Help needed - Pilon fracture right distal tibia

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Hi all, first time posting here, looking for some advice. I (34M from UK) broke my tibia 9 weeks ago and it required surgery and a metal plate and screws (ORIF). I have just had the cast removed and have been given a 'fixed walker' boot and there are three things I wanted some advice on.Firstly, there are three screws which I can clearly feel sticking out of the shin bone. This is not the head of the screw but the tip. As the flesh on the front of the shin is very thin I imagine that these will cause problems, is this normal? It seems like very shoddy work to me to use a screw that is several mm too long.Secondly, the doctor told me I would not need Physio, but from what I have found online most people with this type of injury do require physiotherapy, as far as I know there was no tendon/ligament damage is this why?Thirdly, I am experiencing pins and needles quite often, I assume that this implies some level of nerve damage. The doctor I saw didn't seem too interested when I mentioned this. Should they be doing anything to assess this/ or to treat it?I have attached some photos of CT scans before showing the original injury and an x-ray after which shows the screw extending beyond the front of the shin bone.

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  • Posted

    Hi sorry about your accident. I can not speak for the screws but for the therapy yes go. Therapy will help strength and range return. My doctor left it up to me and I had no clue were to begin. Therapy has been a huge help. The pins and needles are. Or al or at least normal from what I have had. They get worse for me if I sit too long and in the morning. Good luck.
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  • Posted

    Hi Friarken,

    I had TAR and have also experiencing the horrific pins and needles. Had more x-rays done and all my 26 bolts and plates seem to be holding my foot.

    I had to get another opinion because the orthopedic surgeon that I saw was not responding to my questions.

    I have never felt so vulnerable. I'm really confused and scared since I'm not acquainted with medical science.

    For now the only good suggestion that has worked for the pins and needles is to make a homemade ice pack.

    One cup rubbing alcohol and two cups water. Freeze for an hour or two. Elevate your foot, wrap a towel and put the frozen Ziploc bags.

    I have been in constant pain. Yours truly Monica

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  • Posted

    Hi, I looked at your x-ray, and the screws are very long. I know someone who also had a screw that was too long, and he had to have a second op. to rectify it. Pysotherapy is very important, I would not let it go if I were you. The pins and needles could be normal especially if you only started weight bearing. I had orif surgery in March after I broke my ankle, tibia and fibula. I started Pysotherapy as soon as I started weight bearing, I found it very important. I was taught how to massage the surgical incisions to break down scar tissue. I was also given exercises to do at home, I was helped to walk correctly, because after you start weight bearing you will have some pain and you tend to walk incorrectly to compensate for the pain, this puts pressure on the knee and you could end up with a sore knee. I experienced pins and needles for a while once I started walking and at times it felt like an electric shock in my foot. A physiotherapist will explain and help you with all these issues. I am six months post op and I can do 99% of what I used to, due to first of all God then my surgeon and physiotherapists. Don't accept 2nd best get another opinion, and get the best help you can, it is for you and your recovery. Hope you find the best help soon and hope you have a speedy recovery.

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  • Posted

    Hey i Know it can be stressful.But everything you experiencing is Normal you are going to feep the screws and plates. i had both plates and Screws My doctor also told me i dpnt need therapy A week after my surgery i was moving my ankle I do my excercise every day just like the therapist I push myself .I have pain its normal to have pain..Btw this is my 7th week OFIR YOUR xrays look great IF U FEEL LIKE U NEED THERAPY THEN GO HEAD..but you have to push yourself i AM WALKIN WITHOUT MY CRUTCHES GOOD LUCK TAKE IT EASY AND TRY NOT TO STRESS 😊

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  • Posted

    Sometimes they have to use a longer screw in order to make a solid connection with the bone- I am not sure if this is your scenario or not- I could feel all of the hardware in my foot until they removed it and it caused me pain and irritation the entire time. Some things that helped were extra padding in the area that it stuck out. The pins and needles is normal- there is nerve damage whenever they perform surgery- it took 6 months for me to regain feeling in my toes and at the 10 month mark I still regularly have nerve pain in the toes - they regrow super slowly- there's a cream called LIvRelief that I found helped a lot for the nerve pains. If you had a fracture it is likely you also had some damage to ligaments etc even if they weren't the primary injury and you should expect they will take a bit of work as well. Definitely go to physio if you are in a position to do it!

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  • Posted

    Hi friarken

    I too had pilon fracture just over a year ago, 2 plates and 12 screws. I was told by one doctor at the ortho clinic I would get physio but at my next visit I saw another doctor who told me definetely not until I could walk unaided. But I knew from reading other people's experiences that the sooner the better. So I pushed for it and had an appointment within 2 weeks. It definetely helped me with range of movement but unfortunately I was still in a lot of pain due to the metalwork and have just had surgery to remove the plates and most of the pins. u should ask again at ur next appointment if ur concerned as some of the doctors I saw were better and more approachable than others. Good luck with ur recovery.

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    • Posted

      Hi Bailey,

      I also have plates and 26 screws which are non removable. The pins and needles sensations are non stop. I'm waiting for a second opinion from California.

      Things should be better soon. I'm so happy to have found this group.

      I never imagined that literally two seconds could change your life.

      My insurance only covered four pts to come to my home. I'm currently homebound!

      Respectfully yours, Monika

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    • Posted

      hi Monika

      Never a truer word spoken, how 2 seconds can change your life. Sounds like ur still having a terrible time and I hope that ur situation improves for the better soon.

      I've always been pretty healthy and still am apart from this ankle. But I'm determined to get back as much mobility as I can. Hopefully getting the pins and plates out will ease the pain and stop me having to take painkillers all day and increase my range of movement. Trying not to build my hopes up too much tho just in case there's no improvement but it was worth a try.

      Out Nhs has been amazing. Am so thankful for all they've done for me since my accident.

      Take care X

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  • Posted

    Hi I shattered my ankle a broke my leg in 3 places in a head on collision that was 5 and a half years ago. I had 4 surgeries one was because I could see the screw through my skin very painful they had to fix it now I have arthritis all over my foot. I did rehab for a year but the arthritis still grew and now I can barely move it and in constant pain now they want a complete ankle replacement I'm nervous but I feel I have no choice. I can tell you a screw pushing into you is painful you need to have that fixed I hope you have better luck than I have now facing another surgery hopefully my last I wish you the best

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