One of the most common questions that we get while talking to patients about surgery is what to expect during recovery and how long it will take. We typically get our answers from both literature and our own experiences with patients, and we try to develop trust with our patients so we can overcome the challenges of recovery together. Once in a while, we even experience going through surgery and the subsequent recovery ourselves, which is what happened to me recently when I broke my leg. While every procedure is different and the recovery time varies depending on the characteristics of the patient and the operation, I would like to discuss my recovery and some of the experiences I’ve had during my time practicing.
Soft tissue vs bone:
When we do osseous (bone) surgery, the expected time for a bone to heal is typically between 8-12 weeks, as long as there are no complications with the surgery, falls, issues with patient compliance, etc. When we talk about soft tissue healing, it generally takes about 6-8 weeks, again if everything goes to plan. The hardest part of all of this is ensuring peak function after the tissue has “healed”. There is a delicate balance between immobilizing your patient and letting your patient function during the healing process. Usually if you let them move more they have a better function capacity when their structure heals, but you can also risk sacrificing the healing process with increased movement. On the other hand, if you immobilize your patient for too long, it can cause stiffness and reduced range of motion. This is why post-operative physical therapy is so important if the patient feels that they have a reduced function after they have healed. One of the hardest things to understand as a patient is that after you are “healed”/discharged by the doctor, it does not mean that your improvement will stop. Up to and even further than a year out of surgery we can expected to continually see improvement as our bones remodel and the soft tissue adapts to the strains of everyday life.
Earlier this year, April 2019, I broke my Tibia and Fibula (both leg bones), while playing hockey. I immediately knew the bones were broken as I hit the ice. I was brought to the emergency department by the ambulance and was seen by the on call doctor. We decided that surgery would be the following day and I would be getting a rod in my leg. The surgeon fixed the tibia bone and left the fibula unfixated, a standard approach to my specific fracture pattern. I thought of myself as an ideal patient. I was non-weight bearing until he said I could be and I never walked on my leg. I even stayed non-weight bearing for an additional four weeks. During this time I tried to keep up the range of motion of my right ankle with dorsiflexion and plantarflexion exercises. My tibia went on to heal perfectly, but I am still having residual pain in my leg. The pain has improved with time but I have continued limitation on things like jogging, walking on uneven surfaces, and walking downstairs. All of these functions will return in the future as I rehab my soft tissue and as the bones continue to heal and remodel. I am now 5 months post-op and my function continues to get better every week. This is obviously frustrating to any adult that has had to go through a prolonged recovery period, but the importance of reviewing my case with patients is that not every surgery will be a quick recovery. Sometimes it will take the better part of a year to feel the way you did before the injury/surgery.
I hope this story highlights some of the expectations and challenges that the patient and doctor face after surgery and injury during the recovery process. It is always the plan as the surgeon to have my patients return to function as soon as possible and to live the best life they can. Sometimes these outcomes are delayed or cannot be fully reached. I hope for all of my patients a fast recovery and for them to know that if there are any challenges we will overcome them together.