As some of you on here already know, I broke my leg skating Saturday. I did an RBO 3-turn, got a little off-balance, pitched forward a little, started to fall, put my left foot down, which got twisted under me as I fell. My coach didn't tell me this at the time, but she was near me and heard the snap. After being carried off the ice by the skating director (some of you may know her from Champ Masters at AN) and Flo's pairs partner (strong guy!), I went off to the hospital in an ambulance. Diagnosis: 2 fractures, 1 in the tibia near the ankle - at the top of my skate - and 1 in the fibula near the knee.

Today, I saw an ortho doc for the permanent cast (which was the most painful thing I have ever experienced - try flexing an ankle at a fracture point - my mom told me it looked and sounded worse than childbirth) and discussed options. I don't need surgery, b/c the fracture is not that displaced (this is the tibia fracture, doc said he's not worried about the fibula fracture - that bone doesn't bear a lot of weight and those type of fractures usually heal by themselves) but the recovery time is much longer w/o surgery. 6 weeks in this hard cast I'm in now (which goes from the base of my toes up almost to my crotch), 4 weeks in a hard cast that goes to just below the knee, and then a few more weeks in something else - boot, or maybe another hard cast, depending on healing.

If I had surgery, which consists of 5 small incisions (3 by the knee, 2 by the ankle bone) and inserting a rod into the tibia and holding it with 2 screws near the ankle, I'd be in a walking boot (removable) for 4 weeks (or did he say 6?) with little to no weight-bearing and then I could walk and start PT. So recovery time would be at least a month less, and I wouldn't have to wear this blasted cast. The way things are now, I can't drive (it's my left leg so doesn't affect my driving, but I can't fit and manage the cast in the driver's seat) and can't really sit at a desk for long periods, so no work. I've got 5 weeks of sick leave accumulated, but this would be longer than that and I suspect my boss wouldn't want me out that long - although I talked to her today and she understands my options and so far has been supportive.

But there are of course risks with surgery - infection, the screws and/or rod not working right and/or being uncomfortable. OTOH, I might end up needing surgery anyway if the fracture doesn't heal by itself in the cast. The procedure takes about an hour and I would need to spend 1 night in the hospital for monitoring and pain mgmt (although none of the pain meds they gave me through an IV at the hospital on Saturday seemed to work so I don't know how well my pain would be managed anyway). I've never had surgery or general anesthesia before (unless you count tooth extractions and 'laughing gas') and I've never been in the hospital. I'm not in any hurry to break that streak, lol, but I just don't feel like the non-surgery option is feasible. It's not about getting back to skating (I'm sort of waffling about whether skating is worth this agony, but I could also break my leg walking down the street, or doing some other activity) but about living my life and doing basic things. My mom has been staying with me since Saturday but she can't do that forever.

Has anyone here had (or know someone who had) this type of surgery? I would be interested to hear about the recovery process, whether the rod and screws worked as they should. I asked the doctor if I'd set off metal detectors and he said I might - I think there is a card/letter I can carry stating that - I've heard people with pacemakers have them. I also asked if I'd feel the hardware and he said I'd probably feel the screws and possibly the rod. They can be removed, but would have to stay in for at least 18 months. And that would mean another surgery.

I'd also be interested to hear from anyone who has had a fracture and developed blisters at and near the fracture site - I'll spare everyone the details, but I've got 3 (large) ones - just above the ankle at the fracture site and 2 along the back of my ankle/heel. I saw them when they took the temp cast off today. Never heard of them before but they are supposedly common (and very gross) and the ortho tech that was putting the cast on could give me no time range for them going away. Doc said they wouldn't affect the surgery, if I got it, b/c he can work the screws around the blister site and the most important incision spot is around the knee, which is unaffected. If anyone's had them, how long did they take to go away? If you had the surgery and had to deal with these things, was it a problem?

I'm just really worried about being back to normal, not necessarily for skating, but generally. The tech guy said I'd have swelling for months, but it wouldn't be that noticeable for that whole time. I'm just realy scared right now, so hearing from those who have been through this with a tibia fracture would be helpful.

TIA!

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Terri C is a Bronze lady!
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Ugh, I can's say how sorry I am you have to go through this. I haven't broken my leg, but I can give you some somewhat relevent comments from my still healing wrist. I broke the radius clean through and have a plate and screws holding it together now.

The original break didn't hurt that much - by the time the shock wore off the morphine had kicked in. The post-op pain was significantly worse than the original fracture - and lasted around twice as long before it got to the 'only hurts when bumped' stage. During those days I thought having to get surgery sucked big time and dearly wished I could have just been left to heal in peace.

However, since I did have the surgery, I got the cast off after only two weeks and am now running around in a removeable brace. I've started PT to get the movement back. I'm entirely shocked how much my wrist has frozen up after only 3 weeks (surgery 1 week after the break). I would have been casted 6 weeks without the surgery and I don't want to think about how much harder recovering from that would be.

I've heard from someone else who has a wrist plate like mine that it can hurt when it warms up after getting really cold (the contraction/expansion thing) and I'm afraid this may be a problem for me skating. If the rod is all the way inside your bone that shouldn't be a problem for you.

hope that helps at least a little.

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So sorry about your ankle. I am a pnysical therapist and have seen many patients with either option. With both options, you will have a lot of swelling after the boot/cast. You will have a significant loss of range of motion for a few months. The major difference between the two options is the amount of return of motion, specifically dorsiflexion (bringing your toes and foot toward you). I have noticed a better return of motion in patients who have chosen not to do the plates and screws than those who do chose the hardware. This may be purely by coincedence, yet it has followed a common pattern. The plate may also create a bit more bulk in the ankle and affect your wearing of shoes/skates. The pros to the plate and screws is your are virtually guaranteed that the bone will heal straight, as opposed to gambling without the plate and screws.

The decision is hard to make, and both options aren't any fun. Does the doctor make one recommendation over the other?

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I can offer several points here. I was an orthopedic surgical nurse for 13 years. Tibial rods usually go in pretty easily, heal quickly and generally only come back to remove the screws. The rod usually stays in. Taking the screws out would involve a tiny incision over it, minimal pain, quick recovery. Taking the rod out is a little more difficult. You can move your leg ankle quicker and it won't stiffen as much. If you like your surgeon and he has a good reputation, I would go for the rodding simply for the healing time. Plus, you can wash your leg. Imagine what unwashed for six week smells like!

You could go back to work before you are completely healed, as long as you can get by on crutches.

I have never personally had a tibia fracture, but I do work as an orthopedic nurse practitioner (I am also fairly local to you, so if you want an opinion on your surgeon, feel free to PM me). I would recommend going for the rod mostly for the reasons other people mentioned. You will get your motion back much quicker, less time lugging around a cast, your mobility will be better quicker, etc. I know having surgery sucks, but I think in the long run you will be happier. At least where I am, most if not all fractures similar to yours are treated surgically. As far as risks of surgery, usually the surgery goes really well. Infections are pretty rare as is failure of the hardware/procedure. You would probably be in the boot for 6 wks with no weight bearing then progressive weight bearing with PT. You would certainly be driving sooner after surgery and working too.

Fracture blisters are nasty aren't they. They occur because of the swelling and bleeding that occurs around the site of the fracture(and usually below as well because of gravity). The ones that I have seen take several weeks to resolve. Elevate your leg above your heart and ice, ice, ice. The cold will get through the cast even though it won't feel terribly cold to you.

Feel free to ask me any questions. I'm sorry this happened, it must really suck. Good luck with your decision, and heal quickly!!

So sorry to hear about your leg. I have no opinion on if you should do surgery or not, I would research both options and see which you think works best for you.

With regards to the TSA, my mother's metal knee doesn't set off the metal detector but she's 5'4 and 200+, my resurfaced hip sets off the TSA metal detectors at virtually all airports, notes don't work as they can be easily forged, you will have to learn to dress in clothing with no metal, that fits well but is ease to cope with the pat down. After 2 years, it only adds about 10 minutes to my travel time and is not that bad.

Good luck with your choice, my 2nd surgery went really well, but I had an awesome surgeon, so that would be what helped me decide to go for that choice.

Leslie

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*Hugs* What a very horrid thing to happen!

If your doctor is recommending surgery, I'd listen - if it will heal quicker, and help you get back to a normal life, and sooner or later back on the ice, that is probably your best option.

It could well be you won't even need a general anaesthetic - very often, they can do these things with an epidural, although they sedate you so you are pretty well out of it anyway.

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I'm so sorry about your leg and I hope you heal quickly and uneventfully.

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Oh wow that's horrible I hope you get better quickly. I've been off the ice/injured for just over 2 weeks now in a boot (sprain + hairline fracture) and it sucks, I can't even imagine how much worse it must be for you.

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First of all, to the original poster, no real advice. I am very sorry to hear of your injury though! I hope you have a swift and uneventful recovery regardless of which method you use.

My wrist fracture from this summer was similar to yours, liz_on_ice. Only I went the opposite route - no surgery, 6 weeks of casting. 3 weeks in a full arm cast (over the elbow) and 3 more in a shorter one that gave me the use of the elbow back. And I had practically zero range of motion right after the cast came off, and the whole hand was so weak I couldn't even squeeze a tube of toothpaste effectively. I kept working the range of motion and that did come back pretty quickly - it seemed like every day I could do something that I couldn't do the previous day. The strength has been slower to return, but I haven't been working on that as much as I probably should be. The one positive about the cast was, I was almost entirely pain-free immediately after they casted it. I took the vicodin from the ER for the first day or so, switched to regular old Tylenol for a couple of days after that, and never really needed anything after that.

We've had a couple of cold spells already and I *have* noticed it does get a bit sore when the weather changes.

Sorry about the injury. That sounds awful.

I suggest the surgery. Not only will you get out of your casts quicker and have a better QOL but those at our age should have our lower limbs immobilized as little as possible just due to increased risks of blood clots.

Wishing you the best in your recovery-

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So sorry to hear about your injury! Not sure if this is along the same line of injury & repair-several years ago one of the hockey guys got slammed into the boards. His foot went one way his body another and he fractured his leg in pretty much the same way as yours. He had external hardware & screws installed. He had a rolling walker for his leg (pretty fun for the girls at the rink to play with) and in a short time he was out of the contraption and into rehab. It took a bit longer for him to get back on the ice because of some residual swelling and fear on his part (he was slammed really hard) but the next year he was back and in great form.

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Skate@Delaware
Ah, show skating!!! I do it for the glitter!

So sorry to hear about your leg. That must have been awful. Whatever you do, heal quickly.

Quick update: I am having surgery tomorrow. Saw a doctor today who thinks I should have it ASAP, b/c I was going crazy in the hard cast. There is the risk of developing compartment syndrome (think Tessa Virtue last season) when operating when the leg is still swollen but there is a risk of clots if we wait. I am very worried about clots so they are going to give me shots of luvenox (sp?) post-surgery. Shots in the abdomen. Oh boy. 1 shot each day for the first 5 days after surgery. Maybe I can get my mom to give me those - she's always enjoyed medical stuff. While they split the cast open today so the new doc could look at my leg, I hid my eyes while my mom peered over at it, with the docs (there were 3, b/c the doc I saw is going out of town for a conference tonight so one of her colleagues is doing it).

I'm really scared of surgery and anesthesia and the whole pain and recovery process, but I don't have a choice. I know I need to think positive.

I'll stay overnight in the hospital tomorrow night and then I'll go to my parents' for the weekend, where I hope I'll be well enough to watch Skate America on IN and TV.

Thank you all for your support and I'll check back in when I can.

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Terri C is a Bronze lady!
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GOOD LUCK!! We'll be thinking of you.

Be strong! We're all pulling for you!

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I am too, so I remind myself what a blessing it is that we have modern medicine when we really need it! Good luck & best wishes for a speedy recovery.

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Good luck! Try to stay as positive as possible--I've found this makes a difference, at least for me, in how I feel coming out of anesthesia.

I'm glad to hear they'll be keeping you overnight. Don't be shy about asking for more pain medication if you need it. In the past, I was nervous about asking for certain pain meds or saying morphine doesn't help me, but I finally learned to speak up until the pain was gone.

Wishing you an uneventful surgery, easy pain management and a quick recovery!

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I had a surgeon who reminded me of a the bottle of whisky they gave to Nelson before chopping his arm off. Wasn't really what I needed to hear, but does show the blessings of modern medicine.
Surgery isn't really that bad. Just take care and look after yourself afterwards. Pain management is key as is getting sleep when you need it.

Good luck.

Don't take your pain meds on an empty stomach.

feel better soon.

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Best Wishes for a very speedy and comfortable recovery Deb !!!

Debbie - So sorry to hear about your fall! Take care and heal well.

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Thanks, everyone, for the encouragement. I had surgery on Thurs, stayed overnight at the hospital, came home Friday to my parents' condo (no steps) where I will probably stay until T-giving. On Wed the 25th I go back to the doc to have the hard cast removed and they'll put me in a sock or stocking or something with a walking boot. No weight-bearing, but I'll at least be able to shower normally and can drive and possibly return to work. It's a min of 6 weeks (I guess these next 2 weeks are included) of no weight-bearing, but could be longer, and then partial weight-bearing and PT.

The doc said the surgery went well, everything is lined up and he's optimistic, but he also said that the swelling could take up to a year to fully go away (which means I might not fit into my shoes or skates until then) and that the screws might cause a prob with skate fitting - b/c my ankle is thin and the screws might be felt (after he said that, I started envisioning having the cast taken off and seeing screws poking out of my skin, although he says that won't happen). I can have the screws removed after 6 mos, though, if they are a problem.

Since I got home, the pain has been pretty bad. Today was the first day I felt well enough to get out of bed and walk/crutch to the kitchen where the computer is. I was glad to at least be able to watch the FD live (and the NBC broadcast earlier). The doc's assistant said the swelling and pain reach their peak at 72 hrs post-op, so if that is true, the pain should be on the downward side. I've also got to take an antibiotic every 6 hours for about 4 days and have shots of Lovenox to prevent clots. Originally, they told me I'd get 5 - 1 a day for 5 days - but apparently the 5-day dose is very concentrated and I don't weigh enough for that option, so I get them for 14 days. (yeah, I know, it's better than getting clots...)

I know I'll get through this, but it's so hard to look ahead at months of recovery. At this point, I just want the pain to stop and to have my life back. Not just skating, but everything. I can't go to the Kaleidoscope show Monday (Dorothy Hamill cancer benefit in DC), which sounds awesome, and no Easterns, and not really much of anything that involves leaving the house. And I really hate showering on a bench....although it will probably be easier once the casting comes off and I don't need to deal with the plastic shield.

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glad to hear the update and that you are feeling a little better. once you get that hard cast off and get to wash you'll start feeling better. I found myself really perking up just a few days into PT. Maybe too perky

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It's all about the dress!

(((((Debbie))))) I'm so glad the surgery went well and you are on the mend. Thank goodness you can stay with your parents and not have to deal with steps! If you don't have a subscription to IceNetwork, this might be the time to buy one. Of course, it's nothing like going to the events, but at least you can see almost everything whenever you want. I give you tons of credit. I think I would be crying buckets in your place.

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