I'm a 33-year-old male. Eight weeks ago, I fell 40' while ice climbing, and suffered a (grade II?) comminuted pilon fracture of the tibia, and a comminuted fracture of the fibula. I was treated at Harborview Medical Center within 24 hours of the accident. First surgery was ORIF for the fibula and the installation of an external fixator for the tibia/ankle. Second surgery was ORIF for the tibia, ten days later. Two plates were used for the tibia.

My question is, the medial tibial plate seems to be not entirely flush with the curved surface of the bone. If I press on the end of the tibial plate furthest from the ankle, I can feel a tickling in the medial bulge of the distal end of the tibia, which is the other end of the tibial plate. Is this normal? Does it indicate a problem with the implant? Or maybe it just means that pressing one end of the implant mechanically stimulates the other end?

-- Stephen Ramsey (denali2003@yahoo.com), August 25, 2004

Answers

I forgot to mention, here is a hyperlink to a web page that contains an X-ray of the ankle (near the bottom of the page).

http://www.speakeasy.net/~sramsey/climbing/triplog/200406-baker

-- Stephen Ramsey (denali2003@yahoo.com), August 30, 2004.

I got a tibial plateau fracture several years ago from a skiing accident (collision with a snowboarder). It seems to me that you're still pretty close (six weeks) from the time of your accident, and your body should still be healing - I sure wasn't in walking condition six weeks from surgery myself. My pair of three-inch screws show up on the x-ray with their heads sticking out from the bone a little bit, but that doesn't seem to be causing a problem. Also, the surgery certainly disrupts the nerves in the region, and having unusual skin sensation even months afterward is very typical - perhaps that's all you're experiencing. Of course, you should be able to discuss your sensations with your doc. Good luck on your recovery - I was skiing the following year.

-- Craig Hansen (craig.hansen@mail.com), September 01, 2004.

I suffered a crushing fx to my distal tib/fib and was dislocated at the joint for two weeks after my accident (rollover) until my o.r.i.f was performed by one of the two leading ortho surgeons in Florida. I have nerve damage to two toes from the long dislocation. I now after almost a month post op can wiggle my toes without too much pain. I still have lateral joint pain and worry continously that my plates etc will move...my luck. I'm in a cast for three months maybe more with no weight bearing to be sure that the bone graphs / screws at the joint hold. He said they have a high failure rate. I just want to know that I will walk again, I worry constantly. Your stories were a inspiration to me. Thank you

-- Becca Peterson (blondieparamedic@aol.com), September 21, 2004.