An Exterior Fixator Designed to Fix a Problem

Over 30 years ago, just prior to beginning my career in Horticulture, I fell during a hiking trip and broke both the tibia and fibula of my right leg. Even though the fall was not major, the break was. I was taken out of the forest and rushed to the emergency room where, to my relief, a bone specialist was on duty. I thought I was in good hands because the bones had splintered around the break and presented a challenge to the other doctors. I went into surgery and emerged two and a half hours later in cast up to my hip. This took place in May of 1972. I did heal in the six months predicted, but the effects of the break were long term. When the cast was removed my right leg was 1/2 inch shorter than the left. Oh well, I guess I could deal with that.

Well, 36 plus years later, after dozens of orthodics, and several braces, I had such pain in my right knee and ankle I needed crutches at the end of the day to get into the house after work. I went to many of doctors in those years because I had severe back problems as well. Every one prescribed new orthodics (which, of course, no insurance in my state paid for) that lasted for 6 months to a year and had to be replaced again. And each time I had to go to another doctor because my knee was getting worse and the old style did not help any longer and they would not help me any further. After several adjustments, I would struggle with that insert until pain sent me to the doctor again.

Because I worked in greenhouses on concrete floors, my condition was beginning to deteriorate quickly. Finally, I was referred to a new practice of sports doctors in my town that specialized in this type of injury. I was elated. I made the appointment and we discussed the possibilities. First, we tried another brace that helped support my knee. That was horrendous, but I tolerated it for 3 months until I had the ol' arthroscopic surgery where the doctor goes into the knee and scrapes the "feathered" cartilage around the kneecap. That and the brace kept me going for another three months until I decided on the major surgery to correct the problem.

It seemed that when the bones initially healed all those many years ago, my tibia and fibula had twisted to the outside somewhat and caused my knee and ankle to twist along with them. That is what caused so much pain.
This surgery was going to be brutal but I was prepared. It consisted of cutting both bones where they had overlapped so long ago, and separate the tibia only by 2 centimeters, the amount of the difference in length that I lost. It consisted of holding the top and the bottom of the bone apart with an external fixator, where metal rods were inserted through the skin, muscles and bones to a top and bottom ring on the outside of my leg. The rings are supported by 6 metal adjustable struts that help align the bone and straighten out the knee and ankle. The procedure lasted 2 1/2 hours, and when I awoke I was all wired up with my leg elevated and plenty of morphine dripping into my veins.

With the fixator in place, I began the long road to growing new bone to fill in the 2 cm between the top and bottom of the tibia. This would give me back the length I lost. I am no spring chicken, and I wondered if my aging body was up to the challenge. I did my daily cleaning of the pin sites and kept the leg really clean. I made trips to the doctor at first every week to check the pin sites, then every two weeks, then every six weeks once the healing was underway. Every visit we took x-rays to see how the space was filling in. SLOWLY! We could see some clouding in the space, but it was gradual. I was prescribed an ultrasound unit to force more growth, and I did the process twice a day for 11 1/2 months.

This brings me up to date. The last date of the doctor visit was in January. Still not enough growth to take off the fixator. He wanted to consult with several other doctors who also specialized in these contraptions and would call me the next day. That was two months ago. He finally called me last week and said he was going to refer me to another specialist 40 miles away that had more experience with what to do next.

I had that office visit today, and we decided to take off the fixator and proceed to put a rod inside the tibia to straighten it more and get the thing healed. The first thing we have to do is to remove the fixator, an overnight stay in the hospital, put me in a cast, and apply intravenous antibiotics for the next several weeks. This is to minimize the chance of bone infection. Then in about 6 to 8 weeks, we will do the rod thing. He asked me when I wanted to get the fixator off and I said that afternoon! We will aim for sometime this week, hopefully. I may loose a centimeter or two in length, but hopefully I'll be walking again soon.

You may ask why I put myself through this horrid-looking procedure that kept me from working, driving, and going down stairs for so long. Simple. I am a very active individual that loves the outdoor activities of hiking, backpacking, kayaking, snowshoeing and dog sledding. I am also an avid artist and gardener. The injury to my leg after that accident began to deteriorate my right knee, leg and ankle. There would be a possibility that I might loose the ability to do any of these things, and even walking would become next to impossible. To do knee and ankle replacement would only fix the symptoms and they would only deteriorate after a short time. I had to correct the problem. I have hope and faith that things will go okay and with God's help and a lot of therapy, I will get my mobility back.

If you look at the picture next to the beginning of this article, you can see what I have tolerated for so long. It has not been easy, and the end in not quite in sight, but I do see a bit of light at the end of the tunnel. I just hope it doesn't go out.