Forum menu
P.S. I thought the wound doesn't look too bad at the moment,I've seen much much worse,but that's another thread entirely.
P.P.S I would show your linked site to your consultant and ask him his opinion,he may move beyond "it's too early to tell yet" and give you a serious opinion of the likely outcomes.
i am not aiming for amputation, i am aiming for full recovery!
I did the same thing to the same ankle but a bit less dramatically about 7 years ago. That time I got away with 29 weeks in a cast, an arthoscopy and months of bloody physio.
That was followed by 7 years of painful limping. I was actually arranging further physio for the following week until I broke it.
Glad I broke my bad ankle, it would have been agony limping on the bad ankle. It is bad enough using crutches now with a broken/bruised wrist.
[i]P.P.S I would show your linked site to your consultant and ask him his opinion,he may move beyond "it's too early to tell yet" and give you a serious opinion of the likely outcomes.[/i]
I am taking my linked page and the one you sent and asking his opinion on them, what he would recommend and why he would recommend/reject the other approaches.
Have you bought that bloody Maserati yet?
That is cool.as.tits.
I had an offer on one of the Maseratis but it was rejected on Friday night thank god. Can you imagine how pi55ed off I would be sat in bed with a Maser parked on the drive!
I'll look after it for you 'till you're mended.
In fact, buy it, then have an auction temporary ownership, a week at a time. 🙂
And I do believe that pets aid recovery from traumatic injuries.
Have you considered a cat?
[img] 
[/img]
I wasn't suggesting that you were aiming for amputation,but you may need to be firm with the surgeons about what you are aiming for,and what you are prepared to accept.To an orthopaedic surgeon amputation is an easy operation with a reliable outcome,and rehab is fairly straightforward,and mostly done as an outpatient,it ticks a lot of boxes for them.
ah, pig's trotters! I knew there was something I was meant to get from the butchers.
Pah, thats nothing look at my mates leg....
[url= http://farm9.staticflickr.com/8465/8094655948_a45f774243_z.jp g" target="_blank">
[url= http://www.flickr.com/photos/jimmygrainger/8094655948/ ]Stu's leg 3[/url] by [url= http://www.flickr.com/people/jimmygrainger/ ]jimmyg352[/url], on Flickr
[url= http://farm9.staticflickr.com/8329/8094657018_33fceccae5_z.jp g" target="_blank">
[url= http://www.flickr.com/photos/jimmygrainger/8094657018/ ]Stu's leg 4[/url] by [url= http://www.flickr.com/people/jimmygrainger/ ]jimmyg352[/url], on Flickr
[url= http://farm9.staticflickr.com/8194/8094648655_384534d7ab_z.jp g" target="_blank">
[url= http://www.flickr.com/photos/jimmygrainger/8094648655/ ]Stu's leg 2[/url] by [url= http://www.flickr.com/people/jimmygrainger/ ]jimmyg352[/url], on Flickr
He was basejumping in Patagonia with one of those wingsuits & hit a bird which he thinks might have been a goose of some sort, went out of control somewhat & crash landed into some rocks. He thinks the impact of the bird affected his chute deployment hence the crazy landing & smashed legs. His other leg was actually a worse injury but doesn't look as dramastic.
He's an ex Royal Marine though & therefore, as hard as ****.
Can't ride his bike yet though. 😐
& before anyone asks, yes he was wearing a helmet!
is that tattoo what I think it is?
[i]is that tattoo what I think it is?[/i]
Ha ha, no but I know what your'e thinking. It's a sword handle or something.
yeah, I was thinking sword handle. what did you think I was thinking?
Cos you wouldn't have said, 'is that tattoo what I think it is' if you thought it was a sword handle!
I'm wondering if a few of us can use this thread as very good reason to not do any DIY.
Especially 'at height'
and esselgruntfuttock, why does Stu's leg look like its got a red coloured haggis on it?
Dunno what that is, hang on a bit & I'll find out.........
Right, that 'red haggis' is a lump of muscle taken off Stu's back as he had a bit of calf muscle missing. The mesh looking thing is a skin graft.
Thanks for letting me know,
I think 🙄
Could be worse I know a guy who's ladder slipped I guess in quite a similar fashion to yours, he broke both arms quite badly landing hands first. His missus had to wipe his arse for months.
Dezb for post of the week!?
Jeez and there was me feeling all sorry for myself with my arm in a cast with a suspected scaphoid fracture. I have no idea how I would even begin to deal mentally with your injury. Speedy recovery to you and remember there's always a small army of well wishers, forum strangers and smart arses to provide support/light hearted relief.
Could be worse I know a guy who's ladder slipped I guess in quite a similar fashion to yours
Thought you were going somewhere else with that, somewhere that might also have ended with
His missus had to wipe his arse for months
😯
another good reason to stay indoors.
Good luck mate!
Ooof.
That's all really.
[i]my arm in a cast with a suspected scaphoid fracture.[/i]
I have one of those too but didn't like to mention it as I couldn't use crutches properly with a cast on. Wrist strap and pain pills all the way...
* LATEST UPDATE **
Saw the consultant who did the operation yesterday and he is really pleased with the healing rate which is great.
He reckons I should be able to put my foot down but not fully load bearing in the next 12-16 weeks which he was very pleased with but I am slightly less excited by the prospect.
Anyway, more pictures but less gore.
It is like opening presents at Christmas
[img] 
[/img]
The dressing is nice and clean
[img] 
[/img]
Wow! It doesn't look like the same ankle as last week
[img] 
[/img]
Gone is all the puss and rotting skin and all that is left is a small scar and some dry skin
[img] 
[/img]
Amazing how quickly the calf muscle has wasted, this is three weeks
[img] 
[/img]
Managed, finally, to get a picture of an x-ray. You will be glad/horrified to know that the bolts are Titanium
[img] 
[/img]
Updated x-ray to show the problem area - bone loss
[img] 
[/img]
wow, some improvement in looks at least.
The 2 largest screws, are they going to come out before weight bearing?
2 big screws will probably stay in place because Doc reckons the most likely outcome at the moment would be to fuse the ankle with some more metalwork joining the heel to the talus and the tibia/fibia.
There is significant bone loss around the fracture (see updated x-ray) so it is unlikely to take my body weight especially as the blood supply to the joint is from the front and has be totally severed by the fracture.
Still, best result I could have hoped for given what I did.
Doc reckons it was the worst injury he has seen all year and a couple of times during the operation when he couldn't get the bits back together he considered amputation but decided to give it 'one last try'. I am a really big fan of 'one last try' right now. 😉
WCA, that's looking a lot better than in the last set of photos! Glad to see that things are healing well and that you are staying positive. I'm also glad to see that you have got proper Ti bolts. My wife only had stainless steel which is really not that cool.
😯Doc reckons it was the worst injury he has seen all year and a couple of times during the operation when he couldn't get the bits back together he considered amputation
Blimey, well done doc! Bet he's on your christmas card list now!
could he not have reconnected the bloody supply?
Apparently not.
From Googling about the fracture it says that the fact that I fully dislocated the rear of the talus including the talar mount(?) means there will always be a loss of blood supply. This suggests there was nothing he could have done.
I am trying to get hold of some pre-op x-rays but as he described it to me, the rear of the talar bone (the bit with the big screws in) was fully dislocated and was stuck behind the heel and the fibia. He had to cut the bottom of the fibia off to be able to get the pliers in to grab the bone and then use some kind of reverse clamp to push the fibia up, the heel down and then pull the big bone fragment back into the gap. He then screwed the bit he had cut off back on which is the two small screws.
I guess most people have (or choose to have) a romantic picture of surgery which is all careful incisions with intricate and delicate work using tweezers and magnifying glasses rather than the reality of hacksaws, pliers, hammers and chisels.
thanks for sharing all this by the way. I find it fascinating in a voyeuristic* way.
*the non-fwappy type
Doc reckons it was the worst injury he has seen all year and a couple of times during the operation when he couldn't get the bits back together he considered amputation but decided to give it 'one last try'.
Bet you're glad you weren't last on the list on a Friday... 😉
DrP
For the voyeuristic among you, some edited highlights from the consultants notes for the operation (plus my translation
Dr: Serious nature, limb threatening nature and risk of AVM(100%) explained along with their risks
Translation : Dr told Nick he had done a proper job on the ankle and it was quite possible he would lose the foot. There was a 100% risk of AVN (losing the blood supply to the bone) which is not good. Isn't 100% risk a certainty [pedant]?
Dr : Completely displaced rotated and dislocated talas body located behind tibial platform
Translation : The big bit of the talus bone was very definitely in the wrong place and hiding behind the leg bone instead of being fixed underneath it. This is sub-optimal
Dr : Commimuted + multi fragmentary fracture
Translation : Lots of chips, fragments and generally a messy break with lots of debris.
Dr : Eventual reduction with combination of pointed reduction clamps to pull body fragment from impacted position in hind foot
Translation : Eventually got most the bits of bone back together with pointy pliers to pull the bits out that were stuck in the back of the heel.
Dr : Trethowan ring handled retractors around body fragment to protect tibialis posterior flexar digitomy NV bundle which were all very firmly compressed but appeared intact
Translation : Hooky tools with looped handles used to protect the main leg muscle, toe wiggling bit and Neurovascular bundle, a term applied to the body nerves, arteries, veins and lymphatic that tend to travel together in the body, which looked squashed but not broken.
Dr : Very difficult reduction and unstable as severe comminution and anterior and medial bone loss
Translation : Very hard to put this lot back together as there was lots of bits of bone debris and bone just plain missing from the front and middle
Dr : Medial malleolar osteotomy performed with combination of 2.5mm drill holes and microsagittal saw and osteotome
Translation : Used a drill and saw to get stuff in the right place
Dr : Talus reduced by closest alignment with direct visualisation of neck and medial surface
Translation : Put the talus bits back together judging their position by eye.
Dr : Orientation best for bone stock available and mechanics of fracture
Translation : Might not be in the best position but it is the best given what we had to work with.
Bet you're glad you weren't last on the list on a Friday...
With an injury like that you get top priority and are rushed past all those malingerers with nothing worse than a gaping flesh-wound, as my wife found out when she did something similar.
Good luck with the healing WCA.
Sounds like you got the best outcome from something very nasty and bravo to the surgeon.
Good luck and healing vibes to you.
Mostly Balanced - Hope the wife is okay. Your right about queu jumping, from the op notes:
Dr : GA ("crash induction" - requested theatre ASAP)
Translation : Nick's back, take him to his usual theatre and start work immediately
Nick : Saturday afternoon in the theatre and I slept through the whole show 🙁
So, would you class yourself a a regular customer at your local A&E? Have they given you a frequent flyer card yet?
On Friday I'm going to Laandon to visit an overseas customer whose lower leg got broken by a motorcycle taxi. They gave him a nice metal plate to hold the bone together but also gave him a nasty African bacterial infection, at one point he nearly died but is now on the mend in London after three more operations.
How many Nectar points is that one worth?
globalti - I hope you client gets well. I had an infection scare last week (see previous photos) but got away with a week of penecillin
Nick. Wifey says thanks. Her break was 6 years ago now and also inolved a dislocation. She still has restricted movement in the ankle and it stiffens up badly overnight or after an hour or more sat down.
Did he actually say "you may wake up missing a foot" .. ?