The Recovery Process of Tibia Reconstruction

For 37 years, I had to endure the discomfort and inconvenience of a leg that was one half inch shorter and slighted turned to the inside. After the initial brake healed and the cast was removed, the surprise to both my doctor and my self was not totally unexpected. This is not what he hoped for. Because the break splintered part of both bones, he could not put the two ends back together the usual way. He had to overlap them and push them together to insure that they would heal. In fact, he had to re-break them two other times to get them to try to line up better.

For six months I endured the crutches and when the cast finally came off, I had the awful experience to find the half inch difference and the change in the position of my foot and knee. I had no choice but to cope. As a result, my lower right leg became slightly turned and I lost the muscle in my calf. My lower right leg was now slightly deformed and thinner than the left calf.

The injury happened while hiking when I tried to jump a rushing stream. My foot slipped off the wet rock and fell between two boulders. My foot went one way and my body the other. I don't know why the break was so severe. It seemed like a simple fall and it was not very far. The result changed my life.

For the first five years I never used any kind of lift or insert and I soon began developing back problems. Why the doctor did not tell me to try to get my spine realigned, I do not know, but the back problem soon became on-going. It wasn't long before I began to see my knee and ankle swell from the pressure of walking on it. I worked in greenhouses on concrete floors and the stress on these two joints began to show within the first ten years after the initial break.

I began using inserts to try to level my hips and turn my foot to the inside. They would wear out in only months and the pain returned. I would seek another doctor to see if there was any possible solution to the problem. I would try different types of orthotics, put lifts on the bottom of the right shoe, and went to chiropractor after chiropractor to seek some relief from the pain.

I am very active outdoors and when I met my partner at 52, he introduced me into the world of backpacking. So I started doing outdoor activities I never tried before. I also raise Siberian Huskies and dog sled when the snow cooperates. I tried not to let this disfigurement interfere in all that I loved to do. But finally in 2007, the pain just became too intense and I could find not relief. This is when I met the orthopedic doctor who accepted the challenge to try to fix the problem.

I was extremely excited to begin the procedure even though it meant wearing an external fixator on the my leg to hold the top and bottom of the tibia two centimeters apart while my body grew bone in the space.

I was extremely diligent in doing everything I had to do to help the process and not get a bone infection. After eight months, the x-rays showed no noticeable bone growth and my doctor began to get depressed over the matter. For the next three months I had no contact with him until he called me to say he was turning my case over to another trauma surgeon.

After have the fixator on for a full year, it was finally time to remove it. Then, after the removal, when an x-ray was taken, we could see that one half of the bone had actually grown in, but was not fussed together yet. I had to have an IV drip-line inserted and had to have an hour drip of heavy duty antibiotics both morning and evening to prevent bone infection. After a month I was able to proceed to having a titanium rod inserted through the tibia to help the bone to join together. After three months, we could see the bone filling in and it was just about healed. It finally fussed together and the last cast came off.

Now began the really hard part. I had to get my foot and ankle to work again. I could put all my weight on my right leg and could walk with only one crutch, but the foot and ankle was very rigid and walking was difficult. Thus began the physical therapy to get things moving again.

I have been in physical therapy for five months now and I am making progress, but I have to really push the exercised to the limit. The most difficult exercise is to bend my ankle forward so I can have normal range in walking. I work my foot hard every day and I can feel the difference it is making. It hurts a lot to do these movements, but I can feel the ankle loosening up. The knee is back in the prober position, and I have very little pain it. There is a bit of swelling but no pain when I walk or put weight on my right leg.

The exercises include walking every day, which I do with enthusiasm. I have been a walker since I began walking. I walked a mile to school each day all through the twelve years, and I love to hike. When walking began to be very difficult, I had to stop walking my dogs each day. I just could not do it without sever pain with each step.

Gradually, the walking became easier, and I got off of the crutch and began using a cane. I walk around the neighborhood and all my neighbors have watched the progress, from the walking with the fixator on crutches, to the cane, they continuously comment on my progress, giving me the support to continue. They really want to see me on the dog sled again!

In late October, I began walking one dog daily again. We do not go far but I do not need the cane. I still have a limp because I still have pain in my leg when I walk. . Since beginning PT in July, my foot and ankle have improved by 50% but I still have a long way to go. The dogs have not been on a walk for over a year, and they are extremely excited to go again. We walk much slower than before, but the dogs seem to realize that I still have a way to go before we can get up to the usual speed. After all, these dogs are pullers and they do not hesitate in trying to yank my arms off.

I still have pain in my leg, but not so much in the foot and ankle any more. It is now centered more in the muscles surrounding the tibia. The calf muscles need building to regain the shape. My calf is still much thinner but it now has the definition it should have. My upper thigh muscle is also weak and I have to build that up as well. They are now in a position they have not been in 37 years, and they protest every time I stretch them. But they are getting there and with more concentrated effort, I will be back backpacking and dog sledding by next year.

I am 60 years old and I never thought my body would actually grow in two centimeters of bone to fill a gap. I have always been health conscience and try to eat lots of veggies, lean meats--no vegetarian in these shoes, and drink plenty of water. I take vitamins every day-and have been since I was ten years old and I also added a protein drink in the morning with these vitamins to aid in the building of bone and muscle development. It is working. I am also loosing the weight I gained while I could not do much, and I feel so much better. I have a home-based typing job and I no longer have to work in greenhouses to make a living. No more concrete floors for me!

It has not been easy, but I am doing something I never thought I could accomplish in a million years. I will continue to exercise and work my foot and ankle and build up the muscle. My philosophy has always been "we do not get old, we get better" and I truly believe that is what is happening to me. I may age, but my heart and mind continue to grow in ways that keep me young inside.

As we baby boomers get on in years, we are discovering there are limitations as to what we can do. But I know that if we keep in mind that we can do it, we will succeed in way we never dreamed possible. I do not have a lot of money but I do have my health and I hope to keep it for years to come.

There is still one more surgery on the horizon for me before this procedure is complete. That is to remove the titanium rod and pins in April of 2010, about a year after the rod was put in. The doctor wants to make sure the one is well-healed and joined together before removing them. I am hoping that the removal of the rods and especially the pins the hold the rod in place, will help to loosen the foot and ankle. I continue to exercise it and walk every day, but there is still a lot of pain and once in a while I need to take some pain reliever at night so I can sleep, especially if I had a busy day on my feet. The house work still hasn't gone away!

When I went to the doctor in October, I took my x-rays home to show my physical therapist so she could see exactly where the huge pins were located in relation to the muscles. I really wanted to have a record of these x-rays so I could look back at all I went through to get back my mobility. The doctor's practice is not digital as yet and could not put them on a disc for me. So I tried to do something that just might work. In the morning, I taped each x-ray to my slider door and took a picture with the digital camera. And it worked great!

I had my last appointment on December 16 and, of course, new he took new x-rays. They showed the area where the bone fussed and all looks extremely good. He is extremely pleased with the way I walk and how my right calf is beginning to have good definition, and areas that I thought would not develop show signs of muscle growth. I never fails to amaze me how well my leg has healed from this procedure.

I stopped in my first doctor's office to pick up the x--rays that were taken while under his care. I had had no contact with any one in that office since January of this year. All the staff were surprised to see me and happy to see how well things turned out. Just as I was leaving with the packet of x--rays in hand, my doctor came out of one of the examination rooms and was very surprised and pleased to see me. I gave that man a great big hug! I showed him how the leg looked and told him how the bone did grow the time I was with him but the fixator interfered with the x-ray image and we could not see any growth at all. He was surprised to hear that I was only in a cast for three months after the rod was put in and walking with no aid in two months after that. This gave him closure-and a big smile!

I am hoping for a very active winter outside if we have some snow. I'm not ready for dog sledding as I am not at the running stage yet; perhaps next year. But walking the dogs, snow shoeing, and even a snowman here and there are not out of the question for this season.