent been on complaining and moaning.
and let me not forget that i can walk on my toes and heels, all around the gym and pt place, thus the "awesome" response about how i walk.
bett
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06-07-2017, 05:04 AM #71Registered User
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hi guys- bett here. somehow my last long post, sorry, is in the beginning of the thread. can someone read it and give me some info . getting those shots in the ankle, starting this friday so im a tad bit freaked. not fda approved for ankles, only knees-comes from the comb of the rooster. know what i mean? i'll be back to see if you can read the first long one and maybe have some info for me. im coming around to 2 1/2 years and when it's going to rain, oh well, you must know.
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06-12-2017, 03:01 PM #72Registered User
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chandni
yup, that's why im having the rooster comb shots they give for knees, not fda approved yet for ankles and shoulders, had first shot friday, this coming fri next shot and fri after the third shot.praying it helps.
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06-17-2017, 06:51 PM #73Registered User
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As previously stated, surgery was 2/23/2017 with a result of 1 plate and 10 screws. Current status of life/ activity level consist of full time industrial electrician in work boots, active body builder working up to 400lb squats and deadlifts on a free bar, swimming and alot of walking. its safe to say im kicking this injuries ass. Still experimenting alot of stiffness and mild discomfort, especially after sitting/laying down for an extended period of time, but the knots and stiffness normal go away after a solid 10 steps. FYI incase anyone was curious...
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06-19-2017, 05:28 AM #74Registered User
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ok, bett here . had my second shot (rooster comb) and for two days i could have felt better but managed as yesterday was fathers day and of course, in my house. when everyone left i passed out with ice on the ankle. woke up, went back to sleep for a bit, and getting ready for the gym. i sure hope these shots work. last one on fri.
joy.
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06-19-2017, 04:09 PM #75Registered User
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Bett, certainly hope you start to see some improvements and that the treatments will help.
As for me, I'm in my last week of 6 weeks of IV antibiotics, 3x/day, every day (Picc line). Weekly visits to the ID/infusion center. PT hasn't been happening - some of that is just time available on my part, but the bigger thing being my insurance decided I didn't need anymore. I've got the exercises, so pretty much up to me now.
Overall, the leg is feeling better, I'm guessing that infection was causing more problems than I was aware. Still have some swelling if I push it a lot, but I'm starting to do more, go on longer walks, ride more, etc. Less elevation, and overall it's improving. Pain is usually in areas no where near the break - so more likely to be muscles/tendons. My shitty knee (well, both are bad, but okay if I keep them strong) has actually caused more problems walking than my ankle.
Still lacking on ROM, but slow improvements, some days better than others, so inflammation definitely plays a big role in that one.
Hardest part for me at this point is part of me wants and feels like I should be more active than I am - that I should be doing more and back at the gym, etc. The other part of me is just kind of tired of this, knows I'll have another big set back when we remove hardware (not sure when yet, but potentially in a month or so), and I'm kind of in "meh, why bother" mode.
I'm still doing my pt and exercises, slowly adding more activity/longer walks/etc, but definitely not like the "athletic" side of my brain says I should be. Still a daily struggle not to get "depressed" about it - it's now over 6 months since I broke it, and while I can walk fairly quickly again, and even hobble-run a few steps when I need to, there's still the constant pain. It's not bad enough for any meds or stopping me from doing much, but it gets tiring when every. single. time. you get up the first few steps are a total hobble, and the rest there's just enough there that you can't ever completely forget about it.
Just hoping my body can kick the infection once hardware is removed, chronic osteomyelitis is no joke, and something I'll probably have to worry about the rest of my life now :/ Not dealing with that particularly well, either.
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