Broken Fibula and Tibia

Hi all,

 This year I have completed the Nettle Warrior Tough Guy comfotably, many shorter 3-10K runs, the Great North Swim and Yorkshire 3 peaksonly to flounder on a tiny hill running in the Mens Health survival challenge (which I completed easily last year).  Although luckily this was planned to be my last major run of the year and I would have expected 10 minutes off my previous time!

Running a great time, already covered 5km and despite using caution on hilss, I slipped on a small (10 foot) grass mound.  My main right foot slipped under my leg breaking my Fibula and Tibia near the ankle joint (about 2-3cm up).  I have now have plates and pins fitted and a cast til, well I expect Christmas, although they say 6-12 weeks.

 I would be interested in hearing from people who have suffered similar imjuries and how it has effected them, especially from people who have made recovery and carried on competing.

 Thank you

Dear all,

The prognosis for an ankle fracture depends on a number of things.

Firstly, it depends on the state of the ankle prior to the injury. In a fit young athlete with no previous history of trauma or early degenerative changes then the prognosis is good.  How do you tell? Have a look for the tell tail signs on the xray taken after you broke your ankle.  Are there signs of early arthritis? These are joint space narrowing, marginal osteophytes, subchondral sclerosis and subchondral cysts.Then it depends on the general condition of the patient. A patient with concommitant disease or patients immunosuppressed or on steroids will not heal as well as a patient who is healthy.

Secondly, it depends on the skill of the surgeon and the facilities he or she are working in. A skilled surgeon will recognise that swelling is a major determinant on recovery without complication and will often delay fixation for a few days to . After theatre the patient with a perfectly reduced fracture, held with the minimum of internal fixation will have the best prognosis. Unfortunately, the requirement for a perfect reduction in ankle fractures is critical. Just a few millimeters of malalignment of the ankle mortice can mean the difference between no later osteoarthritis and painful osteoarthritis.

Thirdly, some patients will require metal removal especially if the plates and screws are prominant.  When running bones flex and metal does not.  This causes pain at the surface of the bone. I have removed many screws and plates from runners in the past to help them back to sport.  It is also important to consider filling empty screw holes because biomechanically these act as stress risers and are therefore a site of refracture.  These days in sports men and women I am filling the hoels with calcuim paste which allows the bone cells to remodel the void left by the screw over time. I recommend when rehabilitating that patients progress from plaster casts to Aircast XP Walkers to ankle stirrups to ankle inversion protection braces like the Aircast A60 as these can prevent recurrent injury.

Hope this helps.

John Hardy

NM, only broke my fib but did end up with 2 plates and screws.  That was 6 years ago, had the plates removed after a year and made a ful recovery and now doing VLM next year.

Good luck with your recovery.

Also just broke my fibula (Feb this year) and just did Loch Ness marathon a couple of weeks ago. I was incredibly lucky tho - simple break and easy recovery.

Looks like JH knows what he's talking about so take heed and take care! Do what you can when you can but slowly slowly

Thank you for all the replies.

 It is now nearing the end off February.  I can walk unaided and do longer walks with poles.

I can swim a mile again and use a cross trainer instead of the treadmill but at present as still cant run or even jog or walk fast.

 My last x-ray showed the bone was still fractured slightly and recovery has been very slow but is progressing.  (Possible due to too much alcohol over the years - Interesting danger that you never get told)

I can understand why the plates would be removed later as they do cause pain almost like pinching.

Other than that going ok and have entered the Great North Swim again.

 Just thought I would update those who have taken the time to reply to the thread. 

 Thank you.

I broke tib and fib back in 2004 and then took up running in 2006 with the race for life. I got really good shoes- pro grid omni which give some stability but not too much- had my gait analysed.  by 2007 did first half marathon having never really run before and have run regularly ever since.  Increase miles slowly, don't wear high heels- they are lethal.  Take high strength cod liver oil. 

I haven't had any problems, I just ensure that I gradually increase mileage adn change shoes every 500 miles or so. Ionly run 3 or 4 days a week so I get a rest.   I can still occasionally feel the plate and screws, but not the wires.  Will sometimes ache a bit but nothing much and not for long enough to put me off running.  perhaps I've been a bit cautious, but I was in my 40's when I broke my ankle slipping over in the mud on a country walk.

Good luck and be positive- fast walking is a good way to prepare you joints and muscles to build up. personally I coudln't swim for a while as waggling my foot hurt.

Hi All

 Had my one year x-ray last week and technically all is healed except it hurts when walking fast or any sort of running on the ball of the foot or toes.  Swells now and then so have agreed to have all the plates removed, another op but in 6 months times.

 I have taken to cycling to avoid the impacts and recently did my first event, the Warwickshire Fun Triathlon. 200m swim, 24K cycle and 1.5 km run.

 Finished is good time to come 29th so was very happy with that and am setting my sights at the London Triathlon Olympic distance but may have to wait til 2012 with the op. 

The race was good but I felt terrified on the run especially as it was very muddy and I hadn't ran other than on the treadmill since the accident, but limped around it, still in comfortable shape and didnt get over taking by anyone which helped confidence.

Might try another soon.

Thank all

Great to hear that you have recovered well. I read with interest the comments from fellow runnins as I have just broken my tibia right at the ankle joint and also the fibula further up with a maisonneurve fracture. The tibia has 4 titanium screws holding it together, I opted to take a cab to King's Collge  Hospital rather than allowing an ambulance to take me to the nearest hospital, which has a woeful reputation.

I am on my 4th cast and after nearly 3 weeks, pain is subsiding and having rested and been signed off work, am feeling that things are starting to recover.

I am keen to know the strategies that runners had in place after cast removal and the pins removed/pins in arguement.

I am an ultramarathoner and recently competed in the UK ultra distance championships, the 85 mile Ridgeway Challenge.

Hi All

Its difficult to know a strategy as every will recover differently and have different determinations and pains.

 I am still awaiting a op to have the plates removed as they hurt daily and often swell.  That said I train around this and am aware of my work commitments ect so plan big sessions before easy work days as I drive lots.

I did yesterday though, complete the London Triathlon.  I used this as a goal and pushed further in doing the Olympic Distance.  loved it but had to pace on the run as I now run with a limp to avoid the pain.  If I run on the front of my foot it hurts so I have to land flat footed.  i am told this is caused by the ligaments ect rubbing across the plates and will stop once they are removed.  Did a modest 2h 50 so very happy.  I could push the distance of the run and feels like I could keep going for a lot longer but havent tried.

 I was advised to try swimming and cycling hence where the Triathlon gives me a good mix.  Cycling has helped build the stamina back up (even rode to the Snowdon Summit recently).

Another year has passed since the second op.  Had to wait until late spring before I could try running again.

Tried running more this year, struggled mentally with running outside particularly with hills.  Started with treadmill running around June time.

In August I thought I need to get over my fears now.  I contacted the Mens Health Survival Challenge organisors and had a chat with them,  This is the event that I broke my leg on.  They agreed me a place in the race for October.

I now had to seriously get running.  I could manager about 5k indoors at this point.  I did some research and bought some mountain style trail shoes, big rubber spikes and sticky rubber.  I then took to the local hills and started to build back up.

At the end of September I entered the Nottingham half marathon (flat roads I know) to see if I could manage distance.  I still get a lot of pain in the ankle but it does not seem to worsen so I kept running.  Completed in a modest 1h 53.  Somewhat off my old PB's of 1h35s.

I turned up at the start for the Survival Challenge, never been so nervous about a race, tried all my old techniques of listening to certain music anthems, pysching my self and focusing.  I decided to start mid position in the pack and take me time.

The first few obstacles were easy (being lightweight helps).  I reached the place where I broke my leg and the course avoids the exact spot now but I still have to walk down the hills but everyone who overtook me I caught back up on the flats.  I ran a good race and enjoyed the event and atmosphere to finish in 1h 25m.  Not sure whats good for this race but I had accomplised my goal.

Need to try bigger, better and faster now.

Reading this thread from start to finish for the first time, it's very sobering to think of the possible long term implications of just one little slip or trip. Good to see you've found yourself another sport - I started triathlon just last year and it's such a blast, I love it. Especially the shorter distance ones where the transitions are just a mad scramble.

It must be bloody annoying though not being able to run as fast or as far as you used to, even three years down the line. There's a guy at my running club who's obviously had some awful lower leg injury (loads of scars - I've never asked him about it yet) and runs on the tiptoes of his left foot and with his toes pointing in. He's got a very awkward looking gait but is still pretty fast - he runs a marathon in 3:30. I'd imagine even if you don't get your previous smooth gait back you'll still be able to improve your speed and stamina over time...