Intramedullary nail - anyone else got one?
Discussion
Managed to break my leg a couple of weeks back, and now have a Ti rod fitted in my tibia - just wondering if anyone could share their experiences, particularly recovery times, how soon you could drive, any particular physio that helped etc?
The physios in the hospital had me out of bed putting weight on the leg within 24 hours of the operation, but I'm still using two crutches to hobble around for now (slightly scared of doing any damage to the fibula, which is fusing by itself).
I was discharged with some painkillers, some anti-coagulant meds (to be injected) and the absolute minimum of information...
Thanks!
The physios in the hospital had me out of bed putting weight on the leg within 24 hours of the operation, but I'm still using two crutches to hobble around for now (slightly scared of doing any damage to the fibula, which is fusing by itself).
I was discharged with some painkillers, some anti-coagulant meds (to be injected) and the absolute minimum of information...
Thanks!
I have a stainless steel Küntscher nail (basically an intramedullary nail that hasn't been fixed in place with screws) in my right femur. It has been in there for 30 years last September and it has made airport security 'fun' a few times.
Due to the nature of the fracture I was kept in traction for two weeks after surgery and iirc I was running up and down stairs 4-5 weeks later.
Personally I'd suggest you keep your weight off the leg for a couple of weeks but try to keep the leg moving, knee bends etc to keep the blood flowing and stop muscle wastage.
Due to the nature of the fracture I was kept in traction for two weeks after surgery and iirc I was running up and down stairs 4-5 weeks later.
Personally I'd suggest you keep your weight off the leg for a couple of weeks but try to keep the leg moving, knee bends etc to keep the blood flowing and stop muscle wastage.
I had one put in back in 2012 when I snapped my leg in three places.
Work i was off for five months and driving afer 2.5 months i think it was. I couldn't weight bear for two weeks I was told.
I had physiotherapy from two months after the OP for I think eight months can't remember exactly it was 8 years ago now.
There is a thread on here that has a lot of info and posts from a doctor I also shared my x-Ray pictures its worth searching for.
I had the rod taken out in December 2014 and walked out the same day with two weeks off for the cuts to heal.
Edit
Read this
https://www.pistonheads.com/gassing/topic.asp?h=0&...
Work i was off for five months and driving afer 2.5 months i think it was. I couldn't weight bear for two weeks I was told.
I had physiotherapy from two months after the OP for I think eight months can't remember exactly it was 8 years ago now.
There is a thread on here that has a lot of info and posts from a doctor I also shared my x-Ray pictures its worth searching for.
I had the rod taken out in December 2014 and walked out the same day with two weeks off for the cuts to heal.
Edit
Read this
https://www.pistonheads.com/gassing/topic.asp?h=0&...
Edited by myvision on Wednesday 15th January 20:34
No experience of having one, but I've put a fair few in other people. Finally, a thread where I know what I'm talking about!!!!
If you have been told you can bear weight, you can bear weight. In fact putting load through the fracture site is often helpful; it 'stimulates healing' for want of a better expression. If you want to research this, look at absolute vs relative stability and Perrin's strain theory of bone healing.
The fibula is irrelevant in most cases. In its middle section it is just an attachment for muscles. It takes almost no weight. Do not worry about the fibula.
Most people with a tibial nail can walk as much as pain allows. Metal fatigue is a thing, however, so don't run marathons before the bone has healed - usually about 12 weeks for a tibia. Of course, if you smoke you can double that figure. There never was a more immediate excuse to stop!
Walking is the very best DVT prevention.
Driving can happen when you can walk without crutches and feel you will be safe out on the road. You have to be able to stamp on the brake pedal without wincing. If it's your left leg and you have an automatic, then crack on straight away.
Nails are best left in. Occasionally if it's a bit long at the top it's worth taking out to protect the knee. It's sometimes necessary to take a screw out to allow a bit of movement if healing isn't progressing (see above re strain).
I've taken a couple out of a motorcycle racer and a parachutist, purely because they are almost guaranteed to break it again and extracting a broken nail to fix a new fracture is a right faff.
If you have been told you can bear weight, you can bear weight. In fact putting load through the fracture site is often helpful; it 'stimulates healing' for want of a better expression. If you want to research this, look at absolute vs relative stability and Perrin's strain theory of bone healing.
The fibula is irrelevant in most cases. In its middle section it is just an attachment for muscles. It takes almost no weight. Do not worry about the fibula.
Most people with a tibial nail can walk as much as pain allows. Metal fatigue is a thing, however, so don't run marathons before the bone has healed - usually about 12 weeks for a tibia. Of course, if you smoke you can double that figure. There never was a more immediate excuse to stop!
Walking is the very best DVT prevention.
Driving can happen when you can walk without crutches and feel you will be safe out on the road. You have to be able to stamp on the brake pedal without wincing. If it's your left leg and you have an automatic, then crack on straight away.
Nails are best left in. Occasionally if it's a bit long at the top it's worth taking out to protect the knee. It's sometimes necessary to take a screw out to allow a bit of movement if healing isn't progressing (see above re strain).
I've taken a couple out of a motorcycle racer and a parachutist, purely because they are almost guaranteed to break it again and extracting a broken nail to fix a new fracture is a right faff.
Thanks all - I'll take a look at that thread.
I'm doing some leg raises, ankle rotations ('writing' the alphabet with my feet), that sort of thing. Main concern is not wanting to do any additional damage really. Follow up at the hospital in a few days so fingers crossed they'll give me some practical advice.
I'm doing some leg raises, ankle rotations ('writing' the alphabet with my feet), that sort of thing. Main concern is not wanting to do any additional damage really. Follow up at the hospital in a few days so fingers crossed they'll give me some practical advice.
Dr Mike - thanks for taking the time to post. I watched a video of the op (not mine!) - it's brutal! Awls, electric drills, hammers...and yet when I was in the recovery room I was in less pain than when I went in, didn't even need the morphine they'd hooked up to my cannula. You and your colleagues have my respect, and gratitude.
Tango13 said:
I have a stainless steel Küntscher nail (basically an intramedullary nail that hasn't been fixed in place with screws) in my right femur. It has been in there for 30 years last September and it has made airport security 'fun' a few times.
Due to the nature of the fracture I was kept in traction for two weeks after surgery and iirc I was running up and down stairs 4-5 weeks later.
Personally I'd suggest you keep your weight off the leg for a couple of weeks but try to keep the leg moving, knee bends etc to keep the blood flowing and stop muscle wastage.
You should do what your surgeon suggests, even though well meaning advice on a forum is provided. Due to the nature of the fracture I was kept in traction for two weeks after surgery and iirc I was running up and down stairs 4-5 weeks later.
Personally I'd suggest you keep your weight off the leg for a couple of weeks but try to keep the leg moving, knee bends etc to keep the blood flowing and stop muscle wastage.
Sorry, but this is complex. What's the fracture configuration, what's the VTE risk, Where's the butterfly fragment? Is it dynamically or static locked? Segmental?
No medical advice here without sight of xrays or patient please
Another trauma surgeon.
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