Sorry to hear you're getting screwed. Take heart as I tell you what may be bit of worst case.

Broken fibula and detached ligament. The fix was 2 screws and reattaching the ligament.

Find out if there is anyway to determine in advance if you are sensitive to the material the doc will be using for the stiches. Why? Because I had either a post operative infection or reaction to the material.

I was in a soft cast with bed rest, transitioned to rigid cast, which transitioned to walking cast. Total time on the bench: 7 months. I am now up to 2.5 miles per run. A very slow run at that. But I am healed and back in the game.

Good luck.

What are your other choices? Obviously, doing nothing isn't going to work. Is a 12 week recovery going to be any worse that the pain you've gone through for the last year?

No doc has really given me any other choices, so i guess none?

I haven't ran since 7/17/04 -the day I found out I had the break, with one small test run in Late Oct. I did 4 races with it broken, and managed to finish all of them. I looked pathetic while doing it, since I was not able to run at all due to the pain, except for racing. I really is sad to have a 2-3 min lead off the bike and loose a sprint by 2-3 minutes, all in the run!

Since I have not run in 5 months I have very little pain, except on days where I am on my feet all day or when I tweek it a bit. Even so that pain is tolerable, I would say if I did nothing I could live with it. But I can't run-AT ALL. I did one short 20 min light run in late Oct and it did not hurt all during the run, I thought I was in the clrear. Within 30 minutes of finishing the run I was in major pain, and could not bear weight the next morning. That lasted for about a week. Now in mid Dec I am back to the no pain from day to day, but know that the first step I take in anger will be a problem. So basically I could quit racing and go about my life without the surgery. But quiting tri is nowhere near my top ten things to do list. Especially with my number one being do a IM.

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I'm just a 10 cent rider on a $2,500.00 Bike

Sounds like you've made the right choice. Good luck, and be sure to follow the doc's and therapist's instructions during recovery. It sounds like it will be worth it. The jitters are perfectly normal, just remind yourself that it's the only way to get where you want to be.

Tom

Well, I haven't had ankle surgery but I have had 6 knee sugeries: 4 arthroscopic and two through an incision. My biggest was an ACL replacement (middle third procedure) where, if I remember correctly, a screw or staple was used.

It took a while to bounce back, and I was very concerned about ever recovering from the surgery "fully". The key in the decision for me was this:

• Chances of recovering without any surgery: About 0.
• Chances of recovering with surgery: Pretty darn good with dilligent therapy.

As it turns out, my post-op knee is very good, as are most ACL patients who stick to their therapy. I think you'll be fine if you follow the doctor's instructions and keep the faith.

Best wishes for a favorable outcome and a quick recovery.

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Tom Demerly
The Tri Shop.com

After being on the losing end of a bike/kid encounter, I now have 26 screws in my pelvis. No cast, just crutches for 6 weeks.

My recovery schedule:

aquajogging/swimming the 2nd week

weight training - isolated to non-weightbearing at the same time. cycling (spinning on the trainer) the day I came off the crutches. cycling on the road - 7 weeks, full speed at 11 weeks.

running - 12 weeks, easy, full speed at 15 weeks

No lingering side effects other than some stiffness on that side and the scar. I call it David Copperfield's mistake.

Just don't push it too fast and you will be as good as new.

"It is never too late to fix your childhood!" Tom Robbins

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Dean Wilson
http://www.anaerobiczone.com
Bicycle Protection Indoors & Out

This is a serious question: Do metal detectors at the airport sound when you pass through?

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Tom Demerly
The Tri Shop.com

As far as metal detectors at the airport: NO

I've put in long 1/3 tubular buttress plates with 5-7 screws for ankle fractures and the metal detectors still don't go off (at least that's what my patient's tell me).

A non-union medial malleolar fracture is somewhat unusual since these usually heal well, even in idiot non-compliant triathletes like us. You even failed an external bone stim, huh?! 2 screws to hold the medial malleolar fracture fragment to the tibia should not lay you up too much as there is not a lot of tissue dissection getting down there. Hell, I've even fired in a few cannulated (hollow) screws over top of wires with a live C-arm (X-ray) through an incision less than an inch for these things.

Biggest thing in my mind is why you didn't heal in the first place. I have walked these surgeries with a few weeks (when fresh), but in your case, I would be pretty conservative as well and shoot for the long side of recovery time with your history and it is the "off season" anyway.

Best of luck to you! Now be a good boy and follow all instructions!

Dr. R

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Fatigue is biochemical, not biomechanical.
- Andrew Coggan, PhD

I had two really nice titanium screws placed in my knee. Random thoughts/advice on the situation:

Cut back on the calories while not exercising I know that sounds pretty normal but a guy used to exercising two times a day is used to eating alot and you may not realize this until you start to gain weight.

In my case I should have pushed the therapy thing a little harder. the breaking up of scar tissue and lack of flexibility can be a royal pain in the ass to recover from.

Try as hard mentally to just make this time period a well deserved break. I found myself scouring books and internet to find out what supplements and/or food that would help promote my healing, it really helped to get my mind on to something besides sympathy for myself

You'll still be able to work out your upper body, go to the gym it helped me alot.

for what it is worth, the knee I had worked on is great, no problems, I had the screws removed a year after the surgery. The screws and a copy of the xray with them in my knee sit on my desk as a reminder.

Only one time thus far. After removing belt, shoes, watch, wallet, change & keys, the "wand" was still picking me up at LAX. Once I showed them the scar by raising my shirt, I was good to go. Nudity was the next option.

I think they were still calibrating new equipment after 9/11.

"It is never too late to fix your childhood!" Tom Robbins

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Dean Wilson
http://www.anaerobiczone.com
Bicycle Protection Indoors & Out

The non union thing has all of my docs baffled also. And the Doc who is doing the surgery spent more time probing me about reasons why it broke in the first place and why it has healed on it's own than he did talking to me about my options and the surgery. I tried imobliazation for 8 weeks in conjunction with 8 weeks of a Bone Stim- ($3500 Device!!! do the math boys and figure out all the goodies that would buy you!). I stopped the Bone stim after 8 weeks becasue the my maellous was becoming so big, noticably larger than my left side.

My thoughts exactly on the tissue disection since is it so near the surface. But I am worried about that part of this whole thing. My guess is that all of my pain from day to day and after my most recent jog was tendonitis and not bone pain. The pain radiates up the front and side of my tibia and some times down towards the arch (non arch in my case -flat like a pancake) of my foot. Very rarely is the pain directly on the fracture. This tells me that the tendon that runs down over the medial maellous is not being supported by the bone and being streched or pulled to much. My hope is that the repair will add more stability to the joint.

I wonder if I have weak bone or low bone density? Being a former "hard core" swimmer which is a non impact sport and can deplete the body of Calcium, factored in with being a non milk drinker I wonder if that may be part of my problem. I don't have a big history of broken bones, they are my ankle of course, three broken toes all from water polo (treading water and kicking someone) and a broken hand from basketball. But I suppose the transition to serious running may have caught up with me.

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I'm just a 10 cent rider on a $2,500.00 Bike

If I had enough hardware to set off a metal detector I'd be like, "Yeah, you know, this brotha is a survivor...!"

Pretty amazing you got through that.

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Tom Demerly
The Tri Shop.com

Been there done that , Here is my ankle 14 yrs ago

You can get the bone density thing checked easily with a DEXA scan, and in my part of the world would have the service covered given the previos fracture.

My experience lately is that some airport metal detectors at some airports will pick up orthopaedic hardware, which didn't used to happen.

My experience with these is different from the roof's; I have seen about 5 medial malleolar fractures initially treated without surgery go on to nonunion in the last 2 years - lateral side not as common. The good news is that they seem to heal pretty well with the very easy operation that you describe. I live in a place where ankle fractures are very common (end up operating on about 50 / yr, and most are treated w/o surgery) - maybe that's the difference. Don't sweat it, it'll probably turn out well.

Deke

You are describing some chronic PT tendonitis/tenosynovitis. This tendon runs behind the medial malleolus in a groove and may be getting irritated as it is "gliding" on the fractured edges of bone? Have you had an MRI of the ankle. Did your surgeon talk to you about this? This would likely be more noticeable/magnified with a flat foot like yourself as the PT tendon is the main invertor of foot and "supports" the arch (so to speak). You may want to make sure your surgeon is a foot and ankle specialist or is at least experienced with these sort of things as this sounds a little different. Fixing the medial malleolar non-union is no big deal like deke and myself mentioned, but the PT tendon problem is much more of an issue.

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Fatigue is biochemical, not biomechanical.
- Andrew Coggan, PhD

First of all, the screws will be no problem. Apparently there is a good blood supply to that bone, and should heal just fine. I had the same surgery in march of last year. In fact, my x-ray looks very similar to the one shown, a long plate on the fibula, 8 screws, and two long screws in the medial mal., left leg. Yours is much less involved. I had a non union of the fib fracture, but the mal. healed right away. The fibula plate broke somehow, so I had all of the metal removed, and a bone graft done at the same time. Been using a stim. device as well. I have noticed my maleolus to be bigger, but thought it was from surgery. Your post has me freaking out now. Am I making my leg bone grow in size with this device? My hearing has gotten terrible as well since I started using the stimulator. Anyone else have experience with one of these things? Please let me know. I was hoping for hardware in the 35-39 ag at LP when I got hurt. This sucks!! Time has dragged by since the accident. Nine months now, and all I can do is swim and bike, and am partially deaf. I will be back for xray on jan 6 to see how the fib is healing. Your xray will probably look healed within 8 weeks.

Good Luck!