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Author Topic: healing during wait time btw ext. fixation and surgery  (Read 2809 times)

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Offline deluded

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healing during wait time btw ext. fixation and surgery
« on: September 04, 2009, 04:05:00 PM »
I had a motocycle accident aug 10th, external fixation was applied to await reduced swelling  sufficient for internal surgery on seemingly bad TPF.

The trauma doc cleared me for surgery for 1st week of sept, but a rash of car accidents has crowded the schedule until the middle of the following week, making it almost a month until i will have surgery.

How does healing of this complicated fracture (i think he said schatzker type V but not sure) complicate the internal fixation procedure and how much does this interim healing affect the joint surfaces?

I named myself "deluded" because I am under the impression that although i expect a long recovery period, I will at some point be "better than new" even tho I already had some arthritis and pain in this knee prior to the injury.

I'm 46, kinda heavy, but have been successfully losing wt while waiting for sugrery.
I am able to devote a lot of effort to rehab.

Any thoughts? ty!

Offline Lizn8r

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Re: healing during wait time btw ext. fixation and surgery
« Reply #1 on: September 04, 2009, 05:34:18 PM »
I can't answer any of your questions but I can tell you I'm sorry about your accident and refer you to this board here...http://www.kneeguru.co.uk/KNEEtalk/index.php?board=21.0.  They'll be able to help you out ...

Good luck and I hope you're back riding soon!

Liz
Sep '99: Tore left ACL (football) - misdiagnosed
Sep '99-Apr '09: Lived with pain and buckling
Apr '09: New PCP (who listened), MRI and OS consult - proper dx
May '09: LK ACL Allograft and 25% medial meniscus removal
Sep '09: Released from PT and OS ... back to things I haven't done in 10 years!

Offline Java

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Re: healing during wait time btw ext. fixation and surgery
« Reply #2 on: October 01, 2009, 05:57:05 PM »
Hi Deluded,

I feel your pain.  Almost a year ago, October 2nd, 2008, I was in an accident where my horse fell on top of me.  I suffered a displaced TPF. The top of my Tibia sheered off, then shattered in several places.  Those pieces were in various positions inside my leg, which cut off blood flow to my foot.  I had immediate surgery, where like you, I had an external fixator put on. With two rods through the top of my thigh, and two rods through my lower leg.  The main concern at the time was getting blood flow back to my foot, because there was a risk of losing the foot.  I spent a week in the hospital while they monitored me.  I was started on daily blood thinners (Lovinox injections) and had to have  some sort of "pump" on my other leg that felt like a blood pressure cuff, that kept the blood moving.  After spending a week in the hospital I went home.  I have to say, looking back at this past year, the weeks I spent in the hospital/ home with the external fixator on, were the worst weeks of my life! I basically stayed in bed, except to get up and go to the bathroom with the walker...and as you know, getting close to the toilet is a nightmare! I spent my time with my leg propped up on pillows, my back was killing me! And it grossed me out when people (doctor's and nurses) would grab my leg by the metal bars to move it around!
And when I did have to get up and haul my leg over the bed, the blood rush to my foot once I stood up was so painful.
I also ended up with an infection from one of the rods in the lowest point on my shin.  I developed a goose egg size lump around where the rod went in...so I was on antibiotics.
The day of my actual surgery was October 14th, 2008.  At that time, the OS put in 2 plates and 15 screws.....then the fun began!
I know you are just at the beginning. And I truly feel for you.  I've heard of people who have had their fixator on for several months, so in the end, I guess I got lucky with a little over two weeks total.

A wasn't worried about my ROM or potential arthritis, or anything like that in the beginning, while I had the external fixator on.  It's only after the surgical repairs, that it became VERY impotant to get that knee joint moving.  I guess it will depend on how your OS fixes you.  Everyone heals differently......

Let me know how it goes :)

Hang in there!

Java

Offline dm

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Re: healing during wait time btw ext. fixation and surgery
« Reply #3 on: October 21, 2009, 03:01:34 AM »
Delays between being put in an external fixator and surgery can vary for different reasons. My mom spent  6 months in an external fixator for double tib-fib compound fractures with approximately 8 pieces per bone within a 6 in span. Basically the middle of each bone got smashed when a car bumper hit it at 35mph. They then put a metal rod down the tibia after 6 months of nonunion. My mom had other broken bones as the result of her accident besides the leg, including 3 neck vertebrae, a shoulder broke in 2 places, and she couldn't walk for a year, so I saw  and helped her deal with a lot. I was there when they took the fixator out.

If you're not on antibiotics with a fixator in place, you should be, to prevent infection from starting. Waiting until an infection starts to begin antibiotics was the mistake I saw with the other posts. They should have been given prophylactically and if not, that was the doctor's mistake, since those rods go right to bone. Iodine should be painted around the rods daily as well.

they drill right through as needed to set internal fixation. My mom had her knee opened up to have a rod rammed down through the upper portion of her tibia and seated into the lower end of it. Ick! They basically replaced the middle of her tibia where the bone wouldn't heal right with titanium so she could walk again. The bone bits eventually fused around the the titanium rod,but it took over a year, much longer  than they could leave an external fixator in place.

multiple arthroscopies 2/00,3/01,6/01,1/03, 12/07,10/10. chondromalacia, severe medial joint space narrowing following 3 partial menisectomies, chronic pain problems, kneecap problems, OCD lesion, failed mfx.