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    Fractured tibia

    I have a displaced and angulated tibia. I'm 37 years post with bad osteoporosis. The ED put on a fiberglass cast until I was to see the ortho they referred me to. I got a call from his office saying I shouldnt have been given it because could cause sores and I should just wrap my leg with pillows and tape it! I called my primary for a 2nd opinion. What is it I should ask for? I occasionally have some mild AD, clamminess not raised BP, mostly when lying on my back. Advice?
    Embrace uncertainty. Hard problems rarely have easy solutions. Jonah Lehrer

    #2
    I wonder if an air cast would help. At least until you get something better.

    Those things that look like halo braces and pins might prevent pressure sores but would hamper transfers and mobility.

    By the way, nice to see you on here again, its been a while... sorry about the leg though.

    Comment


      #3
      When I broke both ankles a few years ago, they were wrapped with ace wraps then air casts on top of that. They were also elevated day and night. I rented a chair with elevating leg rests.They were changed and checked daily. I am 33 years post with osteoporosis as well. Sorry to hear about your break.

      Comment


        #4
        Do you stand or walk with braces at all? If so, you may be a candidate for surgical stabilization of your fracture.

        I agree that you should not be in a hard cast. Have seen too many pressure injuries as a result. Much better to use a soft splint. Where on the tibia is your fracture? Generally it is important to stabilize both the joint above and below any fracture, so for the tibia, this would usually mean the knee and ankle. You want a splint that can be removed at least daily for skin inspection. Here are a couple examples.

        https://www.alimed.com/miami-tibial-...EaAn0IEALw_wcB

        https://www.etennurologicalsupplies....g-p/fb3000.htm

        Your orthopedist should be able to refer you to an orthotist who can get you the right type of splint.

        Alternatively, your current cast can be "bivalved" (cut down both sides) and used as a removable splint; holding the two sides together by wrapping with an Ace wrap, and allowing it to be removed for skin inspection at least daily.

        (KLD)
        The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

        Comment


          #5
          No I'm a complete. The fracture is around the middle of my calf and the ED just called to say I also have a small displaced fracture of the fibula.

          Those splints pictured go above knee do they allow the knee to bend? My chair doesnt have elevating leg rests, it tilts.

          Thanks Scott and sugarcube.
          Embrace uncertainty. Hard problems rarely have easy solutions. Jonah Lehrer

          Comment


            #6
            You were missed!
            Good luck with the lame leg.
            Not that I recommend it, but I recently had my right leg amputated at the knee for non healing progressing wounds that go back 23 years.
            69yo male T12 complete since 1995
            NW NJ

            Comment


              #7
              Originally posted by leschinsky View Post
              No I'm a complete. The fracture is around the middle of my calf and the ED just called to say I also have a small displaced fracture of the fibula.
              Those splints pictured go above knee do they allow the knee to bend? My chair doesnt have elevating leg rests, it tilts. ll
              Many people who are complete still stand (such as in a standing frame).

              Consult with your orthopedist if you need to keep your knee straight, at least initially. If so, you may need to use a different wheelchair temporarily.

              (KLD)
              The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

              Comment


                #8
                Originally posted by pfcs49 View Post
                You were missed!
                Good luck with the lame leg.
                Not that I recommend it, but I recently had my right leg amputated at the knee for non healing progressing wounds that go back 23 years.
                Thanks! I need to come by more than just when I need something


                Sorry KLD thought you meant stand on my own volition. So surgery is completely out then?
                Embrace uncertainty. Hard problems rarely have easy solutions. Jonah Lehrer

                Comment


                  #9
                  at least will need a soft brace, I used a Bledsoe brand..it was very good quality...I would give you a link but i'm not supposed to, I don't think...

                  Comment


                    #10
                    Originally posted by leschinsky View Post
                    Sorry KLD thought you meant stand on my own volition. So surgery is completely out then?
                    Yes, usually that is not done for those with paralysis due to the surgical risks, unless standing is part of your normal routine. Plates and pins can be a problem with significant osteoporosis.

                    Originally posted by airart1 View Post
                    at least will need a soft brace, I used a Bledsoe brand..it was very good quality...I would give you a link but i'm not supposed to, I don't think...
                    Why not?

                    (KLD)
                    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

                    Comment


                      #11
                      I didn't think you could live link a product...bought mine from the company..

                      http://www.bledsoebrace.com/products/original-knee/

                      Comment


                        #12
                        Originally posted by airart1 View Post
                        I didn't think you could live link a product...bought mine from the company..

                        http://www.bledsoebrace.com/products/original-knee/
                        no leg braces there. thanks
                        Embrace uncertainty. Hard problems rarely have easy solutions. Jonah Lehrer

                        Comment


                          #13
                          I got the findings online of the xrays. The one of the ankle area:

                          FINDINGS:There is a mildly displaced spiral fracture through the distal tibial
                          diaphysis. The bones are demineralized. Distal fibula appears intact.
                          Severe degenerative changes are present at the tibiotalar joint.

                          IMPRESSION:
                          1. Mildly displaced spiral fracture through the distal tibial diaphysis.


                          The tibia-fibula xray

                          FINDINGS:
                          Oblique fracture of the distal tibial shaft is appreciated. The fibula is
                          intact. The medial and lateral malleoli are unremarkable. The proximal
                          fibular shaft shows a nondisplaced fracture. Joint spaces are preserved.

                          IMPRESSION:
                          1. Proximal fibular fracture with distal tibial oblique fracture. Alignment
                          is near anatomic.


                          What's with the mild in the first one but "appreciated" in the 2nd? Is it bad sounding?
                          Embrace uncertainty. Hard problems rarely have easy solutions. Jonah Lehrer

                          Comment


                            #14
                            Originally posted by leschinsky View Post
                            I got the findings online of the xrays. The one of the ankle area:

                            FINDINGS:There is a mildly displaced spiral fracture through the distal tibial
                            diaphysis. The bones are demineralized. Distal fibula appears intact.
                            Severe degenerative changes are present at the tibiotalar joint.

                            IMPRESSION:
                            1. Mildly displaced spiral fracture through the distal tibial diaphysis.


                            The tibia-fibula xray

                            FINDINGS:
                            Oblique fracture of the distal tibial shaft is appreciated. The fibula is
                            intact. The medial and lateral malleoli are unremarkable. The proximal
                            fibular shaft shows a nondisplaced fracture. Joint spaces are preserved.

                            IMPRESSION:
                            1. Proximal fibular fracture with distal tibial oblique fracture. Alignment
                            is near anatomic.


                            What's with the mild in the first one but "appreciated" in the 2nd? Is it bad sounding?
                            I'm no expert but my interpretation of "appreciated" means that the mild fracture is noted. It is just restating what has already been said. The words "near anatomic" might be a good thing, almost the same as being nondisplaced, but not quite. My fractures were nondisplaced. That is good in the sense that it did not require surgery, but still very fragile. Any movement or pressure could make the bones move. You have to be very careful about moving your leg at all while it is healing.
                            Last edited by Sugarcube; 9 Dec 2019, 1:37 PM.

                            Comment


                              #15
                              Originally posted by Sugarcube View Post
                              I'm no expert but my interpretation of "appreciated" means that the mild fracture is noted. It is just restating what has already been said. The words "near anatomic" might be a good thing, almost the same as being nondisplaced, but not quite. My fractures were nondisplaced. That is good in the sense that it did not require surgery, but still very fragile. Any movement or pressure could make the bones move. You have to be very careful about moving your leg at all while it is healing.
                              Thanks.

                              I met with the ortho surgeon. Luckily he had experience with SCI people and his main concern too was pressure sores. So he recommended a titanium rod and I agreed. 6-12 weeks of being with a cast would be just too difficult.
                              Embrace uncertainty. Hard problems rarely have easy solutions. Jonah Lehrer

                              Comment

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