EpicSki › The Barking Bear Forums › Ski Training and Pro Forums › Fitness, Injury, and Recovery › Tibial IM Rod removal: recovery time?
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Tibial IM Rod removal: recovery time?

post #1 of 30
12/17/08 at 5:41pm
Thread Starter 
Anyone on the board have their IM rod removed from the tibia? How long was the recovery period? I am scheduled to get it out in 2 weeks. My surgeon was originally going to take out the screws only, but looked at the X-rays and said the leg is fully healed after 9 months, and therefore the rod can come out as well. He thought that I would be better served in the long run without the rod in there, as I am very active and enjoy running.

I suspect most of the recovery will be building up the soft tissue, probably spent in PT. He wasn't clear on the recovery time, but I have a personal goal to be back skiing in February (5 weeks after surgery).
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post #2 of 30
12/17/08 at 5:50pm
Keep in mind that sometimes the rod is a complete b*tch to get out. Young people have tighter medullary canals and healing at the fracture site can be pretty robust. Occasionally it is simply not possible to remove the rod. If the screws and nails come out without any issues, it's reasonable to target returning to skiing at 6 weeks. Remember that the screw holes have to heal, otherwise they act as a stress riser. I'm sure your surgeon will give you some advice .
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post #3 of 30
12/18/08 at 7:17am
Congratulations on having the hardware out. Is there a reason to have it out now, and not at the end of ski season??

I remember being able to walk unaided within days, but it was against the advice of the orthopedist, who reamed me out. Start reading on page 13.....I don't recall all the details. It wasn't a bad surgery at all. There are pictures, too.

http://forums.epicski.com/showthread...=51304&page=13

Good luck! I'd love to hear about your experience with the rod removal. You're a young man, aren't you? Old ladies take longer to heal.
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post #4 of 30
12/18/08 at 8:06am
As I recall, VSP had his rod out as soon as it was practical, PM him I'm sure his exeperience would be helpful in estimating recovery time.
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post #5 of 30
12/18/08 at 10:51am
If it isn't bothering you, check with your surgeon and see if he can take it out after the season...
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post #6 of 30
12/19/08 at 11:45am
Thread Starter 
Quote:
Originally Posted by U.P. Racer View Post
If it isn't bothering you, check with your surgeon and see if he can take it out after the season...
Unfortunately, then I am into cycling season, which is just as important to me as skiing. The main reason I wanted to do it now was to save on the surgery costs before my co-pay and deductable reset. Also, he can do the screws only, and I can get the rod taken out in fall, after the race season is over but 2 months before I will be skiing. He said the leg will be theoretically weaker without the screws, but should be fine to ski on.
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post #7 of 30
12/20/08 at 7:31am
Get it all done in one fell swoop. Once he's in there, no reason not to just take it out and be done with it.
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post #8 of 30
12/20/08 at 7:35am
Quote:
Originally Posted by Bonni View Post
Get it all done in one fell swoop. Once he's in there, no reason not to just take it out and be done with it.
The screws can usually be taken out in the office/clinic under local anaesthetic. This may be a cheaper initial option for the OP.
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post #9 of 30
12/20/08 at 7:39am
I was tellin bonni that my, admittedly paranoid, worry would be that the rod will not break should the same event sequence happen that broke your/her leg to begin with. Then what?? My minds eye sees very bad things.
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post #10 of 30
12/20/08 at 7:45am
Quote:
Originally Posted by dawgcatching View Post
The main reason I wanted to do it now was to save on the surgery costs before my co-pay and deductable reset. .
Quote:
Originally Posted by jdistefa View Post
The screws can usually be taken out in the office/clinic under local anaesthetic. This may be a cheaper initial option for the OP.
If the reason is for the lower co-pay.....you'll just have that big whallop next year.

I guess I don't see a reason to take out just the screws? What purpose will that serve?
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post #11 of 30
12/20/08 at 8:23am
Quote:
Originally Posted by Bonni View Post
I guess I don't see a reason to take out just the screws? What purpose will that serve?
Sometimes the screws are a source of pain, especially in a ski boot. Not sure if this is an issue for the OP.
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post #12 of 30
12/20/08 at 8:28am
Quote:
Originally Posted by skier_j View Post
I was tellin bonni that my, admittedly paranoid, worry would be that the rod will not break should the same event sequence happen that broke your/her leg to begin with. Then what?? My minds eye sees very bad things.
Lots of people ski with nails/rods still in place. Of course, that doesn't mean that it's a good idea.

Most of the current nails are titanium alloys, designed to flex at a similar rate to bone. However, based on the energy and mechanism of a fall, you can break bone at the top/bottom of the rod (stress riser) or the bone can literally explode around the nail.

I generally counsel people to avoid bumps & jumps.
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post #13 of 30
12/22/08 at 11:01am
Quote:
Originally Posted by jdistefa View Post
Lots of people ski with nails/rods still in place. Of course, that doesn't mean that it's a good idea.

Most of the current nails are titanium alloys, designed to flex at a similar rate to bone. However, based on the energy and mechanism of a fall, you can break bone at the top/bottom of the rod (stress riser) or the bone can literally explode around the nail.

I generally counsel people to avoid bumps & jumps.
sorry, i was out skiing all weekend!

Exploding is what the minds eye was seeing!
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post #14 of 30
12/22/08 at 11:49am
Mr TC has a titanium rod in his femur and his tibia, from two separate injuries. He has never considered having them removed, and continues to life a high adventure life.

When he had a little dirt bike accident, he injured his ankle (I believe he broke it, but he refused to go to the doctor), the screws showed up clearly in the bruising.
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post #15 of 30
12/22/08 at 2:08pm
Better to take out the hardware.
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post #16 of 30
12/23/08 at 8:53pm
Thread Starter 
Yep, the hardware is all coming out. I hoped to maybe get by with just the screws removed (they are painful when active, such as running and jumping) but after speaking with a couple of very active people in the same position, it sounds like the rod should come out now, rather than later. I may have to write off another 6 weeks of the season, but that is better than having to deal with this down the road, and have to pay for another surgery ($500 plus 20% adds up quickly). I will be going in on the 29th.

The good news: I should be back on the snow in 6 weeks. The 6-week target date is February 9th. Hopefully I can stay strong in the meantime and get some turns in during February and March. As I will be up and moving around, hopefully the leg won't completely atrophy (unlike last time) when it shrunk to basically nothing.
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post #17 of 30
12/23/08 at 9:48pm
I don't think you will atrophy..

When I had my femur IM removed, I was allowed to be very active right after the surgery. I think he said 2 days (how long it took to have incision sights to clot and dry..

Just told no skiing but by then it was the end of the season. He told me I could bike, run, etc.

I'm suspect if you asked your Ortho, he would tell you any low impact workouts even moderate impact workouts would be fine. It's the heavy shock and impacts that will be a problem
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post #18 of 30
12/24/08 at 8:11am
I was walking around 5 days later unassisted (gingerly, though, and mostly from my own fears). I would think that skiing 6 weeks later might not be a good idea.

It's not the bone you have to worry about so much, it's the knee. They move tendons aside, drill into the bone to pull the rod out, and your knee is going to be weak and healing, even with PT and working it.

Take time and care. You only have one body.
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post #19 of 30
12/24/08 at 8:19am
Quote:
Originally Posted by Trekchick View Post
Mr TC has a titanium rod in his femur and his tibia, from two separate injuries. He has never considered having them removed, and continues to life a high adventure life.

When he had a little dirt bike accident, he injured his ankle (I believe he broke it, but he refused to go to the doctor), the screws showed up clearly in the bruising.
My oldest boy still has his rod and screws inplace after 5 years now with no problems and no reason to take them out.
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post #20 of 30
12/24/08 at 8:36am
Quote:
Originally Posted by Bonni View Post
I was walking around 5 days later unassisted (gingerly, though, and mostly from my own fears). I would think that skiing 6 weeks later might not be a good idea.

It's not the bone you have to worry about so much, it's the knee. They move tendons aside, drill into the bone to pull the rod out, and your knee is going to be weak and healing, even with PT and working it.
The portal for the IM nail is in front and lateral to the patellar tendon, so if done correctly, there's no manipulation of significant soft tissue. The whole procedure is done without violating the knee capsule.

FYI, if he's young and healthy, 6 weeks for return to sport is generally fine. I'm sure he'll discuss it with his physician.
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post #21 of 30
12/24/08 at 8:52am
I have a rod in my tibia from a motorcycle accident in 1981 and it is still in there.
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post #22 of 30
12/25/08 at 3:30pm
Thread Starter 
6 weeks is the general time he threw at me, but he also said I would be back racing my bicycle in a big stage race 12 weeks after my surgery last time True, I was putting in normal mileage 12 weeks after, but riding and racing in a Cat 1/2 stage race are 2 different things, especially when one of the stages is a twisty crit which brings down 25% of the field at some point in the race. My PT (also my team coach) laughed when I told him about it: "don't even think about it" was his response.

Anyways, I talked with a couple of other people who were in a similar position to myself, and they said that 6 weeks was about right for them to return to skiing. I definitely need the hardware out: I am getting general pain on the screws, and it hasn't improved in the past 2 months or so. We just got done snowshoeing for 3 hours and I definitely feel those screws in there. I am not convinced the rod has to come out immediately, but I feel it in there when trying to run, and it would probably have to come out at some point. Everyone is different, but as my leg hasn't gotten better in the past 2 months, and according to the X-rays it is 90% healed, I figure that it would be best to get it pulled now.

Unfortunately, that means I won't be on the snow until February/March, but hopefully I can still get in a solid 30 days or so.

Scott
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post #23 of 30
12/25/08 at 11:45pm
Yeah yank it out...when you finish a building and call it done you don't leave the scaffolding behind, you take it all down.
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post #24 of 30
12/26/08 at 6:21am
Quote:
Originally Posted by jdistefa View Post
The portal for the IM nail is in front and lateral to the patellar tendon, so if done correctly, there's no manipulation of significant soft tissue. The whole procedure is done without violating the knee capsule.

FYI, if he's young and healthy, 6 weeks for return to sport is generally fine. I'm sure he'll discuss it with his physician.
Have you had this done to yourself? You sound like you know nothing of how it feels.

I still can't lean on my knee on a hard surface for any amount of time...8 months post IM removal.....and the ortho says that is normal. It takes time to heal. 6 weeks may not be enough heal time to ski hard.

Good luck, dawg....sending good vibes your way.
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post #25 of 30
12/26/08 at 7:32am
Quote:
Originally Posted by Bonni View Post
Have you had this done to yourself? You sound like you know nothing of how it feels.

I still can't lean on my knee on a hard surface for any amount of time...8 months post IM removal.....and the ortho says that is normal. It takes time to heal. 6 weeks may not be enough heal time to ski hard.
I was simply commenting on the facts of the procedure (which you misrepresented).

Your story of knee discomfort at the portal site is not unusual. Why don't you get a second opinion about the potential cause?

Despite your ongoing anecdotal advice, 6 weeks is generally adequate time for bony healing re. skiing. Also, kneeling is not skiing .

Lastly, FWIW, I'm really getting tired of you sniping away at me in various threads. Why don't you simply PM me whatever it is you feel and be done with it?
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post #26 of 30
12/26/08 at 2:37pm
Edited: will PM you.
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post #27 of 30
2/8/10 at 9:55am
my 17yr old son just had a tibial mid shaft fracture with spiral fracture below break. he had a rod with 2 screws on top and bottom, no need for extra hardware along sprial & no cast, just boot. he is a competitive mogul skiier- any experiences on recovery time? thanks
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post #28 of 30
8/19/10 at 7:23pm

I had a tibial spiral fracture and fib break and had a tibial rod inserted 1/10.  Now I have a lot of anterior knee pain.  I am debating getting the rod removed, I've had all but one screw removed and will for sure take that one out.  From what I've researched the knee pain is from insertion of the rod and will likely not go away with removal of the rod.  Anyone have experience with this?

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post #29 of 30
3/21/12 at 9:17am

Hi there, just thought I would add my experiences (so far) - i've been reading up alot on tibial IM rod removals over the last year or so, and opinions seem varied to say the least!

 

I broke my tib (in 5 places) and fib (in 2 places) also breaking and dislocating my ankle on August bank holiday weekend 2010 in a motocross accident. After having surgery to straighten it all out, and to put the rod in there the surgeon said it had gone as well as it possibly could (was still in a hell of alot of pain!) My recovery was very painful, cant remember the exact time till i was back walking again but the first month or 2 were definitely the worst. I started racing again but have heard alot of horror stories about people breaking their tibia again with the rod in there and there being complications. I could eventually start to train properly again (running every morning) but after a while the screws and rod would bother me when running.

On the advice of my consultant, I decided to get the rod removed (he suggested it as a precaution incase i broke it again as the main reason) - so last wednesday I had the rod removed! Again, i think i was lucky as the surgeon (different surgeon at a different hospital to the one i was treated at originally) said the rod and screws had come out as well as possible. I had quite alot of bleeding immediately after surgery, but after that had been sorted out I was allowed to go home the same day!

 

I was advised to use crutches- but told I would be able to partially weight bear for 2 weeks (at which point I would have to go back in for my stitches out) It actually felt really good- and I havent had to have any painkillers at all since leaving the hospital! I could walk without crutches the next day (with a bit of a limp) and now, a week after surgery I have started cycling on a stationary cycle, and also rowing! I'm amazed at how well its doing so far, my knees still a bit sore and tight, but it seems to improve significantly every time i cycle, I think it just needs exercise to get it moving! I'm back at the hospital on monday, to get the stitches removed at which point i plan on starting running again, and then hopefully start racing again in around 4 weeks (so just under 6 weeks post surgery)

 

Will add more as I  carry on my recovery! In summary though, I am very pleased so far, its been much easier/ less painful than i expected!

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post #30 of 30
7/13/12 at 11:36am
Hey just thought id drop in and post my experience so far. I'm 23 year old male who broke both tib/fib bad in a work accident 18 months ago. I Just had IM tibial rod and screws removed a week ago and going really well so far, I was on crutches for just one day after surgery and walking stronger everyday! Nearly feel like I can run already! Havnt taken any pain meds but the wounds are a bit sore but so far so good. Hopefully my leg will be back to %100 after all this as I couldn't run properly with the rod in. Good luck peeps :-)
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