Embonious 4:38am Oct 25 2019
Hi Stephen, sorry to hear about your fracture and your uncomfortable cast. What a trip, right?
I wanted to offer my insight on surgery:
For context, my fractures are tib/fib- they were compound/open- and span about 7 cm starting about 7cm above the ankle. Low on the tib- notoriously slow healing, as you probably know. I didn't see healing for the first 3-4ish months, but was able to start a touch of weight bearing thanks to my IM rod. I had soft tissue damage and "degloving" of the bone (the blood supply was damaged and the muscle dealt with a fair amount of internal bleeding) so this contributed to my slower healing as well.
Basically, the pros of hardware are you're on your feet sooner and you can get into rehab more quickly. I still have an atrophied leg, which is slowly but surely regaining strength- there's not a lot you can do to avoid that- but my Achilles escaped with less shortening that you'd deal with in cast.
The cons of hardware- it's pretty hard to avoid additional damage from the surgery- nerve/tendon/tissue damage. I have a numb knee and top of the foot, which used to be really annoying but I'm now used to it. As you become more mobile, the hardware poses more problems- pain becomes a pretty regular feature of life and causes mobility issues in the joints. I will have another surgery next year to remove everything. I'm still not sure how things will be once my fractures are healed (I'm at 13 months and getting closer to full heal, but not there yet), but for now it feels like I probably won't be going anywhere at a fast pace or doing any dynamic exercise/sports before the removal. It can be frustrating to feel like I have a cap on what I can do to improve my mobility. Right now I do lots of strength and mobility training to quell the urge to move my body- pull ups, push ups, core work, and lots and lots of stretching.
So overall- surgery speeds up the initial healing and gets you to weight bearing faster, but ends up being a bit of hassle in the mid/later stages of your injury. I didn't have a choice with hardware and I don't have regrets at all- I'm so glad it exists! but I do think that if you're able to avoid surgery, you do yourself a lot of favors in the long run and have a more consistent rehab experience.
Best of luck and wishing you speedy healing and good sleep!!
14 Sept 2018- hit by car, compound open tib/fib fracture etc, emergency surgery IM nail + screws
19 Sept 2018- released from hospital, NWB
04 Dec 2018- allowed 30%, working towards 100% WB indoors
18 Feb 2019- First steps!