Removal of plate and screws from tibia fracture

@lilypaws, ouch. Your poor daughter. Spraining her ankle as dismounting the horse is bad enough, but to have it stepped on must've really hurt. I'm sure both she and the horse were spooked. @jenniferhunter just recently went through surgery after being thrown from a horse. I'm sure she can commiserate. I wish her (and you) all the best for the surgery tomorrow.

@lilypaws I certainly will pray for her surgery. Will you post an update?

@lilypaws Oh, I am so sorry about your daughter. That is a terrible injury and will be a long recovery. Having a horse step on you makes the injury worse. I had my horse step on my foot once, and I pulled my foot out immediately before he got all his weight on it, and I was just bruised just from that. I took a couple months to stop hurting. I fractured and dislocated/sprained my ankle falling off another horse at a gallop that spooked while riding trails. I presume that my injury happened by catching my toe on the ground when I landed at high speed in a grassy field, and it probably caused a twisting motion. I also had 2 surgeries, the first cleaned up the wound from the compound fracture of the fibula, and got the bone back inside, and placed a fixator cage to stabilize the ankle. I was on a trail riding trip at the time and was sent home and needed to find another surgeon to fix the ankle. The second surgery set the bones with plates and screws. My tibia was shattered on the front and the "knob" was sheared off the inside of it and the fibula was broken. It was also dislocated. This is a very painful injury and the best thing is to just rest with the leg elevated. After the bones fuse back together, the sprain of ligaments still needs to heal. That is where I am right now. I have begun weight bearing and walking and need to do that for my doctor tomorrow. I have a lace up ankle brace that supports and protects the sprain and I wear it to avoid twisting my ankle which would re-injure the ankle. I am working with a physical therapist to get back strength and range of motion and to try to walk correctly. It affects the entire leg because the muscles atrophy from non use and my entire leg is smaller than the other after 3 months of not walking. Now my hip flexors are so tight from sitting that I am having trouble standing up straight which affects my pelvis and back. This is what I work on in physical therapy.

At the beginning of all this, I was wiped out and just wanted to sleep. Every time I had to get up, it was painful and exhausting. I weaned off the pain meds pretty soon. They just nauseated me, and then you take meds for nausea. Ice helped a lot with elevating to help reduce swelling pressure and pain. I am sure your daughter will appreciate your support even when you can't be there. I went through my first surgery alone far from home after an hour long ride in an ambulance. After that, it was all I could do not to toss my cookies. I could hardly eat and keep food down. I did better after taking half pills of pain meds and I tried to spread them out a much as possible. I wasn't very interested in company because I felt so lousy and it took 2 days before I could figure out how to navigate stairs and use a walker. That was so painful every time my foot was lowered as it just increased the swelling pressure.

When I had my second surgery, I discussed the nausea issues, and they put an anti-nausea patch behind my ear before I went into surgery. That worked like a charm. I also had a nerve block injection after surgery that took pain away for a day or 2. It worked so well that I had no feeling at all in my foot and my toes felt like rubber and dead weight. When pain returned, I needed pain meds, but I was careful and I alternated between the hydrocodone and the ibuprofin. I also had daily aspirin to prevent blood clots which are a risk after any surgery and because of being sedentary for a long time. They told me it would be 3 months before I recovered enough to begin walking again and that is right. Walking correctly with proper alignment is going to take longer as will rebuilding muscle.

Hi @lilypaws,

I was wondering how your daughter is doing since her surgery. If you are comfortable doing so, can you post an update?

My daughter slipped off her horse and the horse stepped on her ankle. She had a compound tibia, the bone was sticking out of the skin. Her ankle was out of joint and her fabula had 3 breaks in it. He put a plate in with screws. He had two post that sticks out of her breaks to keep them in place. At lease they got her pain now, but we cannot go up and see her. I saw her before and after her 2 surgeries.The worse thing the surgeon said would be arthritis. So far her insurance has not covered rehab. They are having an outside doctor to see her and write something to the insurance. lilypaws

She is doing better especially with the pain she had before. She's tired of being in the hospital. So far insurance won't cover Rehab. They are going to send a different doctor in to see her and write up a message for the insurance.

@jenniferhunter Cassidee also has a fixator Cage too. She also had 2 surgeries. Your's sounds worse. She can't put any weight on it for 6 to 8 weeks. Still waiting for insurance to ok rehab. If you feel nauseated after a surgery tell the anathesia (SP) doctor and he will put something in your IV that helps. They did a nerve block on Cassidee's first surgery, but not on her 2nd. The anesthesis (sp) thought they thought they should do one, but the surgeon didn't think so. She was in so much pain after the surgery, even the strongest med did not help. When I see that doctor again I'm going to comment to him not doing one.

@lilypaws What helped my pain at the beginning was elevation of my ankle with ice packs. That made the difference when the meds were not enough. I did have a nerve block after the second surgery for the plates and screws which helped for a few days.

It's too early right now for your daughter to do rehab. The bones have to start to heal and be confirmed at follow up with X rays. That will come after the 6 to 8 weeks. I have been out of my cast now for 6 weeks, and I started my rehab at about 4 weeks after the cast was removed. The surgeon asked me to put 25% weight bearing on the operated leg the first week, 50% on week 2, 75% on week 3, and 100% on week 4. After I was able to do that, I explained all my issues and asked for physical therapy and I am dealing with weak muscles, and learning to walk again. My body has tried to compensate because my hip flexors are way too tight because of sitting with my leg elevated for 3 months and I wasn't able to stand up straight, and when I try it feels like I'm trying to rip my leg off. The hips and knee are painful because of this misalignment that we are working on along with range of motion and rebuilding strength. My knee and hip ache and keep me awake at night and I have to shift around to get it to stop. That's all part of having tight muscle spasms in my leg from the injury which are getting better as my PT works on them. I don't have any power to push off with my toes and it's hard to get the leg to trail backward because of hip tightness in front and rear end muscles that have are not doing the job to oppose the muscles in front. Alignment is important so I don't wear out the other joints. This is a very long recovery for sure and I have been told a year for full recovery, and that I will have post traumatic arthritis in my future. The fracture went through the joint space, so I lost some of the cartilage. With an open fracture, infection is a big concern, and your daughter is likely on antibiotics. Infections can cause complications that require multiple surgeries to clean out infection. I do know someone who went through that and almost lost her foot. She started with an injury and fracture of the foot/ankle after slipping on ice.

Hi, I’ve read many of the discussions on the forum about tibia plateau fracture‘s that people have had. I wanted to share and get some feedback from those that have had the same issue that I have been experiencing since my accident.

In 2018 I had an accident and tore my meniscus and fractured my Fibia and broke my tibia and had an external hardware attached to my bone on my left leg. My orthopedic surgeon replaced hat with internal hardware that consisted of 12 screws and a plate.

After, three months of laying around with no weight bearing on my leg I begin PT then had 50% weight bearing on my leg in January 2019. It wasn’t too bad I thought I was getting better and making progress. I used a walker and crutches to get around and felt I was gaining muscle and stability again.

But, after 10 months of PT I got frustrated because I really worked hard at gaining muscle and strengthening of my leg and it just hurt and didn’t want it to hurt. Was taking pain meds for awhile but again tried to strengthen my leg. I was seeing progress but continual pain.

I said I needed to get the hardware out of my leg because it was hurting so much under my knee were all those screws were in bedded. The plate was just as bad as it continually pressed against my bone and tendons. I thought OK this will be great I can get this internal hardware taken out and I’ll feel much better and continue gaining muscle and strengthening my knee and leg.

Well its August 2020 I had my internal hardware removed. At first it felt great getting the screws out of my leg and I definitely felt the difference for the first couple of weeks and believe that all that pain from the screws & plate was going away.

As of today September 16th after I got my stitches removed I had 30 staples with my first surgery and I had another orthopedic surgeon take out the hardware this round so he put stitches there instead. The scar looks like an upside down hockey stick. But at least my scar is Looking better again every day Like it did before the second surgery.

My complaint is I still have pain on the side where the plate was and underneath the knee where the screws were. It has been stiff for a while which that’s gone away some more but I don’t like the feeling at all. I do stretch my leg and bend it more and it looks pretty good you were to see it no one would believe I even had a problem. But, after months and months of swimming and stretching which help some, the pain doesn’t go away.

We’re a month out post surgery with taking the internal hardware out but wondering if it’s going change for the better and become more “normal”? Or will I always have this pain? I’m thinking of getting a shot which will lubricate the knee helping it become less sensitive.

Does anyone have some experience from removal of internal hardware? What happened and how are you coping.

Hi @caligirlian, and welcome to Mayo Clinic Connect. I moved your message and questions to this existing discussion called "Removal of plate and screws from tibia fracture." As it turns out @tc125, who also experienced a broken tibia and surgery in 2018 asked similar questions. In this discussion you'll also meet @bernese53 @pthielen5923 @quiteachiver75 @jenniferhunter @red3 and others.

Caligirlian, are you also seeing a physiotherapist?