Robot Leg Success Hacks
June 17, 2019 6:22 PM   Subscribe

Hey guys, I have a titanium rod and steel plate in my right leg as of 3 weeks ago. This was a gruesome accident followed by emergency surgery while vacationing far away from home. Help me figure out how to live with this and prepare for things I don't know to expect.

Day 2 of vacation I suffered a spiral fracture in both bones in my right leg. I now have an intramedullary rod and steel plate, along with 3 screws. It happened literally on the opposite end of the US from where I live and I probably won't be back for years, if ever. Things I wonder are:

1. Will this cause a problem at airports? I canceled my flight home and traveled by train, and the hospital didn't explain what to do.

2. Are there certain hacks for recovering/living with hardware you learned firsthand that i could benefit from? Did your shoe size change, for example, after you broke your leg?

I was doped to the nines at release and they sent me home with nothing, no instructions, not even an ortho referral (though I do have a doctor now for my 6-week followup visit on July 5).

thanks in advance!
posted by Unicorn on the cob to Health & Fitness (13 answers total) 3 users marked this as a favorite
Buddy of mine spiraled his tibia (while trying to toss my drunk ass in a river).

He has to do the hokey-pokey (right foot in, right foot out) at metal detectors. And the excess volume (from the metal) in his foot makes buying work boots interesting - however, I'm pretty sure the company steel-toe program gets him two different size boots each year.
posted by notsnot at 6:35 PM on June 17, 2019 [1 favorite]

Get set up with physical therapy. Soon. Pay for it out of pocket if you have to(assuming you have the means to do so). My wrist is permanently messed up- and more messed up than it needs to because my family didn’t recognize how valuable physical therapy can be (and we had no money and terrible insurance).

Also, right now start moving things like your toes and ankles, even a little bit. It is tempting to not, but the more muscles atrophy and scar tissue forms in these next few weeks, the longer the recovery will be.
posted by rockindata at 6:50 PM on June 17, 2019 [22 favorites]

Glad you are ok-enough to be posting here. My spouse did something similar, but not as severe
While we were 3000 miles away on vacation. As the partner, the big instruction was to connect with the docs at home. Not a whole lot of special instructions as the goal was stabilizing for primary treatment at home. We flew back, security was fine. Spouse was navigating with crutches-how are you getting around? Are you released to return to work?

When you are prescribed physical therapy after your follow up appointment & the healing sets in, that will help you get more mobility.
posted by childofTethys at 7:02 PM on June 17, 2019

Depending on the detection method this will show up in security scans so it is best to just mention it to whoever is on duty. No need to elaborate - "I have a steel rod in my right leg" should suffice, and they may do a hand-scan on you or something.

IANAD but absolutely do physical therapy as mentioned above, and talk to your local medical provider about what you can expect or whether there's anything you can do ahead of your 6-week followup. There may very well be a local group of folks who have had just this sort of thing happen who can help you understand. I would check the bulletin board at the medical or PT center or even at the VA or something.

Sorry this happened to you! But I've had several friends and family get rods and plates and are doing great today - athletic, happy, etc. You should be too!
posted by BlackLeotardFront at 7:05 PM on June 17, 2019

I have a rod in my leg but no plate.

I also did it on holiday (spiral fracture of tib/fib; they nailed the tib and left the fib broken). I did it on another continent, and flying home a couple of weeks later was fine, but I was on two weeks of blood thinners as a precaution against clots and DVT.

Just once, while the dressing was on, my ankle tripped the microwave scanner, but neither that nor hoops have tripped since. (That was probably the dressing; long damp hair trips that scanner every time...) Perhaps the plate will change that or perhaps not, but a friend of a friend got a plate removed from their wrist when healing was complete, so that may be an option. I flew several times with the crutches, which gets you bumped to the front of all the queues and is otherwise totally OK.

Seconding PT. You need to be moving your ankle and knee to get range of motion back, and it comes back pretty quickly with practice - again, our circumstances are different, but I was driving at two weeks, walking cautiously by three and I gave up on crutches by week 10 (which was caution, because I had a lot of walking to do and wanted to keep them handy in case I got tired). Strength suffers too; running takes a while to come back, as does balancing on that leg, presumably because the muscles need to recover; tiptoeing on that foot is impossible, then hard, but comes back with practice. Judging by the exciting array of colours my leg and foot went through, the surgery bruised it up spectacularly as well as the trauma of the accident. My PT also told me to stretch and massage the scars once they'd sealed up to make sure they didn't tighten.

Long term risks for the surgery are mainly knee pain - I don't have any, but kneeling still feels weird when the floor presses on what I presume is scar tissue. If I think about it the knee fees different, but mostly I don't even notice. I had numb spots by the scars for a while but no longer.

I do have screw nobbles at the top of my leg and the ankle, and the ankle ones sometimes get mildly irritated when I wear boots with thick socks. That stops the moment I take them off.

It's been a year now and I've been pretty normal for most of it.
posted by How much is that froggie in the window at 7:29 PM on June 17, 2019 [1 favorite]

I have a plate and three screws in my ankle from 1993. I wish I had known enough to demand physical therapy at the time - don't go without it like I did. The hardware hardly ever bothers me now, but I don't have the range of movement in my foot/ankle that I should have, and it does ache sometimes in bad weather. It took me at least a year before I felt absolutely secure when using that leg, though. Be patient with yourself; it's OK to feel a bit protective of the healing bone.

I hardly ever have issues going through metal detectors. Some airports have more sensitive scanners than others (looking at you, Cincinnati), but a quick "I have a steel rod and plate in my right ankle" and a quick wand scan clears it up without issues. Mostly it's the screw heads sticking out under the skin that's an issue, with some shoes rubbing the skin raw there. Usually a quick spray of liquid band aid on that area before I wear new shoes is enough to mitigate it.

Sorry to hear about your accident. Best of luck when healing. And please, please demand PT - it's absolutely crucial to getting your full normal use back.
posted by gemmy at 7:56 PM on June 17, 2019 [2 favorites]

Go see an orthopedist ASAP. Make sure your surgery was done correctly and that everything looks good. Don’t wait for weeks.
posted by quince at 8:04 PM on June 17, 2019

My brother had to be cut out of an open wheel racecar after hitting the barrier head on at high speed (stuck throttle). Lots of ironmongery in his legs, but he made a full recovery.

Just be aware that if you have another accident, those plates and screws churn up the bones. He told his doc (as an aside) that he was going skiing, and the doc scheduled an immediate surgery to remove said hardware because 'if you damage those legs with those screws and plates in there, you will never walk straight again'.
posted by GeeEmm at 8:16 PM on June 17, 2019

If you have pain after a few months, ask the docs to x-ray your leg again. Sometimes the screws they put in get the pointy end into muscles. You may get another surgery. Ask me how I know that :) Anyways, the more you can move around stuff, the less physical therapy and the quicker the recovery. As far as painkillers go, the sooner off them, the better imho. Ouchie alot, but better to deal with pain then addiction.
posted by baegucb at 9:13 PM on June 17, 2019

I only broke my fibula but I’m a practicing martial artist and I run. I heartily echo that you absolutely need physio. Tib fib breaks can take a while, and building up the right muscles and preserving mobility is hugely important. Here’s what I’ve got to add:

- I had a plate in my wrist already which has set scanners off; it wasn’t a big deal. I haven’t set any off since. My ortho said as I age the leg plate/screws may bother me (skin will be less elastic) and need to come out. Obviously a rod stays in :p but it won’t rub.

- even with great physio, it’s taken me just over a year to be close to normal and my leg still swells up sometimes (I was kicking things yesterday and it did.) it’s a process. I’m middle aged so it may just take longer.

- my gait is a bit off just due to the extra weight in that leg and so I am doing a second round of physio now that I’m training for a run

- be prepared for a downturn in mood and get help if you get depressed. It’s a very natural reaction and for me it hit at about the 7 month mark
posted by warriorqueen at 4:06 AM on June 18, 2019 [1 favorite]

Oh and my shoe size did not change at all but one pair of ankle boots isn’t comfortable and I decided never to wear heels again regularly as my PT was like, your calves are terrible, and I worked to stretch them for months.
posted by warriorqueen at 4:09 AM on June 18, 2019

Thanks for all these answers! I've had one followup x-ray, and it looked great (to my untrained eye). I've been standing just for balance on the foot and wiggling my toes, plus my MIL (former ER nurse) told me to try tracing the alphabet with my foot while it's propped up, so that's going okay. Hopefully I can start physio July 5.

I was kickboxing 3x a week (kickboxer of the month for May, woohoo! *cries*), so I'm hopeful my physical training will help me get through PT and back in the gym sooner than later.

Sounds like I need to avoid heels once shoes are a thing again, try liquid bandaids on my scars before wearing boots and plan to try and get the screws out once the bones heal fully. Thanks everyone! I'd still love any more suggestions if people have them. More advice is always better with this type of thing, I think. :)
posted by Unicorn on the cob at 7:49 AM on June 18, 2019 [1 favorite]

Sorry this happened to you. As everyone here with experience knows, it suuuuuucks. I think the mental stress that can come with this kind of thing shouldn't be ignored - it's important to take care of yourself, talk to someone professionally if you need to. This kind of thing can make you a little less OK, and it's OK to not be OK :).

I had an outside fracture to my tib/fib in April of 2018. Left part of my bone on Market Street in San Francisco. I was on an electric skateboard, in the bike lane, when I rolled over a manhole cover that somebody decided to dig the asphalt up around and not replace. I had the whole thing on video on my GoPro, but even in high def video, you could never see it before I was hurtling through the air. You could see my right leg at a right angle as I came to a stop, though.

Plate on the tib, plate on the fib, and a dozen or so wood screws to hold the plates on, and bolt my leg back together (all stainless steel). I was super lucky, healthcare wise - UCSF is a top 5 hospital in the US and a UCSF ortho trauma surgeon was the guy on duty at SFGH when I arrived there. I've seen him for all my follow ups. The day after the accident, when I first spoke to him post-surgery, he told me that I needed to get home as soon as possible to reduce my risk of infection in the bones / wound. 20 years ago, I would have had about a 33% chance of getting an infection, which he said thanks to modern medicine I now had only a 10% chance of, but still a chance. He said we'd be having a "very different conversation" if I did get an infection.

So, I told them to take me off the IV right then and there, and they laughed at me and said "Maybe tomrorow." I convinced my night nurse that same night to stop the IV meds and switch me to the pills. He told me that there was a set schedule of what meds he could give me and when, but that he could only give them when I asked for them, but he would just bring them on the schedule anyway because I was definitely going to be asking for them. He was right, I spent the whole night white-knuckling the bed, sweating through everything, half-screaming most of the time. By the 2nd morning it was manageable enough and I went home later that day.

I hit the PT HARD, and boy am I glad I did. If I could change anything, I would have been more consistent with my at-home reps. Here's the atrophy I had to recover from once I could start PT.

Ultimately, my tibia (the weight bearing of the two) healed more or less but the hardware was so painful the doc decided to take it out. My fib did not heal and so when he went in to take out the tib hardware, he also cut some bone out of the tib just below the knee, and used that to fill the gap in the fib. They let me keep the tib hardware. At my last appointment he said it's looking good and I could start a light return to jogging. He's been a good doctor at setting my expectations low, after the first surgery he told me I likely would never run again.

In a sense, he was right, I'll never be able to do a marathon on my new leg, but I can jog enough to help my kid learn to ride a bike, I think. It hurts a bit every time I step on it, but it's just the new normal I'm getting used to. Hurts right now just sitting here typing. What I need to focus on according to the doc is not re-injuring it. So no more skateboarding, basketball, anything that requires jumping really for me ever again. I'll always be slower going down stairs too.

I've traveled with my hardware - people fly on planes every day with it. If you set off the metal detector, you just explain why and they give you a pat-down. If you go through the body scanner, there's no metal detector to set off and they'll never know you traveled with your bionic leg. I wouldn't really give that another thought.

My right leg / ankle is definitely a different shape now and my shoes fit a little different than they did before, but I'm still the same size. Getting some good inserts / wearing tennies with good arch support can help.

My PT massaged my scars which felt like fucking murder but I'm glad they did, to keep things stretchy down there. Unfortunately my crappy health insurance capped the number of times I can see him and we can't afford more so I'm doing my PT on my own now.

It sounds to me like the hospital that let you go with no instructions wasn't necessarily the greatest. If I were in your shoes I would be sure to find a good orthopedic surgeon in your home area, get an appointment ASAP, share your story and any x-ray / files you can get with him/her, and then let that doctor and your PT help you manage your return to as-close-to-normal as you can get. DON'T just start doing whatever you think you can, weight bearing wise. Have them help you manage based on their experience of what and how much is safe to do and when. In my case it meant many months non-weight bearing, then a boot and a slow return to weight bearing all while in PT. Then more non-weight bearing after the 2nd surgery.

Also, elevation is your friend - as much as you can keep your wound site elevated above your heart, the better off you'll be. Your vascular plumbing down there works a little differently now and it needs all the help it can get.

Feel free to DM me if you have more questions. Hope some of this could be helpful. Take good care! Having 2 working legs is highly underrated.
posted by allkindsoftime at 12:16 PM on June 18, 2019 [1 favorite]

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