Hardware removal after tibial plateau fracture (tpf)

@anemarie Have you talked to your doctor about your concerns of infection? This would be their concern too, and they could prescribe antibiotics to take before your surgery to lower that risk. Your fracture is similar to mine that involved both tibia and fibula, but mine didn't extend up quite as far. My fibula had a clean snap, so the surgeon added only one screw inside it, and I had 2 plates on the tibia like yours, but they were about half as long as the big one. The inside "Ankle Knob" that is part of the Tibia was sheared off, and the front of the tibia had cracks that looked like puzzle pieces but not fractured all the way through. The plate in front was under the tendons on the front of shin, and when that plate was removed, I felt like the tendons moved better because they were not sliding over a plate anymore.

The day I broke my ankle, I was riding a horse and fell when the horse bolted. The day before that, I found a tick on me and wasn't sure if it had started to bite, so I went to the doctor and was put on antibiotics, so that was actually a good thing when I broke my ankle because being around a barnyard and fracturing your leg with a compound open fracture, raises the risk of infection a lot. I had no issues with it at all.

I had my hardware removed because my body was reacting to the metal inside and it caused me pain, and also massive hives on my body unless I stayed on antihistamines all the time. I felt like someone was always kicking me in the shin, and I was getting pigmentation starting to develop over the plates on my skin. Having all the hardware removed made a big difference and my health improved, even my breathing. I have asthma, and was getting lots of phlegm all the time. It wasn't just the hardware on my ankle, it was dental work with metals causing it, and that had been removed and I was breathing better until I broke my ankle, and the breathing problems returned when I got metal back in my body. I have no metal now and it makes a big difference for me.

What I think about is could you also have a problem with metals, and could you still have pain if only some of the hardware screws are removed? Do you think that would be a good conversation to have with your surgeon, and ask if all the hardware should be removed or just part of it? You have had this so many years, and may not need any of it anymore. I know I feel so much better with all the hardware removed from my leg. I didn't have trouble walking after my hardware was removed. I had some pain, and there is a recovery after surgery, but much easier than recovering from a fracture.

Hi Jenniffer my accident was me being at the wrong moment and time. I was hit by a lost bullet 9 mm bullet it Hit the ground and then my leg. it went in and out the other side.
We had talked about removing it all but he is more conservative and wants to take it step by step. This is minor surgery removing 4 screws. While removing everything would be mayor surgery.
As for the concerns of infection he is giving me antibiotics before. So I should be Fine. Still the mind is always concerned of what may or may not happen.
Thank you so much for your input
Annie

@anemarie
Annie, yes , I understand. That must have been traumatic when you realized how you were injured. Did you recover your proper function of your ankle and walking ability? I'm still working on that myself, and muscle is very slowly rebuilding. I know when my ankle gets too tired, I just have to sit down. I take care of horses and have to walk on uneven ground or mud with lots of hoof impressions and that is very difficult and tires me out. When it freezes it's like walking on rocks and I have to try to stabilize my balance. I'm guessing it might take up to 6 years or longer to get maximum ankle improvement. My ankle would get tired and suddenly hurt and collapse under me, and this year, that it happening less often.

Hi Jennifer I didnt recover completely. I cannot go on long walks. like you I have problems on irregular terrain. If i gain a couple of pounds the pain increases. I used to ski. Now I can only do a couple of hours. Now I decided to remove the screws because the doctor suspects there is a problem in that sense and thats even increasing my pain along the years. I have limited flexidorsion (upwards) and in the mornings its rusty and the joint is blocked. I limp in the first 5 minutes. After I walk normally
I dont know if this happens to you.
Anyway preparando myself for tomorrow
Annie

@anemarie

Annie, I have some laxity in the joint. My injury was the fractures, but also a bad sprain and dislocation that happened all at once because of rolling the ankle during the injury. When I stepped on my foot first thing each morning, I used to limp for a few minutes. It helped me to rotate my foot around with my hands which made cracking noises and kind of reset the alignment and position of the ankle joint. The outside of my calf is weaker and there was muscle loss and the inside of the calf would overpower it, and stress the ligaments on the outside of the ankle. It helped to massage out the tight muscles on the inside calf. That is a little better now and I have regained some lost muscle. Moving the foot outward to the side uses the weak muscles and helps to rebuild it. I don't know if there was any nerve damage, but I could feel a nerve firing repetitively right after the injury, so I straightened my ankle just enough to lessen that (but not all the way). I thought leaving it in a stretched state from the trauma would make it worse or could tear through if I left it. That raised a few eyebrows from the medical people, but I have all my sensation in my foot and ankle except some very slight numbness where the incision was during surgery.

I was also weak in pushing off of my toes during walking or stepping down stairs onto my toes. Walking around on my toes was difficult for my weak foot. That has improved too, but there is a point when my strength gives out with fatigue. It used to put me in pain like a sprain for a week, but I have better tolerance now. My dorsi-flexion is not bad. Before the injury, I had a lot of dorsi-flexion because of stretching and horseback riding. Having plates under the tendons in front affects that and limits some movement. Now that my plates are out, it may be slightly better, but it isn't equal to the uninjured leg. It is probably about 4 degrees off.

I find it helpful to use vet wrap on my ankle which is flexible elastic cohesive bandage that sticks to itself but isn't sticky. If I wrap my ankle around the foot and behind the heel (staying off of the Achilles tendon), it gives me some support and my ankle is much better. If I have done too much, wrapping helps, but not too tight or it starts to hurt, and after a couple days, I remove it because it starts to stiffen up. I buy the vet wrap at a farm supply store that sells stuff for livestock and horses.

I know if I am walking stiffly and not moving my foot and ankle normally, it affects the rest of my body and knees. I try to walk gently. I skied some years ago, but I don't know that I should try that again. I can do horseback riding fine on trails, and that takes the place of hiking. The horse I got hurt on was not mine; it was borrowed because my horse got too old and unstable and I wanted to go on a trip with friends. I now have a younger horse who is bonded to me and great on trails. The picture on my profile is my older horse with me.

I lost some cartilage in the joint from the injury. The surgeon said I may need a joint replacement in the future, but I'm doing everything I can to not over stress my ankle. I talked to another doctor who can do stem cell injections in the ankle. It may help clean up some of the ligaments, but it won't replace lost cartilage. That doesn't grow back.

I'm guessing your surgery is tomorrow. I wish you healing and a good recovery and I will be thinking about you. I hope you'll check in from time to time and let me know how you are doing.

Jennifer

Hi are you still in pain after removal of plate and screws?
I just removed 3 screws and I dont see a difference( maybe its too early) I Wonder if I should have been more bold and remove more. I have 3 plates and 14 screws( now 11 screws)

I had 2 plates and all 7 screws removed 2 years after my Tibia Plateau Fracture. I didn't notice much relief, until I had a TKR a few months later. Finally, that's what it took to change the pain to something I can live with if I continue PT. So much better!!!

A quick question, I received 4 compound fractures of left arm one was tibial open high impact. From elbow to wrist my arm looks like the back of a dinosaur the screws against the dermis is profound. Is this normal. It's only been a few months the pain is so intense I barely an able to sleep the 1-10 scale is not close, more like level 250.

Had tibial plateau fracture 2/22/22 repaired with hardware. Feels like a tight ace bandage around my knee and burning down the tibia from the rod when stepping down. Having hardware removed in April 2023. How long after hardware removal before comfortable to walk? Pain after removal?

I had lateral tibial plateau fx in February 2022 and two weeks ago had hardware removed (plate, 8 screws, and rod). Although still sore, feels better with hardware out. Walking and moving well. One day surgery and home.