Tibial IM rod Removal

[lookinback]

I am scheduled for a physical this friday, chat with the anesthesiologist monday, and then a surgery to get my Tibial Rod/screws out next thursday. Its been roughly six months since they put it in and I have been able to lightly return to biking but have been otherwise really limited. Has anyone gotten a tibial rod out so early? This kind of concerns me, however the surgeon seems pretty determined to take it out despite the risk of refracture since the top screw is causing me pain.

What is everyones typical recovery time? I would really hate to miss the entire ski season, snow or not...

[lookinback]

No one has had any experience/discomfort with a tibial rod before??

Physical went well, surgery got the green light for thurs

[Jethro]

I had a bad tib/fib fracture in april of 1989. About a year later I had the rod removed. Like you, the screws were causing me pain, at both the inside of the knee and ankle. If the screw heads had been flush with the bone surface, I would have been fine. I had my screws only removed at about six months. It was a simple injection of a numbing agent at the screw head areas and then they spun out the screws with an allen wrench. I did not feel anything. You could have the screws only removed for now, surprised your surgeon did not offer that option.

[lookinback]

I had a bad tib/fib fracture in april of 1989. About a year later I had the rod removed. Like you, the screws were causing me pain, at both the inside of the knee and ankle. If the screw heads had been flush with the bone surface, I would have been fine. I had my screws only removed at about six months. It was a simple injection of a numbing agent at the screw head areas and then they spun out the screws with an allen wrench. I did not feel anything. You could have the screws only removed for now, surprised your surgeon did not offer that option.

Jethro, thanks a ton for the response...how long was your recovery time after you got your rod taken out?(on crutches,boot, ect) How well has the fracture healed since then?

My surgeon says that the bottom screw could come out with a local, but the top screw is pretty buried in there and I would need to go under if it was removed. That taken into account, he prefers to only have to put me under for one procedure and take everything out instead of stretching it out and doing it twice. I also had expressed previous desires for the rod to be removed in fear of a future break skiing or biking, as im sure you know the rod would only cause further complications.

[Jethro]

I healed really well. I have a gradual lump on my shin from all the bone deposits, but that is only cosmetic. My leg also has skin grafts on it from a complication known as a compartment syndrome. I took a week off of work after the rod removal and that was it.

You are right about getting the rod out. You do not want that thing in there if there is any chance of you injuring the leg again. I don't jump like I did when I was 22, but I still ski fast, ride dirt bikes and mtn bikes, and re-injury cannot be ruled out. If you took it easy for a month or so, I bet a six month rod removal would be fine.

[brosia]

I had mine removed in two stages. First the pins on my ankle because they were hurting in my ski boot about a year after the break. 4 years after the break the rod was still hurting my leg during impact sports like running. I had the rod removed and my leg felt like it was 100% back to normal for the first time since before the injury. I highly suggest getting it taken out. Mine was a quick recovery time. I was walking partially weighted immediately after the surgery and running/skiing within a month.

[criscam]

just my .02.
my doc said there wasn't any reason to take it out unless it was bothering me. also mentioned the risk of a staff infection with surgery. my screws started bothering me a little last year and i ended up getting the lower one taken out. couldn't get both out as he needed at least one in if i was ever to get the rod taken out in the future. also got my calcium build-up on my shin shaved down as it was rubbing in my boot a little.
good luck w/ the surgery.

[lookinback]

just my .02.
my doc said there wasn't any reason to take it out unless it was bothering me. also mentioned the risk of a staff infection with surgery. my screws started bothering me a little last year and i ended up getting the lower one taken out. couldn't get both out as he needed at least one in if i was ever to get the rod taken out in the future. also got my calcium build-up on my shin shaved down as it was rubbing in my boot a little.
good luck w/ the surgery.

Thanks for the responses, I quickly talked with my doctor about the risks of infection today, and he seemed to think it was no more of a risk than putting the rod in. Criscam, I was concerned with the calcification on the shin and boot fitting, did you make any helpful boot modifications before you had it shaved off?

Thanks for the vibes, I will post some pics (x-rays and of the rod) after the procedure.

[criscam]

Thanks for the responses, I quickly talked with my doctor about the risks of infection today, and he seemed to think it was no more of a risk than putting the rod in. Criscam, I was concerned with the calcification on the shin and boot fitting, did you make any helpful boot modifications before you had it shaved off?

Thanks for the vibes, I will post some pics (x-rays and of the rod) after the procedure.

I have zipfits in my resort boots and i think that probably helped initially as the cork is pretty moldable (w/ out heating). the last year or two whenever i skied hard more than a few days in a row i would feel it. i started putting a foam donut around the deposit the end of last year and that helped a little but not enough to not have surgery.

[Jethro]

The lump on the front of my shin is pretty gradual, so it does not bother me in the slightest. I did have a prominent pointy lump ground off the inside of my leg when the rod was removed though. I am in Conformable liners with their foam tongue.

[lookinback]

Surgery Was a success
waay looped out on pain killers right now
I will upload some pics tomorrow
SHOCKED how large/heavy the rod is!

[criscam]

SHOCKED how large/heavy the rod is!

shoulda spent the extra money and went with titanium over lead.

[lookinback]

Knee is a bit sore today and taking it easy, doc said i should be back on my feet next week and on skis in time to catch some spring turns.

[Jax]

^^^

Nice.

I am 8 months post-op of having my IM rod inserted in my left tibia. Really the only thing that bothers me at this point is the edema and the inside of my ankle above (but not on) the lower two screws gets pretty sore. Boot fitting has been a pain but I think I finally have it dialed thanks to Larry's, went with intuitions, padded the giant lump of calcification that I have on my shin as well as the inside ankle, and shaved down the boot board to allow for the random swelling under the ball of my foot that has been happening as of late. My knee and the upper screw have not given me any problems yet, knock on wood. Cold syndrome is bothersome but once I get my ankle to pop in the morning (feels so good) the leg starts to act normal.

I can run on a treadmill for several miles, but I do notice soreness around the break. I do worry about trail running, something I have always enjoyed before my injury.

I have 15 days skiing so far, getting stronger by the day. I am finally able to step into my binding without bending over to assist myself. I keep weighing the pluses and minuses of having the rod taken out, my Ortho said to plan on keeping it in unless there were complications and this is with his understanding that I am not a sedentary person. But I still have this lingering thought in the back of my mind in case of another injury. What are the odds of this type of trauma again to the same leg?

I know there are others that have left the hardware in for many years with no adverse effects- Skiingislife (here on the board) comes to mind, he logged over 200 days last season. Though, he is much younger.

Does age also factor into whether or not to have it removed?

[lookinback]

roughly a month from rod removal and all I have to say is

GETTING IT OUT WAS THE BEST THING EVER!

Still have a bit of the old pain around the top screw but it is getting better day by day. I went cross country skiing yesterday for a couple hours and felt great.

Flying out to seattle March 11 to get the first turns of the season at baker!

[Core Shot]

I am impressed with the quick mobility/recovery of the knee.

Other than major surgery, my big fear was having a super unstable knee for six months.

My knee was so fucked up long after my rod was installed and my break felt better. I assumed that was damage from dislocating my knee for rod access. Maybe its less disruptive to just remove one.
I know they only "released the fascia" but you must have to shove that kneecap out of the way to get access.

Going to get out the screws soon, but had been talked into keeping the rod until this thread brought it up again.
I swear I feel the weight
I know I feel the rod from time to time, esp with pressure changes and some activities.
And if I ever tater again, the theory is better to break the leg than the knee ligaments, but with the rod, aint nothing breaking down there.



Been 3 years, and the shin still hurts after weeks of daily skiing. Interesing about shaving the knob off - had not heard of that before.



Interesting comment about needing a lower screw in order to remove the rod later?
I thought they just thread a slap hammer into the top of it and slap tap it upwards.

[lookinback]

Coreshot, its been months since i have felt any pain around the break, most of the pain has been a result from the surgery. I have ZERO knee pain, I have been going to the gym 6-7 days a week and have been spinning religiously. It was rainy the other day and the entire empty cavity was aching due to the pressure changes, but hopefully that will stop once it has a chance to fill in.

Getting the rod out has made my leg feel lighter, given me more mobility, energy, range of motion, less pain, ect ect.

I was surprised by how deformed the metal was on the top of the rod where the impact driver was threaded in...they really apply a good bit of force on these things!

To answer your question, if the rod is left in for years they do have to chisel away some of the bone growth both at the top and bottom of the rod to "free" it for extraction. Thats what most of the removals happen a few years tops after the original insertion. I had asked my doctor about shaving the lump down and he said since I had a smaller bone structure I need all the bone I can get. But my break is very distal and doesnt interfere with my boots too much, at least in the living room...

I am impressed with the quick mobility/recovery of the knee.

Other than major surgery, my big fear was having a super unstable knee for six months.

My knee was so fucked up long after my rod was installed and my break felt better. I assumed that was damage from dislocating my knee for rod access. Maybe its less disruptive to just remove one.
I know they only "released the fascia" but you must have to shove that kneecap out of the way to get access.

Going to get out the screws soon, but had been talked into keeping the rod until this thread brought it up again.
I swear I feel the weight
I know I feel the rod from time to time, esp with pressure changes and some activities.
And if I ever tater again, the theory is better to break the leg than the knee ligaments, but with the rod, aint nothing breaking down there.



Been 3 years, and the shin still hurts after weeks of daily skiing. Interesing about shaving the knob off - had not heard of that before.



Interesting comment about needing a lower screw in order to remove the rod later?
I thought they just thread a slap hammer into the top of it and slap tap it upwards.

[Dog Pound]

Wow dude, WOW! I am going to have my rod out next week and I can't wait! I've waited 18 months. I am glad you have had such a good recovery. ...and you got to keep the rod! I hope that is the case with me.
Cheers,
Lo

[LightRanger]

Interesting thread. It's been three years and a month since my tib-fib fracture: http://www.tetongravity.com/forums/s...-and-TFH-Folks

Core Shot, I remember you posted on one of my threads. I think it was my bootfitting thread in here.

Anyway, figured out a little over a year ago--a while after my third surgery during which a podiatrist performed a non-indicated surgery to correct a "Checkrein Deformity" (google it)--that my left leg is 2cm shorter and maligned below the fracture site. That, plus the Checkrein Deformity that didn't really get fixed, means I have major surgery again in my future. I walk with a pigeon-toe, can't run very far (or fast), can't hike distance, can't ski, etc. I can climb in the gym (and a little outside), ride a bike (but can't spin for more than 20-30 mins because the off-angle of my left foot makes my knee hurt), and snowboard (but not super hard).

Going to have the procedure below done at Stanford. Hopefully later this year.

Video on how it works:


Press Release on First Clinical Trials (surgeries happened in early December):
Link

Articles by and about the guy in South Florida who did it:
Link
Link

Press release re: FDA approval:
Link

Criscam,
Your experience is interesting. I had my screws pulled in December 2009, ~9-10 months after the initial surgery, and the ortho didn't mention a concern about getting the rod out later if need be. Same when I talked to an orthopedic trauma guy at UC Irvine a year ago--he didn't think it'd be much trouble. I do have some lingering doubt on that point because I've read about "incarcerated rods," but I don't know if leaving a screw in has anything to do with preventing that or not. And, when you had your calcification lump shaved down, was it covered? I would assume most surgeons would say that it's "cosmetic" (in quotes because I don't necessarily think it is).

[lookinback]

Lodopo, how did your surgery go? Any pictures?


Lightranger, that is a very cool setup, thanks a ton for sharing! im researching more on that setup now.

[wasatchback]

Getting the rod removed from my Tibia 12/21. Spiral fractured it 2/17/11, had a non union, bone graft 10/15/11 and Doc says that by 12/21 it should be healed enough to remove the rod. He said recovery will be 3 weeks before I can ski again. Does that sound right? I had originally heard it would be 2 months before I was fully cleared to do whatever I wanted but he said 3 weeks was all it needed.

[Jethro]

Getting the rod removed from my Tibia 12/21. Spiral fractured it 2/17/11, had a non union, bone graft 10/15/11 and Doc says that by 12/21 it should be healed enough to remove the rod. He said recovery will be 3 weeks before I can ski again. Does that sound right? I had originally heard it would be 2 months before I was fully cleared to do whatever I wanted but he said 3 weeks was all it needed.

Glad to hear you will be back skiing at the start of the season. Ever since I had my rod removed in 1989, I have skied with my bindings set a bit lighter. I ski with them around 11-12, down from around 14 before I busted my leg up. There is no way I am gong through all that again.

[LightRanger]

WasatchBack,

Congrats man. Three weeks sounds right. I'm getting mine out on December 6 and my ortho said basically the only thing is that my knee's gonna be super sore because he has to stretch the crap out of my patellar tendon to get it out.

I still probably have surgery farther down the road though before I'm fully skiing again--I had a sold union from a tib-fib spiral/medial malleous fracture, but a misalignment, 2cm shortening, and Checkrein Deformity. In the mean time, I'm snowboarding, slowly, and mountain biking. So it could always be worse. :-)

[XXX-er]

They always tell you to only get the HW out if it bothers you IME you should get it all out asap especialy if you got the universal HC in Canada


I had 3 screws put in a cracked ankle about 15 yrs ago, 5 yrs later I did in the tib/fib and the surgeon had to put a plate in the ankle instead of a rod because he was worried about hitting one of those 3 screws from the 1st injury

he put the plate in end of feb, they cut me open and took it out the following dec along with 2 of the 3 old screws ... one wouldn't budge

So the season following the accident I skated/ skied xc/ tele-ed and I would say 10yrs later the twice broken ankle is stronger than the never broken ankle

IME getting cut open to remove HW is not nearly so bad as getting it put in, they were not suposed to let me but once the juice wore off I walked out of post op

[wasatchback]

Thanks for the info and support.

On a side note.... Every time I go in for Surgery I come out with a nasty rash/hives everywhere they prep my leg. I thought I was allergic to Betadine so the last time they used Chlorhexadine and I had the same reaction. I've got to take steroids to get rid of the hives/rash so I'd like to figure out a solution before my next surgery. I was awake for the last surgery and everyone in the OR said there was no way I would have a reaction to the Chlorhexadine but of course I did. They even cleaned it all off right after I got stitched up.

Could I be allergic to the orange dye in both of them?

Anyone else had a similar experience?

According to the nurse they used Chlorhexadine to clean my skin before inserting an IV. I had no reaction there but there was also no orange dye in it.