Advice needed on taking a metal pin out of my leg

shredhead

Just over a year ago I fell off my bike and snapped my right shin bone and sustained 2 other minor fractures. I have a metal 'nail' (a titanium rod the length of my shinbone) in my shin, held in place by screws at top and bottom. I'm getting contradictory advice from fracture specialist doctors - some say take it out because if I fall off the bike or otherwise break it, it'll be harder to get the pin out if its bent. I've also not got all the movement back in my ankle or knee and I feel the cold in it a lot more. Other doctors say keep it in. The op to remove it is a quick one but I would be off the saddle and not surfing for 6 weeks.
Has anyone else faced this dilemna? What did you do and why?
Ta.

Curious Yellow

Bit of an essay here.

I split off a section of my knee where the knee plateau is located in a skateboarding accident. The surgeons had to pin the split section back to the main part of the knee using two pins.

The injury wrote off my tennis season for that year. I was playing at a fairly high level at the time. Not being able to train for about 10 weeks in the middle of the season meant I lost my place on the county team and dropped off the national circuit that year.

Physio and initial recovery was pretty painful. I was doing physio to keep my full range of motion in the knee during recovery. Moving bones and tendons through healing flesh is not a pleasant feeling. I was on crutches throughout the recovery period (6-8 weeks). I lived at the bottom of a steep hill and I was determined to carry on with life instead of staying at home and feeling sorry for myself. I'm convinced that keeping up this level of physical activity, combined with the physio is what kept me sane through the injury and also got me back on court quicker than the doctors expected.

The bones healed pretty well, but like you, I did feel the cold in the knee with the pins in. To this day, I still feel my right knee gets stiffer if I sit cross legged for an extended period of time. There's an unpleasant crunch whenever I straighten up, but it's not uncomfortable. Yet. I've also never gotten back on a skateboard.

My surgeon told me that he'd be able to make a decision on taking the pins out two years after the injury. I was counting the days until they came out as soon as he said they were ok to come out. I wanted to take them out for a few reasons.

- I thought I'd have more "give" in the knee once the pins came out and my knee healed. It did feel that way after the operation. Pain I previously had when moving side-to-side also disappeared after the pins were out.
- I hated the thought of a "foreign body" being in there.
- I didn't have anything to lose "structurally" by taking the pins out. In fact, bones are supposed to compensate when they break by healing stronger around the area. Of course, there's a risk when you undergo surgery, but I trusted my surgeon to know what he was doing as he had operated on sportsmen before, and I made sure he knew how important it was to me that I be able to play sport to a high standard post op.

Recovery was quicker than I expected. I was in pretty good health. I didn't smoke or drink. I ate very healthily and I was still training regularly. I was back on court in 1 week after the pins came out and playing competitively again in a month.

When I had my injury, my surgeon did tell me that I'd have been better off breaking a shin. These tend to break and heal cleaner than breakages in joints. Personally, I'd want the pins out.

You don't say why some specialists you saw want to keep the pins in. Perhaps you can elaborate?

Ultimately, it seems like you have a decision to make. Take the pins out and take the 6 week hit. Remember, you may heal quicker. Or leave them in, grin and bear it. However, looking back on it, I reckon it comes down to how you feel, and whether you trust your surgeon.

Personally, in terms of physical strength, I'd doubt you'll be disadvantaged by taking the pins out. However, if the surgery is a complex one then the risk may not be worth it. Also, I do not know the level you surf/ride at. If 6 weeks is a break you can take without jeopardising your targets then there's not much to worry about. However, it's a different story if a tournament/race in this 6 weeks will be what defines whether you get a pro contract or not.

bartiebat

I'm waiting for mine to be taken out at the moment, can't flippin wait! I kicked the surgeon in the face when he pressed it so he instantly said yeh that's coming out! It was meant to come out in April but I asked if I could wait for the clocks to go back so I could enjoy the light nights, doc was cool with that. I kitesurf & snowboard too & doc said I'd be fine after 3 weeks but then I have to wear a brace too so could be why I have a quicker recovery. If it hurts get them out, if it doesn't don't worry

shredhead

Thanks very much. Some doctors said leave it in because its not doing any harm. I went to see my GP this morning and discussed it with him and my concerns about them rebreaking it or it being more susceptible to breaking again. The x-rays after 4 months hadn't shown much callus forming and I'm on calcium supplements anyway. So he's writing to the fracture clinic to get the ball rolling and I'm trying to avoid the op after mid Dec so I can go on a surftrip in Feb. This pm I saw the physio at the hospital who gave me more exercises to do to try to loosen my right knee. If it doesn't work its probably the metal in the leg making it hurt and stiff. Here goes!

shredhead

I thought I'd give an update. I had the nail taken out in March 2012, was seeing the physio until October and am now almost back to full health. I think my leg feels different in an unexplained way. I do lots of one legged step ups and some other exercises and when I'm out on my bike I deliberately use my right leg more. I've got nearly all flexibility back through stretching. Surfing is back to its previous (mediocre) standard.
I'm glad I had it done.