The Next Step in Tibia Reconstruction

In 1972 I fell during a hiking trip and broke both bones in my lower right leg, both the tibia and fibula. It was set by a bone specialist in the hospital and for the next six months I wore a cast up to my knee. When the cast was finally removed, My right leg was 1/2 inch shorter than my left. Well, I could live with that--or so I thought.

Because the bones had splintered, the bones were set overlapping each other to fuse the breaks, leaving a 1/2 inch difference in height, and the tibia and fibula sightly turned to the outside. I work in tropical greenhouses on concrete floors, and for 37 years I dealt with it. As time wore on, I continued to develop pain in my right knee and ankle. In all those years, I visited every type of doctor in in a radius of 40 miles to help with the worst pain in my life. It seemed that no one was willing to help me fix the problem just the symptoms. Finally a new sports practice opened up in my town where the doctors dealt with the entire body and not just specialized parts. I had found a doctor who could help.

On April 10, 2008, I had an exterior fixator attached to my lower right leg. The doctor cut the knot out of both bones and adjusted the fixator to hold the bottom of the tibia 1/2 inch below the top and adjusted it to straighten the kneecap--the reason I had so much pain in that knee.

I followed the directions to a tee visiting the doctor every 6 weeks to hopefully see the bone fill in. As of March 23, 2009 there was still about 2-3 millimeters of bone left to fill in. The tibia had not fused. My first doctor sent me to a trauma orthopedist who recommended taking off the fixator and putting in a rod through the tibia to aid in fusing the top and bottom. I immediately asked him when the fixator could be removed and the surgery could be performed. The entire bone would probable fill in if given enough time, but the longer I had the fixator, the greater the chance of infection getting into the bone.

The surgery to remove the fixator took place on March 26, 2009. It was replaced with a cast from my toes to just below the knee. Because I have open wounds in my leg from where the metal pins went into the bone, I had to do a home therapy of antibiotic infusion to prevent infection before the rod could be inserted. So on March 27, 2009, the day after the fixator removal, I was taken to the place where they inserted an IV 'PICC line' where I would insert the IV drip of antibiotics.

This I did not expect! After almost one year on crutches, I was getting pretty good and could walk a mile and a half daily trying to get that bone to fuse. Now however, with the cast from hell, I can barely make it across the room.

The cast must have been put on by the blind leading the blind. In order to put my foot on the floor, I have to stand on my toes of my right leg. It seems that the cast was not given enough of an angle for me to stand on the bottom of my foot. Now because I have an IV insertion tubing on the inside of my upper left arm, I could no longer use my crutches--as least not those crutches--so down to physical therapy to get a different type. I now have the crutches from hell. They are the type that has a cuff that goes around the arm and one steel pole to get me where I need to go. Of course, since two physical therapists were working with me, each crutch was set at a different height. So with my tip-toes and different-height crutches I had to ascend and descend stairs in order to be able to go home. I managed to wobble up and down, and when I got back to bed, I was pooped!

Now I had to have the antibiotics one more time before I could leave. The nurse inserted the IV in the arm contraption, and there I sat for over 2 1/2 hours while the pump kept stopping and beeping waiting to be wiggled so it could continue. Normally the antibiotics would flow into my veins within an hour, but the nurses seemed to be on Mars during this time. One would come in and fix the darned thing, and just as they rounded the corner out of sight, the machine started beeping again! I was finally able to leave at 9 PM and got home at 10 PM on March 27 loaded down with all the supplies and IV bags for the home infusion for the next week.

So the next morning at 9:30 AM the first visiting nurse came into my home to show me how to make heads or tails out of the huge bag of stuff, cooler filled with antibiotic bags, and a pump, she began the process of my road to self-infusing! After three days, the process is not as bad as trying to walk across the room with the cast and crutches from hell.

One of the things I had to do each day with the fixator attached to my leg, was to make sure my right leg was covered during my shower, clean the pin sites each day, and use the ultrasound machine for twenty minutes twice a day to help the bone heal. It took me a hour to take a shower and get dressed and then another 35 minutes to do the ultrasound and cleaning each day before I was ready to do anything. I thought that was bad enough. Actually protecting the cast is far easier and faster than protecting the fixator from getting wet, but now I have the IV 'PICC line" to protect as well. That is another 15 to 20 minutes to finagle a plastic band around my arm and tape the top and bottom to make the site waterproof. Then wobble out to my seat to start the infusion-for an hour twice a day. Hmmm. I really thought that things would be easier once the fixator was off. Silly me!

My next appointment with the doctor is on Friday morning at 9:30 when he will remove this cast (AND BURN IT) and check out the wounds to determine how long I will be on the infusion system, and then set the time for the final (I hope) surgery to place the rod. Even though I am put out with all I have to do just to prepare for the final rod placement, it is a necessary procedure to prevent infection in the bone. I will do what I have to do to get through this, and I keep thinking of the time I will be walking again without crutches. I just keep wondering why the original doctor did not put a rod in my leg, or pin or something, at the time of the initial break. If he had, I would not have to go through all this now. Just wish he were still alive so I could sue him!!!!