broken ankle surgery hardware

[Miranda]

I crashed my xc bike and broke my ankle.

I'm having surgery to get some metal plate and screws put in it soon. Totally not what I expected to hear from the doctor when I went in.

I think one of my biggest concerns at this point is the long term outcome of the hardware. I understand that some people get it removed later due to problems. The RN was telling me she usually sees runners that come back etc.

Well, I'm thinking how's this gonna work with pedaling and clipping out as a cyclists? It's my left ankle, and that's the foot I always clip out with first too.

Any experiences on here of people with this hardware, and/or injury?

Btw, I did do an advanced search and found a couple old threads. Just looking for any kind of additional help.

I'm so sad and worried about the surgery.

[OakLeaf]

(((((((Miranda))))))) Sending healing vibes. Hang in there.

[malkin]

Hang in there and stay calm.
I know someone who had an incompetent butcher repair his broken ankle. He can clip in and out fine. Some residual issues due to the lack of quality.

[bmccasland]

Good healing juju coming at you!

And remember, your PT is your friend. Really. Just because they occasionally channel their medieval ancestors, they are not evil, they will help you recover.

[Tokie]

You may have read my thread (I still recommend the kneeling scooter for mobility, it was great.) I too broke my "clip out" ankle. did lots of PT and when the surgeon gave the go-ahead, got on the trainer. It kind of creeped me out at first - I actually had to sit in the house and look at my bike shoe. Then I progressed to sitting on the sofa and wearing my bike shoe. After that, getting on the trainer was easy. and I just clipped out carefully at the bottom of the pedal stroke, which w/ my speedplays, is super-easy. I still try to clip out at the bottom of my pedal stroke,it's just better and easier. When I first got out of my cast & into my walking boot I went for an x-ray. As soon as I lay my ankle on the table for the lateral view, I knew - that one screw was going to have to come out. It was on the bony prominence, and it hurt to sleep on it and to pull socks on/off over it. 6 mos after my surgery, I went back and had that screw (my call) and 2 screws right next to it (doc's call) removed. that was on a Friday and I went back to work on Monday(on my feet all day, I'm a nurse).It was a bit sore. The doctor said "next year you're going to come back and want all the hardware out", but it really,really doesn't bug me a bit. That, and the fact that it would have been weeks more of "taking it easy" and he said that long-term, that my ankle will be stronger with the hardware left in. Good luck with your surgery, I also highly recommend a "La Fuma" type recliner (I got one on sale online) elevates your legs & feet without flexing at the hip and irritating your psoas. Take care! Tokie

[Tokie]

Oh, and no it doesn't show up on those body scanners at the airport.I still have plenty of screws and the plate, but it just showed my watch and bracelet.

[Wahine]

Hi Miranda. I'm sorry to hear about your accident. That sucks. But rest assured that you will get better and you'll be back to biking in no time after you've healed.

I have treated several mtn bikers with this same type of injury and surgery and none of them have had problems with clipping in and out. So don't worry about that at all.

As for the hardware, they say that it should stay in and that most people don't have any problems with it. Well, I'm not sure who "most people" are or what constitutes "most", but I have seen several patients that have had to have their hardware removed. I don't think there's any research on this but in my experience it seems to be people who are smaller boned that tend to have the most trouble. I would say that the majority of active petite women I see end up having it out. I bet I've seen less than 5 men in my career of 17 years that have had trouble. So take that for what it's worth, nothing really since there's no science behind it. But if you are a petite woman, know that even if you have the hardware removed, it's usually a pretty minor thing and you'll be back on your feet in no time after. Literally, no time.

I hope that helps.

[jessmarimba]

I'd wait and see how you react to having it in before you worry about taking it out! The surgery will go just fine though. Really. And it'll probably hurt afterward, but it'll hurt less in the long term than if you didn't have surgery.

I second the PT - do as they say! Don't push yourself too hard, but don't let yourself wallow in what you can't do, either. That's a tough spiral to get out of.

I haven't ever had hardware for broken bones in my lower extremities, so no help there, but after months of debating and weighing options and keeping track of what hurts and what doesn't, I have decided that I DO want the hardware removed from my back (if my insurance will cover the removal). I think it can be a really individual decision, based on how the hardware is put in, what kind they use, how intrusive it is long-term, and how active you are (and in what ways). And even though I've made the decision, I haven't actually committed to surgery yet. I'll probably wait until January-ish.

[GLC1968]

You may or may not have seen my threads as my injury was to the top joint in my foot, not my ankle. I had three long screws in there for quite some time.

Two things of note.

1) the surgery to put the hardware IN was dreadful. Well, the surgery was ok since I was out, but the recovery SUCKED. I was completely unprepared for the pain. I've had many surgeries before, but never one that involved bone work. The pain was incredible. If you can stomach pain meds, use them (I cannot so I just chose to suffer). Drilling into your bone is a pretty major thing, so keep that in mind. I wish I'd been more mentally prepared, so that's why I'm mentioning it to you.

2) I ended up having my screws removed on the first day that my doc would allow it. Even with them in there, I was able to find a bike shoe/pedal combination that would work so that I could ride, but it was painful. I could not stand at all on the bike and I had to be very careful which foot I unclipped first and which one I stood on when I started. The pain was constant and when I put pressure on the foot (particularly lateral) the pain felt like fire in the bones of my foot. Your hardware will be different and in a different location, so of course, your pain (or lack of it) may be totally different. Starting on the trainer is the best idea because you can control how much you ride, and your balance is not affected by how fast (or which foot) you unclip.

Once the screws came out, the constant pain was gone. Now I'm working on slowly building up my foot and ankle strength. I'm still under strict orders to do no impact because the joint of interest is the main one to take the impact in our feet and I still have holes in my bones. An ankle will be different, I'm sure.

But I agree with the others...I know how hard it is, but you really need to not think about what you can or cannot do at this point. The shock of the news is hard enough and of course, you start to over-analyze everything! But really, just focus on getting through the surgery and then on healing. I have a list of things that made my life a lot easier if you want it (showering, getting around the house, getting around at work, etc). While it seems totally insurmountable right now, in reality, it's what...a few months, a season, a year lost? In the big picture, it's not that long. Heal right the first time and avoid issues in the future!

Hang in there!

[Skierchickie]

I have the plate & screws - broke my fibula mtn biking 3 years ago.

I don't think it affects my biking at all. Don't notice it unclipping from any of my bikes. Running is when I hate it. More specifically, trail running, when I land on a rock or uneven ground. I can xc ski (striding and skating) with no problem.

The doctors and pts all said I healed really well, amazingly fast. But I don't feel like it is quite right, even now, but maybe because I'm in my mid 40s? Still have tingly toes, some aching sometimes, but nothing major. Mainly, it feels like it can't flex properly when it should?

PT took a while, but by winter I was able to ski for hours on end. Possibly wasn't the best plan, since I also stopped doing my PT stuff when skiing started.

Good luck, and don't worry too far ahead. Do your PT! And biking will be fine.

Oh, and I took a total of 3 (maybe 5?) pain pills over 2 or 3 days.
I didn't think the pain was that bad. So everybody is different.

[Artista]

I broke my tibia and fibula and dislocated my ankle in a mountain bike crash almost exactly a year ago. I still have a plate and multiple screws on each side. I can cycle, clip in and out, run, hike, and jump. I have some range of motion limitations and cannot squat nor wear high heels. My ankle is very stiff for the first minute or so when I get up in the middle of the night and in the morning. The last time that my damaged ankle wasn't swollen was when I put on my shoe the morning that I crashed.

I'm not certain whether I'll have the hardware removed. I'm not keen on more surgery with no guarantee that my ankle will improve after surgery. I can live with not being able to squat and not wearing high heels. I'm just not sure how my range of motion limitations and morning stiffness may impact my mobility when I am much, much, older and less active. I'll talk with my surgeon and physical therapist again this winter to see what they think.

I was horrified at the thought of having metal surgically implanted into my body when I broke my ankle. It was my first surgery and my first hospitalization for anything other than child birth. I felt a lot of pressure to come up with every reason to have the hardware removed asap. I never would have believed that I would be on the fence about having it removed a year later.

Don't worry about making a decision about the hardware right now. The hardware may be bothersome from the get-go like GLC's and then the decision to have it removed will be easy. Otherwise, you'll probably have up to 2 years to rehab your ankle and decide whether the hardware is keep-able or not.

[Artista]

I've been thinking about Wahine's earlier post. I am an active, petite, woman. I don't know that I "have" to have the hardware out but I'm pretty sure that it's causing some problems. I've spoken with a couple of men who had ankle hardware installed years ago and never had any problems with it. I don't personally know any women who have had an ankle surgically repaired so I can't take a poll. Still, I wonder if Wahine is on to something.

[Tokie]

I am very petite. the screw I wanted out was just too superficial and "pokey-outy". Even 13 months post-surgery, I have small improvements every few weeks. My girlfriend tells me hers felt better 3 years out & I am so happy with mine already! As for pain, be prepared, it can be tough, especially the first week or three. And especially if your doctor recommends avoiding NSAIDS, as they can interfere with early bone healing. If it hurts, take your pain medicine. Laying around in unneeded misery will not speed your recovery or make you a better woman. You will again have a strong,healthy and active ankle!

[Kiwi Stoker]

I cannot really comment about ankles as I broke my shoulder and had a plate and 11 screws put in.

Just wanted to say depending on how serious the break is (mine was the ball of the joint shattering into 11 large and lots of small pieces) sometimes the joint is never going to be the same. I cannot put my arm over my head anymore as the ball hasn't healed smooth. That is just the way it is. So sometimes you will have to accept some loss. I think if this accident happened 50 years agao I suspect I would of lost my arm.

I am not having the hardware out as I have had two operations of the shoulder already.

[Artista]

I am very petite. the screw I wanted out was just too superficial and "pokey-outy". Even 13 months post-surgery, I have small improvements every few weeks. My girlfriend tells me hers felt better 3 years out & I am so happy with mine already!

Does this mean that you're going to try to keep the "pokey-outy" screw, Tokie?