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Thread: Paraplegic with broken fibula, tibula

  1. #1

    Paraplegic with broken fibula, tibula

    The two fractures were discovered yesterday. I've been a complete paraplegia at L1 since 1993. What kind treatment can I expect.

  2. #2
    I don't know what kind you should expect, but what you need, if this is not a fracture that needs surgical repair, is stabilization of the fractures with a removable splint (no cast) that will allow removal daily for skin checks. A cast is very likely to cause you pressure ulcers. Where is the fracture (high on the lower leg = proximal, low near the ankle = distal)? Do you walk? How do you transfer? It is very likely that you will not be allowed to weight bear on the foot at all, including any weight bearing done when transferring, standing with a standing frame, or walking, braced or not, at least initially. Are you seeing an orthopedic surgeon?

    (KLD)

  3. #3
    I don't weight bear or walk. 1. The fibula is fractured at the proximal neck below the knee. There is a butterfly fragment. There is some mild periosteal
    reaction. 2. Spiral fracture of the distal shaft of the tibia at the junction of the middle and distal thirds. 3. Hairline fracture line extending down toward the distal
    tibia question of subtle deformity or fracture in the distal tibial metaphysis. I see an orthopedic surgeon Monday morning. KDL, it sound onimous.

  4. #4
    Are you wearing a splint right now? This fracture is likely unstable, and if the bones move around, it is going to cause a lot more bleeding. Keep the leg elevated, don't move the ankle or knee if at all possible, and apply ice (if this occurred in the last 48 hours) for short periods of time to help with swelling. If you have any sensation, and need to take anything for pain, avoid NSAIDs or aspirin. Tylenol is OK. You are also at risk for developing a DVT, so discuss with the orthopedic surgeon if you should be prophylaxed for this when you see him/her on Monday.

    (KLD)

  5. #5
    A few year ago I had a spiral fracture of the tibia/fibula. I am C6/7 complete and was put in a removable (what ABs would call a walking cast) cast. X-rays showed bones healed, but probably not in an optimal alignment for walking, as if I could. I don't have pain sensation, and interestingly enough, manipulation of the break area did not cause autonomic response. The "walking cast" allowed for healing, while being able to check for any pressure. Seems like standard operating procedure.

    All the best,
    GJ

  6. #6
    Senior Member Donno's Avatar
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    I would normally agree with GJ, but in this case the break near the knee would be of concern. If you get to add your $0.02, suggest a surgical repair of the knee area, and removable boot for the rest. The removable boot worked really for me, an active T-3.

  7. #7
    Senior Member McDuff's Avatar
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    I'm a T10 para with broken tib/fib also, "luckily" mine are broken down at the ankle, and I am currently in a removable boot. The bones are still aligned so no surgery, but Doc is concerned that the boot is not offering total stability, plus it weighs a ton, so I am getting a custom CROW boot to help on both fronts.

    I'm kinda with Donno, that knee area break is the worrisome one, how to stabilize that is a big problem. As everyone agrees, you can't be in a permanent hard cast 'cause of skin issues, so what to do by the knee? If no surgery involved, you may have a long bout of bedrest ahead of you.

    Good luck tomorrow, let us know what the Doc thinks.

  8. #8
    I appreciate Donno's and McDuff's concern about getting stability at the knee in your injury. The problem I had with my break was osteoporosis. I was about 20 years post injury and my bones would not support any hardware, external or internal, to stabilize the break. Have you seen an orthopedist?

    All the best,
    GJ

  9. #9
    Another thing to consider is placing some type of padding between your skin and the soft cast. I had a couple minor problems with skin breakdown when I had my fractures, and it was caused from the soft casts. The gauze wrap solved this problem for me. It needs to be applied carefully though (smoothly, without any wrinkles). Eventually, when the swelling goes down, you may be able to use a couple pairs of extra large tube socks (cut to fit), but be very careful not to move the joints at all while putting them on. Sorry you are going through this. I hope you heal quickly.

  10. #10
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    As I was going through my bedroom doorway my leg fell off the foot plate and shattered my tibia and Fibia. Had to go the ER with AD, they admitted me with mild constipation. after three days they discharge me and I went and got an outpatient ticket for an x-ray which showed the fracture.

    Was probably about 25 years post maybe 20 years post(C6 complete August 21, 1982) and was in a cast for about 16 to 18 week at least three different one. When I broke my right femur in 87 the doctor wrote my bones are like soap so I can imagine what they were like in the 21st century.

    The femur tibia break just took so long to heal because of my soft bones. When I went in there with AD ( 2nd broken femur) they didn't find it after week and it really screwed me up. The only thing I can say is don't believe them, make yourself a pain in the you "know what".

    If you got got autonomic dysreflexia and they're not taking you seriously the quicker you make yourself heard the better it will be for everyone. Skin, Bladder, Bowels, bons.

    Living by myself taking care of the tibia Fibia rather than the femur, ended up with a pressure sore on my left elbow with the broken leg. First one in 30 some odd years knock on wood.

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