IM Nails


On 2nd January 2010 I broke my tibia and fibula jumping onto the tracks at Clapham Junction Station (London) whilst trying to save a pregnant woman, a blind man and an endangered panda. Okay, I was drunk and rather pathetically fell over and the result was I needed to have an operation to insert an Intramedullary Nail (IM Nail or Rod).

I searched the internet and could not find that much about people’s recovery experiences, what to expect? How quickly would I recover? Would I need the IM Nail taken out? Were there long term problems people experienced with IM Nails?

So I decided to record my experiences just in case it was of any help or use to others going through the same thing:

2mths after the operation >>>
3mths after the operation >>>
4mths after the operation >>>
5mths after the operation >>>
6mths after the operation >>>

1 Yearย after the operation >>>

2 Years after the operation >>>

3 Years after the operation >>>

IM Nail Removal – Your Experiences >>
IM Nail Removal – Carl’s Experience >>

IM Nails and Metal Detectors >>>

TAKE THE IM NAIL SURVEY >> Click Here

Update: Just a quick but massive thank you to everyone who has commented and been willing to share their experiences with others, it really is very helpful to those going through the same thing.



35 responses to “IM Nails

  • Gemma

    Just found this blog and It made me laugh…I too broke my tib/fib 2 weeks ago, drunk in Claham junction. I stayed at St Georges down the road and like you said was not given any information regarding my IM rod and physio etc.

    I’ve been looking for more information about recovery and what to expect, your blog was very helpful. Hopefully I will be able to jog round the common in a few months… Or at least hobble without crutches ๐Ÿ™‚

  • Gemma Eadie

    Yes definitely a “special” club ๐Ÿ™‚ I did mine leapfrogging the bollards outside Mcdonalds on the Northcote Road…in heels. As i came down i just heard the snap and then realised my foot was detached and all floppy! After reading through your blog, i just have one question…what equipment did you find most helpful for rehabilitation…..i have those rubber bands. Was the wobble cushion thingy worth buying?

    • jakemcmillan

      Leapfrogging bollards is definitely more impressive than my silly fall! … I found the wobble cushion quite useful for a couple of months and was worth buying. Then I sold it on ebay so did not cost me much overall at all.

  • Vivian

    Hi, I just came across your blog- hope you still check it. I broke my tib/fib in my left leg a month ago, had surgery and now have a rod and 4 screws in my tib. I wanted to know how you dealt with the atrophy (muscle loss to your bad leg). My bad leg has gotten so skinny and weak compared to my good leg. Did you regain muscle mass easily once you were able to move around more?

    Thank you ๐Ÿ™‚

    • jakemcmillan

      Hi Vivian, thanks for sharing your experience, sorry to hear your bad leg has got so skinny and weak. Once you are able to move around and doing physio, etc. you should be able to put on muscle mass again but it will be gradual until you are able to get to the gym. When one leg is weaker than the other, however, the good leg will over-compensate which is fine when just walking about but when you start to do more strenuous exercise (e.g. jogging/running) it is important to get the muscles in the bad leg up to a similar level otherwise you could create problems in your good leg. The key is just to be patient and make sure you do all your physio exercises.

      Please do let us know how the rest of your recovery goes (best of luck!).

  • Ruth Kinder (@MamaRoo24)

    I have a tibia IM nail (29th June 2012). I have my 6 week following appt on 9th Aug 2012. I’ll see if i can find out what mine is made of. I’m going abroad in April 2013.

  • linda banks

    Oh jeez, I’m crapping myself now as my operation is 8th Sept to have screws out. They say they are leaving the nail in as its the screws causing the problem. Just read recent post about his screws being difficult to remove!!

  • Brett

    Hi everyone ….. I got the email about the survey and it reminded me of how helpful this site was so I thought would share an update.

    Ok so to get you up to date I was hit by a car in Feb broke tib/fib and had IM nail inserted in an Australian public hospital. My last post was about two weeks after so I guess everything else is new.

    After my first appointment I was quite lost as to what to do to help my own recovery after being provided such limited information, I kinda just laid there hoping the pain would dissipate and my leg would magically return to normal. I was wrong. I went to my 6 week appointment and once again was given no information other then to keep bearing weight and was seen for approx 2 mins and was made an appointment for another 5 weeks. At this stage the pain was more pressure then pain and I was really thinking I wanted this recovery thing to speed up so I took matters into my own hands and found a physiotherapist and it was the best thing I did. Just being given guidance and being given exercises makes such a difference and really does assist to speed up your recovery, if you don’t have one I strongly suggest getting one even at the early stages to limit atrophy.

    (sorry have to head out … I’ll update the second half soon)

  • crisconboy

    I am going through this at the moment and blogging my own experience. I expect to hear shortly whether I will require an IM nail or whether I will be getting an external frame. The thought of surgery terrifies me but your blog has really helped me to see that it is for the best. Thank you ๐Ÿ™‚

  • seval

    On the 8th I broke the same places and got the sme thing done. On crutches and plaster atm. Just a question. How long did u stay on cructhes? How many weeks did it take to walk without the cructhes? Thank you. This was a great blog to read.

    • jakemcmillan

      Hi, thanks for posting, but sorry to hear you are going through the same thing as the rest of us IM Nailers! ๐Ÿ™‚ I didn’t have a plaster, but was on crutches for about a month then was able to hobble which gradually, through the help of physio, became more of a normal walk with a limp and then eventually no limp.

      • seval

        Well that was quick to walk then. I’m hoping its that quick with me too. Had a 2 week follow up appointment yesterday. Got rid of the cast, staple sticthes and I have a cam boot on now. Will need to go back in 4 weeks. Then they said I start physio.

  • Corey

    I too had fractured my tibia and fibula ice skating in Jan 2010. Just this November am I back to full out running on the treadmill in training for fitness and weight loss as I managed to gain alot of weight post fracture. I occasionally have twinges of pain but nothing that is keeping me from activity. I wonder if it is wise to try and become a runner again with the nail in place? There doesn’t seam to be much info re: recovery and long term effects with a IM nail. I wonder if I should have the nail removed but the surgeon said I could keep it for life if not having problems! I just don’t want to create problems by repetitive impacts from running. Do you know of anyone running (ie marathons) with a IM nail?

    • jakemcmillan

      Hi Corey, thanks for posting. I have a friend who ran a marathon within 18mths of having an IM Nail put in. From my own experience, I have found that I have had to build up my runs (i.e. length of run) a lot slower than I did prior to my injury otherwise I encounter issues.

    • Independent1

      Might be a good idea to be a runner because I’ve read that the rod can reduce blood flow. I’ve had a few twinges in one of the screws and my GP said to take plenty of exercise. Deep Heat and Co-comodal useful. Am now due to have the screws out because it’s thought one is moving about and it’s through two bones,fibular and tibia which is unusual.

  • Rob

    I broke my tibia and fibula skiing in 1989. I had an IM rod inserted and after developing a DVT in my good leg, i recovered within a year and after 2-3 years my leg felt normal. Early this year i developed pain in the leg with the IM rod that was as bad as i experienced with the original fracture. Xrays and bone scans failed to show a new fracture but did show some acute activity near the original fracture site. OS beleived it was likely a viral infection beteen the rod and the bone, and recommended rod removal even though by this time my leg was improving The rod was removed on Jan 25, and three weeks later i am completely mobile and can do most things with just a little stiffness / discomfort in the knee. I am posting my experience because I after my OS recommended rod removal i was frustrated to not be able to find much about what to expect anywhere.

  • Craig

    Thanks for putting this up. I just broke my tib/ fib in a motorcycle accident and had the nail put in last week. I also sprained my ankle pretty badly as the foot was turned around nearly 180 degrees in the wreck. My dr has me on zero weight bearing for six weeks which seems a lot by the other responses I have seen here.

    I have loss of feeling in some parts of the foot which I haven’t heard much mention of. The possible long term nerve damage is a bit worrisome but it has been a comfort to read others stories of success.

  • Sazofraz

    This is not an encouraging comment. I had always been told that I would make a full recovery from my tibia and fibula breaks. I had a rod put down my right tibia nearly a year ago.
    I was given additional NHS physio after I overdid things and my leg had a blip. Also because I explained that I want to get back to competitive dinghy racing as crew. Obviously this requires skillfull balance and quick reactions. When I was discharged from physio and handed onto the leisure centre GP referral system, I specifically asked the physio whether reacquiring some of the skills and mobility was time critical and was told ‘No, it wasn’t.’ I was also told my leg was mended. Unfortunately about a month ago I tore a muscle in my left leg a bit. Ironically this was doing tennis coaching to get me running on my right leg, the one I broke. The running was coming on really well. I was on crutches for about four days ‘cos of my torn muscle. My right leg really didn’t like having to support the left one. I think I probably damaged my right ankle when I tore my left calf muscle. I finally took myself off to the physio a month later, not having exercised as I had been advised to rest my left leg. My balance on my tiptoes is really bad now. The physio after putting me through my paces suddenly pronounced that my leg would be 100%. She also said, ‘Good Luck getting back to your sports, which I didn’t think sounded promising as it sounded to me that it is now down to luck! I was really taken aback as this is the first I had heard of my leg not going to make a full recovery. I went into classic denial. But now with time to reflect I am wondering what happened to change the outlook. Was it because I slackened off at the gym in favour of bicycling, walking and very gentle tennis coaching? Or because I slackened off exercise altogether around March (8-9 months after op) because I became very busy? Also this last month my pins and even fibular – which I have only on one occasion felt a slight twinge in before and never had any pain from before have started having twinges and sometimes re ankle slight pain. The physio couldn’t find any sign of bent or moved pins but said it’s important that I keep my fracture clinic appointment re checking out pin removal as they will probably xray to check for bent or moved pins. Oddly enough I have recently come off long term medication for something else, that I had no idea also has a pain killing effect and a chemist advised that this could be why I am feeling some pains for the first time!

    Has anyone else experienced going from prediction of complete recovery to your leg will never be a 100%. What caused the difference in forecast?

    Sarah

  • Oliver

    I remember reading your blog in depth last year and being thankful to find something so reassuring online.
    I broke my tib and fib in France Jan 2012 and had a Stryker T2 tibial nail and screws inserted into my right leg. 5 nights in French hospital and a gruesome trip home to start my recovery followed.
    Last Friday (28/6/2013) I had all of the titanium removed here at home. It was all done in trauma/day surgery.

  • Danielle Wepener

    Hello from South Africa!

    I have to say thank you for your blog and your updates on your experiences. I’m 24 and I broke my right Tibia on the 4 Feb 2014. I was at a timber factory (very uneven floor) and I was walking, turned around to talk to someone behind me, stepped on uneven ground and rolled my right ankle, managing to stand on my right leg with my left one as I went down. At first I thought I had just torn my ligaments then I tried to lift the leg and my foot hung down. So gross.

    My dad was with me and managed to splint my leg and drive me to casualty. Most painful moments of my life. I had surgery the next day. My experience was a lot like yours. I spent 8 days in hospital. I’ve been home now 16 days. Knee’s still pretty sore, and I’m going for weekly check ups. My knee staples (looks identical to yours) are seeping with quite a bit so I’ve been put on an antibiotic.

    I’m on crutches. Stairs are still my main nemesis, but I’m getting better.

    I’ve been taking weekly photo’s which has been quite cool.

    Thanks again for the blog and the reassurance.

    Danielle

  • Heather

    I am so happy to find this blog and see the need to share my experience in hopes to steer the conversation to the next surgery. On 8/14/2013, I was 73 minutes into what was supposed to be the championship match of a non-competitive coed soccer game. Now, it should be said that I am American and only play the sport as a date night with my British husband, who is quite good. I enjoy running and am the one, even at 39 that would scream or giggle if I got the ball or scored. At this point in the match we had no subs and were behind 1-2. I was lined up goal side and had the ball land right near me. I positioned my foot to shoot the ball, and WHAM…a 6′ 2″, 220 lb, 32 yr old guy decided to slide tackle as a way of taking the ball from me. He came at me from about 50 feet, full speed. It should be said that I am just 5′ 2″, 118 lbs and as I said, not a great player, but I am athletic and fit. The guy did get the ball away but that is because he shattered my leg and I went immediately to the ground. The guy was so worried that he acquired the ball in a fair tackle he gave no regard to my screams of pain. To this day he has NEVER apologized. Needless to say, the soccer club found him to be negligent and reckless and they have banned him from the club unless he decides to say he is sorry.

    I had at least nine fractures, of all varieties, to my tibia, and my fibula was also broke in two places. The largest break was a compound spiral fracture the doctor referred to looking like butterfly wings. Surgery was needed immediately and I, nor my husband were given any other options other than the IM nail. My husband had never seen anything like my injury in all his 32 years of playing the sport. He feared I may have lost my leg.

    Thankfully I am nearing 7 months post op. Much of my recovery has been similar to all the other stories, until yesterday. I have been to see my surgeon twice for excessive anterior knee pain. At my six month eval, he asked for me to get a CT scan of my leg to see the actual bone healing. Every one of my breaks are healed except the butterfly break, it is only about 50% healed and now being diagnosed as a delayed non-union. My bone is NoT receiving a good enough blood supply to heal it quickly or efficiently, mainly due to the way it is shattered.

    Because I live in the states, our procedures may vary. But my surgeon has presented me with a few options. I am hoping my post may find others that have had non-union and can offer rehab experience, successes, fails, etc. so that I can make a more informed decision.

    1. Tolerate the limp, pain, knee swelling, limited activity for as long as it takes the bone to heal, 12 months, 18??
    2. Use an external bone stimulator. Although this was suggested my dr said he doesn’t believes these work, other than in a lab, so I am excluding this as an option.
    3. Exchange Nail surgery- here they remove the IM nail and insert a rod bigger in diameter. In doing this they also do something called reaming and all of this apparently stimulates bone cell growth around the fracture site. I am non weight bearing again for two weeks and then rebuild up the weight bearing again as we all did in the first surgery. Only this time I won’t have had as much trauma or damage to my leg. Because this is my right leg, I cannot drive until I am again at 100% weight bearing. I expect 4-6 weeks total. Surgery has about an 80% success rate for healing and taking away knee pain.
    4. A bone graft using bone from my pelvis and putting it in my tibia. A very invasive and painful surgery. I myself have ruled out this option for now.

    So there you have it. Again, I am hoping to find that small percent of people who also may have a tibia non union. Especially someone that has had the exchange nailing done that could offer input and opinions. I want to run, kneel, ski, play sports with my kids and more, so this decision is very important to me. To tolerate the limitations and pain for 12 months more or even longer without knowing it WILL heal, or go ahead with the surgery and hope to be of the 80% successes and not the 20% failures. I am determined to heal and move to pain free, just unsure how aggressive I can be.

  • Independent1

    Removal of Screws.
    It’s now nearly 3 years since I broke my leg. I am due to have the screws in my leg (not rod) out in next 18 weeks. One of the screws goes through both my tibia and fibular near the top. I’ve been told that I’ll be off everything for two weeks. Anyone have any idea if I’ll be able to get back to dinghy sailing etc straight after that?

  • Danielle Wepener

    Hey Independent1,

    I’m two weeks post-op from having my IM Nail and two top screws removed. (The bottom two I had removed last year already) I’ve had mine in only 15 months or so. I’ll be honest, the surgery was painful. My doctor explained that my Tibia bone had grown over the screws, and he had to search for them in the bone, with an x-ray machine and chip away at the bone until he could find the screw heads.

    After one day in bed post-op I was mobilsed on two crutches, oh, and I had a drain when I woke up after surgery. The next day I was cleared to go home- drain removed. All good. Still on two crutches but definitely more steady than post-broken leg/IM insertion.

    I still have the staples in, which I’m hoping to get removed tomorrow. I’m already walking without crutches, only using one crutch to steady myself up and downstairs.

    Maybe give yourself an extra week after the doctors two-week recovery period. That’s what I’m doing. (I maybe fine, but my knee is clicking a bit.) Then go dinghy sailing to your hearts content!

    Cheers!

    DW

  • Adam

    Hi Guys,

    First of all, love the blog… it’s so refreshing being able to read and learn about so many people in the same situation as yourself in various stages of recovery – especially with the apparent lack of information out there about IM Nails!

    My broken leg occurred during a game of football (original, I know) when my very own goalkeeper kicked my standing leg instead of the ball approximately 3 minutes in. After a fairly uncomfortable 45 minute wait for an ambulance I found myself in A&E, quickly x-rayed and informed I had a clean fracture which needed to be operated on and set with a pin. That is pretty much all the information I was given, seemingly like many others here (having said that, the amount of morphine nurses were willing to give me made that conversation a bit of a blur).

    By the time I had spoken to the surgeon and anaesthetist it was pushing midnight (I arrived at about 9pm) and waited in A&E for a temporary cast to be put on for the night to give the leg support. This in itself was a painful experience, it doesn’t matter how much gas and pain killers you are given, the feeling of broken tibia rubbing against itself remains one of the most challenging memories of the whole ordeal. Eventually I was found a bed and moved to a ward at about 3am.

    I was second on the list in the morning and was wheeled into surgery around 11am. The operation went well and I was all set to being the long road to recovery. The days following were tough, I have found a lot of people sharing their experiences here about the first few weeks and months and the challenges they present – mine we no different… the painful swelling after the op, the first steps on crutches, the impressive bruising etc.

    So to avoid repetition, fast forward 7 months to here and now and my situation seems to be one I have not come across here (I’ve read most posts, but probably not all!). My rehab has gone as well as I could have hoped, my leg is strong and the range of movement is pretty much back to normal. However, the top two screws are causing an awful lot of pain when trying to run, preventing me from doing so. The last conversation I had with my surgeon was in January, he said if I want to go back and play competitive football the nail must come out before I do so, but it must stay in for 12 months. Initially this was fine, I was happy to go without as I figured I’d be able to jog and even play cricket leading up to the removal.

    This brings me to my current dilemma, unable to run for the foreseeable future, I’m desperate to get the top two screws removed. My physio thinks the surgeon will remove them only when they remove the rest of it, which would potentially leave me 5 months of effective limbo, unable to make the next ‘step’.

    So my question to anyone out there is: Has anyone had their nail removed before the 12 month period? Or: Has anyone been able to get the screws removed before the rest of the metalwork? I’ve asked for an appointment with my surgeon to see if there’s anything he can do for me, so for the moment I have to play a waiting game!

    Thanks
    AH

  • Jonathan Wells

    Great blog and very informative. I broke my tibia and fibia just over 2 weeks ago and after a tough ride in hospital seem to be moving forward now. By tomorrow it will have been 2 weeks since my operation.

    I am now easing myself back into work, 5 or 6 hours per day on my laptop from home.

    My questions would be to anyone with a similar experience. Is this too early to be working? What is the best position to work in with s laptop?

    Thanks

  • Jon Hallett

    Great blog, thanks for sharing. I kind of have an unusual situation. I broke my tibia and fibula taking a ride on a ladder on March 21, 2016. I had an IM nail put in my tibia and a 6″ bridge plate on the outside of my fibula.

    I was able to put my full weight on it on June 4, and things were progressing very well I thought. Then just while walking around on June 28 I felt a little pop when I took a step. I didn’t think too much of it as no pain came along with it, but later that evening it began to get sore and swollen. I went into a clinic to question a doctor about it. I had an x-ray done and discovered that the plate on the fibula actually snapped in two and slightly twisted.

    I will see my surgeon tomorrow morning and discuss where we will go from here.

    I have been searching online if this has happened to anyone else and have come up short handed. Was there a defect in the plate? Has anyone ever experienced this? What happened next? I don’t know what to think about it. It’s a little disheartening and I’m frustrated as there is really nothing I can do about it at this point, but I’m trying to keep a level head and remember that there will be an end to this journey at some point.

    Thanks again for sharing, and I hope to hear if anyone else has had their hardware fail like this.

  • Heather

    Hi! I too have a rod in my tibia. I didn’t have to have the plate but…I have heard of the rod snapping unfortunately. It’s like 1-2% but it happens. I had to have a 2nd rod put in because the first wasn’t healing and the second surgery was much easier!!!! Only two weeks of down time and then physio. Just go with the recommendations. What I have learned is there are “zero” tibia/fibula fractures that are identical. There are no medical references or models like having cancer. Each of our bones break different and heal different. It’s not meant to be a downer, but more of a truth to find a great surgeon and trust your own intuition and get to learn yourself how you will heal. It will help you in the long run. I am 3 years post injury!

  • Kristian Roberts

    I snapped my Tibia/Fibula on August 5th while doing Equestrian Vaulting in Germany; training for the world championships.

    I was doing team, with three of us on the horse, when my teammate squeezed his knees into the horses sensitive flank.. he bucked and my teammate flew into me while my foot was in the handle, breaking my leg with a resounding crack. Didn’t hurt though. Ended up in BGU Murnau hospital in Murnau Germany and had the IM nail and plate with 6 screws on the fib. It’s an easy operation, but the first two days were extremely painful, I texted my coach at 2am freaking out because it hurt so badly! But by the 5th day the pain had mostly subsided.

    By now I’m in PT, doing leg presses with both and one leg, strengthening the glutes and quad. Should be walking 100% by November 2nd and vaulting in another month or so!

    Glad I’m not the only one!

  • Sumith Sadanandan

    Hey Jake,
    I’m Sumith from India. I am a 26 year old IT professional. i broke my right Tibia during March 2015 when my motorbike collided with another. An IM Nail was inserted on the same day. While I was on rehab I found your blog on the internet. I was surprised to see how similar our bone breaks were (Cheers Mate ๐Ÿ™‚ ). Your detailed writing was very helpful. Infact I healed faster than you did :P. I returned to playing football and badminton by early 2016. I used to have Shin stress after I played for prolonged time but it was manageable. Two years later, I went back to my doc and he suggested to get the nail out. I just got it out 3 days back and is under rest. Hoping to recover within 10 days.

    I thought, I need to drop a note to you. Your blog is helping lots of guys.. keep rocking.. stay safe

    ๐Ÿ™‚

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