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How is pain in tibia treated ?

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Practicing since : 2002
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I had transverse fractures of the mid-tibia and fibula six years ago; these were not compound fractures. I had immediate surgery with a rod and screws inserted. Three years ago, the hardware was removed. Last year, I had my knee cleaned up and a LCL release. I've noticed over the past few weeks that I'm having severe pain in my fracture site. My leg has healed extremely well, and I have a wonderful ortho. However, I was wondering if this is normal and/or if it could be due to spring weather fronts coming through. Sometimes the pain is in my entire tibia and can be quite unpleasant. Any advice would be helpful.
Mon, 30 Apr 2012 in TMJ
Answered by Dr. Robert Galamaga 2 hours later
Hello and thank you for the query.

Regarding your leg - I am happy to hear that you did not suffer a compound fracture and that your surgeon was able to surgically assist the natural healing of your broken bones.

If your pain corresponds to the exact area where the injury happened then this is certainly a concern that we need to approach carefully.

For what could trigger the pain, a number of things come to mind. Generally as a broken bone heals there is a good restoration of bone density in the area assuming you have a healthy diet and regular physical activity. If for some reason your bone density is suboptimal, it could put you at risk for developing a small stress or hairline fracture/injury. I am not saying this is the case for sure here - just a consideration.

Next we should consider scar tissue formation. At sites of injury, our bodies are very good at creating scar tissue to stabilize the area to some degree and hopefully promote healing. It is possible that a small amount of scar tissue is irritating a nerve in the leg there where you feel the discomfort. How do we address that? With a 2 week trial of therapeutic dose anti-inflammatory medication. I recommend ibuprofen 600 mg (3 tabs) three times per day with food to prevent stomach irritation. If there is an inflammatory component whether its related to scar tissue or not, your pain should improve or even resolve within 10 days.

If the pain is worsening or if you start favoring the leg by shifting your weight to the opposite leg then this places you at risk for further injury. I would say if within 10 days with daily use of the ibuprofen and mild activity with no heavy lifting, jumping, running etc. that you still have pain, then you should revisit the orthopedician for a good examimatiom. At that point an X-ray might be done to assess the bone anatomy in the area. Further testing would be dictated by the xray findings. Hopefully, you won't have to pay another visit to the orthopedic - time will tell.

I hope you have found this answer to be both adequate and informative. Should you have additional concerns, I am available to address them.


Dr. Galamaga
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