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Tibial IM Nail and knee pain
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Tibial IM Nail and knee pain

Hello. I fractured my Tib/Fib in a snowboarding accident on 3/28/10. I had surgery 3/30/10 to implant tibial intramedullary nail. Surgery went well, incisions healed great and I have retained most all of my range of motion in ankle and knee. Some definate atrophy in my right thigh but I'm sure that will return with therapy (which I just started yesterday). The actual fracture location has little to no pain, usually.

The thing I am concerned about is the anterior knee pain that I experience when putting much weight on the bad leg. The pain is still moderate to severe after 6 weeks. I have read that this is quite common with the procedure. I'm just concerned with the recovery time, etc. involved. I'm hoping that strengthening the muscles back up in the thigh will take some strain off the joint. I have never had a serious injury so maybe I'm rushing things. What is the normal rate of recovery for such things. I am very healthy otherwise. I don't smoke. Been taking Calcium and vitamin D supplements since surgery. I have to at least be able to walk normally before I can return to work. I am a power lineman. I know that climbing poles is out for a few months but walking sure would be nice! Haha!

Any info or life experiences would be appreciated. I'm just not used to being down like this and it's getting a bit depressing. Thanks for any info!
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Avatar_dr_m_tn
Hello!

Complete healing will take place in 16 weeks to 20 weeks, there is no reason to worry and start physiotherapy after confirmation of healing.

Good that you do not smoke and are healthy, this will help in faster recovery. Maintain complete hygiene and avoid infections.

Take care!
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Avatar_f_tn
Hi,There! We have basically the same injury although, yours happened with a little more glamour than mine!LOL Yes, that knee pain is quite the norm,some of us worse than others.For myself it is liveable but I have pain in a different area that over rides the knee pain.Anyway, in researching almost everything to know about this type of injury quite often they will remove the screws that are below your knee & evidently that can reduce the pain as there is a tendon in that area.( this is done on an out patient basis)Then others have to tough it out until they are healed enough (usually 12-18 months) and have the nail removed. Take all thePT you can and do you exercises @ home. range of motion is such a huge player in this game. Might I also suggest taking vitamin C.If you have any other questions don't hesitate. I am 18 months post injury & still dealing w/ issues so chances are I've had the same questions @ some point. Take Care!
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Avatar_m_tn
Thanks so much for the info. It eases my mind a little to know I'm probably just being impatient and trying to do too much too soon. I'm not used to being out of commission for so long. Missing my golf league!! (Among many other activities)
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Avatar_m_tn
Was also wondering if any analgesic creams etc. would help with pain. Aspercreme, Icy Hot, etc. I have been taking ibuprofen for over a month. The bottle says take it no more than 10 days. I think it's starting to work on my stomach a little. I would appreciate any suggestions in that area as well. Thanks alot!!
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Avatar_f_tn
I would be switching that Mortin up for Tylenol. Motrin is very hard on your kidneys as well as your stomach.NSAIDs are fantastic for short term use.Topicals really have not worked for me the best one was Volterin -but this is an ibuprofen as well.- The best relief has been sitting in the bath tub,not that it last for long once you get out but it does settle things down until meds kick in.& of course ice. Ice has been my best friend for months.lol I completely understand being impatient,I thought I was going crazy @ about 2 wk. post op. It does get a little easier.
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Avatar_m_tn
OK. Thanks again!
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Avatar_m_tn
Doing a little better now. It's been 8 weeks since my tibial nailing. I have had some physical therapy to rebuild strength in the injured leg. I have come to the conclusion that any amount of strength training isn't going to reduce the pain in my leg. It seems to be hurting the most now where the locking screws are installed. My surgeon mentioned taking out the top screw to stimulate more bone growth in the fracture area. I wasn't interested in that at the time but I'm really considering it now. More to relieve pain than anything. I have walked around the last 2 days without the aid of my cane. I do have a signifigant limp of course! The most pain I exerience is when I push off of the bad leg. It hurts right where the top screw is. The lower ones are causing some discomfort also but not as much. I'm hoping it isn't much of an ordeal to remove the screw/screws. I assume that they can't take all the screws out and just leave the rod in there loose???
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Avatar_f_tn
Hey! Glad to hear that you are feeling a little better.If we could only heal as quick as we injured ourselves! That is awesome that you are walking unaided! I was further in before I started to walk.My screws bother me as well-first the one below my knee and probably 7 months ago the one above my ankle started.-I think that they are both backing out as well or my leg has atrophied so much that the screws are really prominent. I really don't think that taking out those screws are a big deal(easy for me to say!LOL) but my PT said that the needle to numb the area is the worst part.As far as all the screws being removed...that I don't know.With all the trouble that I have been having my Dr.has just recommended that I have everything taken out so,here I wait for a surgery date.I'm hoping that it will be the answer for me as this gimp act is getting on my last nerve!   How is your range of motion in your ankle? What part of your tibia did you break? Is your fibula healing?  Keep moving.I know that just walking will stimulate bone growth. I think you are doing awesome only 8 weeks in!
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Avatar_m_tn
Thanks for the encouragement! I guess I'm just impatient and unfamiliar with this serious of an injury. My big worry is returning to work and being able to do my job! I am a lineman for the power company. Climbing poles is definately out for awhile but I think in a few more weeks I can do most of the other requirements. I'm running out of sick time!! My range of motion is excellent according to my PT. In the knee and ankle. I feel like taking out the top screw at least will ease some of the pain of weight bearing.

I'm tired of being crippled too!! I go to my orthopedic surgeon next week to see what the next step is. I'll keep ya posted. Thanks for the info.
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Avatar_f_tn
That is huge that your ROM is good.My knee was always good but my ankle is what gives me trouble to this day. Anyway, my neighbor broke his leg last year in a snowmobile accident-he too is a lineman- He was off work for 3 months-I know that you are itching to get back to work but do it slowly as you could cause permanent damage doing to much if your leg isn't ready. Take Care!
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Avatar_f_tn
Hi there, I recently Had the same surgery, it's been 5 weeks and my leg still hurts . Moreover , it is hurting more than earlier weeks when I was in the hospital. Another issue is , my Knee is hot. Is that normal? (I mean only the bad knee) . I would appreciate a reply.
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Avatar_m_tn
Hi all, broke my distal tib/fib in a martial arts accident. Went for surgery, had IM nail inserted and at the 5th week my OS cleared me for full weight bearig. To my surprise, I did away with the crutches quite easily and now at 6th week I'm walking almost normally, just slowly.
OS and PT say it has pretty much to do with me being slim and quite fit (never stop training on daily basis), and since day 1 after the surgery I started exercising twice a day, pool and gym, increasing the intensity as time went by.
Now I can do squats (just body weight of course), leg press with moderate weight, indoor cycling 45 min with low resistace and intervan sprints swimming in the pool.
No pains at all, just a bit of discomfort evey now and then.
Definitely looking into removing all hardware as soon as OS says it can be done.
I hope sharing my good outcome will help everyone keep their hopes high and my advice is to put all efforts in rehab and training!
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Avatar_f_tn
Hi..Its been 4 days after my IM nail surgery.But i cant bend my knee.Just a little.Very stiff.Is this normal?Sorry for my English
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