Broken leg and a future with cycling. Advice, experience…

6 weeks ago I broke both my fibula and tibia whilst Bouldering. I was rushed to the Royal London on a potent cocktail of drugs and sparkly blue lights to have surgery, which consisted of a titanium tibial intramammary nail (sorry I know that’s a mouthful).

The physio team and consultants were happy with the outcome and I was discharged 3 days after surgery. I was told the all important thing - I would be able to return to my life the way it Was, climbing mountains and staying active in the ways that I do.

It was truly remarkable, my leg was in a cast for a mere few hours whilst I was in a&e waiting for surgery, and no cast after the op. So appreciative of the nhs, especially after an accident whilst doing something that I love. However for the first time since it happened, I have concerns about the future impact of the injury on the quality of my life.

I have been walking without crutches for the past 2 weeks and I have steadily noticed that my foot toe’d outwards. I’ve since learnt that this malrotation (bone healing out of rotational alignment) is something that is possible with long bone breakages that are fixed with IM nails.

I have spoken to a consultant back at the hospital and they did not seem surprised but instead explained that this was in fact an outcome of how the bones have fused. His advice was to allow the leg to completely heal and potential future avenues would be realignment (re-break, re-pin, another long healing period….).

It has so far been almost impossible to source a second point of view. I’m seeing the consultant again in 6 weeks for another check but I can’t speak to anyone other than a nurse. The Fracture Clinic Manager is going to liase with the consultant and see if I can get a second opinion from a foot specialist there.

I’m currently out of work on SSP and haven’t been told what I can and can’t do, other than to not swim until wounds have completely healed.

So there is the scenario and at the moment I have more questions than answers. I’ve come here in hope that there is someone out there who has gone through a similar process.

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Wow heal well.
Is the pic to show the outward toe position?
Because unlike you, I don’t have bionic legs and my feet point far more east/west.

I'll admit that I don't really understand what they did to your leg (other than I'm sorry to hear it), but I broke my femur in half - quite high, another inch and it would have shattered my hip - and they gave me an IM nail in the bone and a few pins at the top and bottom of bone. 3 days in hospital, 6 weeks on crutches, but in three months I cycled to the top of Canonbie on my brompton, was doing 40 / 50 miles loops 4/5 months later, which all in all is quick turnaround imo. Physio sucked but it always does but it's always worth doing. Hope that helps?

Edit: what I mean is that if you they need to go back in and rebreak and give you a nail it's a not a bad one to heal up from, more akin to carprentry than fiddly joint/knee/back surgery. Legs and bones have good blood flow.

Otherwise seeing the consultant in 6 weeks is good. I know it's frustrating to be on your ass waiting around but even having the answer now won't change the healing process you still need to go through. Also good to get a second opinion. Sounds like you had a bad break, so some serious fixing is required. Perspective is hard to maintain when you're healing up, but to use a lame sporting cliche at moment you just need to concentrate on getting better.

Thanks alf0nse, yeh with both knees facing forward (parallel to one another) my left for toe’s outward.

Wow that’s great to hear! Did you have any misalignment/malrotation issues? From what I’ve read they’re more common with IM femur operations. And if so, did you have to go down a bike alterations route to accommodate any new body geometry?

And I agree, when you consider swelling, regaining dexterity and muscle mass it is a quick process.

To be honest I had a pretty good and undeterred mindset prior to noticing my foot. I’ve no regret over what happened and it hasn’t put me off returning. A seed has been planted which has made me more aware of my foot, to the extent that I now don’t want to notice it any more.

Keep a positive frame of mind as well. Dont push it and listen to your body. The day back on your bike will be one of the happiest.

also, what sort of physio did you go for? Not really something that I’ve ever had experience with. I haven’t done anything since post op but I normally foam roller and stretch on my yoga mat. I did go swimming for about 4hrs the weekend before the consultant told me not to which was a kick, as it felt amaze balls

I broke my tibia in a fairly serious way when I was 15, ended up with a plate and a bunch of screws in there for 18 months then had more surgery to remove them. My knee / foot ended up with a similar misalignment and it’s not caused me issues. I set my cleats up to allow for the foot angle and thankfully that seems to be enough.

Good luck during the healing process, try not to be too critical and over think things right now - chances are you’ll be back on the bike soon enough and parallel vs angled feet won’t make a difference to your enjoyment.

I was referred to a physio and I did the exercises I was told to do - if you have not been referred to one I would chase up for it. I also did some private physio with some acupuncture but tbh physio is all about repetition and doing whatever exercises 2 / 3 a day for however many weeks and then going back to see if you need new exercises in 4 weeks.

No malrotation issues, just some flexibility and lower back muscle issues which I doubt will ever totally go, just have to keep them moving. No one is going to believe this because of all this shit I talk, but I genuinely think riding fixed, especially descending fixed, was/is awesome for my leg @BareNecessities

I broke my fibula and tibia playfighting aged 26 on Tottenham Marshes. I was drunk. I got metal inserted from under my kneecap and down to ankle, 4 screws. It took me 6 months to get back to 'normal'. 18 months later I had the metal removed as it was screwing with my mental health. I was back to 'normal' within a week after that op. I'm now 46 and have lived a full life over the last 20 years with no problems, moderate to vigorous exercise, 200k audaxes, gym, walking, climbing hills, paddle boarding etc etc
My gait is perfect and I've suffered no phantom pains or suffered in any way since. I don't know how old you are but given my experience with the NHS and similar to you but 20 years ago, give it time, heal up and you'll be amazed within a year how much has changed. Stay strong.

It’s intra-medullary nail. Intramammary would be something very different!

Very sorry to hear about your injury. It will feel really worrying at the moment but you will cycle again. May require more surgery but you will get there. It won’t feel like it, but you have been lucky - tib fib fractures can be really, really bad.

Physio is the key, but it is definitely worth getting a second opinion from another surgeon. In general, more surgery should be the absolutely last resort.

I’m a doctor but not orthopaedic or sports medicine. Let me know or DM if i can help at all.

Dave

I broke my leg falling out of bed as a child, and as a result have a Charlie Chaplin-esq right foot, which when lying on my back points out at about a 40 degree angle.

The only issue I’ve ever had when cycling is finding cleats that let me set an appropriate angle for my foot without bashing my heel into either the crank arm or rear stay.

As others have said, don’t rush it. I’m sure you’ll find something suitable for your set up.

I broke tib/ fib on one leg and femur on the other when a car drove over both legs. Nails were put down both the tib and femur and are still there. I spent six weeks in hospital and six months in a lower leg cast because of slow bone regrowth.

I rode a 200km brevet a year after the crash and have finished 6 x PBP and lots of other long brevets since then. The only significant issues have come from nerve damage caused by the crash. The bone issues have been pretty trivial, other than requiring readjusting cleat angle and saddle height.

Don’t be surprised if there is a small leg length difference now. That is fairly easy to compensate for, if you are aware of the possibility.

similar to others - broke my lower leg and ankle over 20 years ago, it was screwed back together in the Aberdeen Royal Infirmary. It isn't a perfect fix but it's good enough.

I limp a little and running is a bit on / off. Cycling is fine. One hamstring is shorter than the other but that's mainly due to lack of discipline when it comes to stretching and doing flexibility exercises.

Overall, it hasn't stopped me from doing anything I want to do.

Edit: in terms of advice, i'd say try to stay positive, keep moving, work on flexibility. (I've been so so at the first, quite good at the middle one and bad at the last).

I fractured and dislocated my right ankle last Wednesday, slipping on an icy pavement.

It's been popped back in, but I'm waiting for a date for surgery, some metalwork to secure the bone.

I'm hoping for a full recovery, but not too sure what to expect.

I've historically been keen on long distance running and cycling, but that's fallen slightly by the wayside with a young family.

Any anecdata around regarding fractured ankles?

My cousin shattered both his ankles in his early 30s in a dirt bike accident when he overshot his landing.
His wife wasn't too keen on him continuing his hobby anymore so he took up MTB instead. Now some 10 years later he's a more than decent mountain biker / cyclist, having completed Roc d'Azur.
Your ankle will take time to heal, but there's hope just yet

That's comforting. It's now been 10 days since I did it, and I'm still waiting for a surgery date.

Presuming 6 weeks of the cast on will start after surgery, so the last 10 days have been bonus ones.

My leg and foot look really bruised, which ilI wouldn't have expected, and the cast already feels a bit baggy.

My legs are skinny at the best of times, the right one will be twig like