Orthopaedic advice - Compound triple fracture of the leg
Discussion
Looking for some advice here as i saw a similar thread.
3 months ago I had a pretty big accident on a motorbike in India, resulted in a compound triple fracture in my right leg, a broken knuckle and a bunch of other flesh wounds. It required emergency surgery a bunch of screws/rods inserted and a lot of rest.
The impact was mostly my right leg and a large 4wd coming the other way.
Fast forward 3 months to today and I've just starting walking again without a zimmer frame or walking stick.
I had a very good surgeon who is happy with the healing so far, with the lockdown in India - I wasn't able to go and see him for my checkup so can't get an x-ray taken at the moment.
Was hoping to get some advice on the healing process from a surgeon /doctor etc that has some experience.
3 months ago I had a pretty big accident on a motorbike in India, resulted in a compound triple fracture in my right leg, a broken knuckle and a bunch of other flesh wounds. It required emergency surgery a bunch of screws/rods inserted and a lot of rest.
The impact was mostly my right leg and a large 4wd coming the other way.
Fast forward 3 months to today and I've just starting walking again without a zimmer frame or walking stick.
I had a very good surgeon who is happy with the healing so far, with the lockdown in India - I wasn't able to go and see him for my checkup so can't get an x-ray taken at the moment.
Was hoping to get some advice on the healing process from a surgeon /doctor etc that has some experience.
I treat these.
"Fast forward 3 months to today and I've just starting walking again"
That's good progress
There isn't much more that can be said without you being in front of me, and so my internet advice stops here. Sorry.
If you can walk again, with no pus falling out of your wounds, then that would be about 80% of the job. But obviously you want 100% function to return, and the devil is in the detail.
About 50 years ago, before all the advances in trauma surgery, you would have had about a 20:80 chance of losing the leg (against you)
The real questions are: What was the Gustillo & Anderson grade of the original fracture? Is that diastasis screw staying in and what compression was applied? Is your fibular rod stable, because it doesn't look threaded? Is the medial malleolus healing and what was/is the state of the plafond? Is there another true lateral of the ankle? What is your range of movement, state of achilles, any CRPS?
I simply cannot answer any of these, and there may be no problem at all going on here.
I bring it all back to "Fast forward 3 months to today and I've just starting walking again" This is good progress.
"Fast forward 3 months to today and I've just starting walking again"
That's good progress
There isn't much more that can be said without you being in front of me, and so my internet advice stops here. Sorry.
If you can walk again, with no pus falling out of your wounds, then that would be about 80% of the job. But obviously you want 100% function to return, and the devil is in the detail.
About 50 years ago, before all the advances in trauma surgery, you would have had about a 20:80 chance of losing the leg (against you)
The real questions are: What was the Gustillo & Anderson grade of the original fracture? Is that diastasis screw staying in and what compression was applied? Is your fibular rod stable, because it doesn't look threaded? Is the medial malleolus healing and what was/is the state of the plafond? Is there another true lateral of the ankle? What is your range of movement, state of achilles, any CRPS?
I simply cannot answer any of these, and there may be no problem at all going on here.
I bring it all back to "Fast forward 3 months to today and I've just starting walking again" This is good progress.
Edited by The_Doc on Saturday 25th April 17:14
The_Doc said:
I treat these.
"Fast forward 3 months to today and I've just starting walking again"
That's good progress
There isn't much more that can be said without you being in front of me, and so my internet advice stops here. Sorry.
If you can walk again, with no pus falling out of your wounds, then that would be about 80% of the job. But obviously you want 100% function to return, and the devil is in the detail.
About 50 years ago, before all the advances in trauma surgery, you would have had about a 20:80 chance of losing the leg (against you)
The real questions are: What was the Gustillo & Anderson grade of the original fracture? Is that diastasis screw staying in and what compression was applied? Is your fibular rod stable, because it doesn't look threaded? Is the medial malleolus healing and what was/is the state of the plafond? Is there another true lateral of the ankle? What is your range of movement, state of achilles, any CRPS?
I simply cannot answer any of these, and there may be no problem at all going on here.
I bring it all back to "Fast forward 3 months to today and I've just starting walking again" This is good progress.
Thankyou for the internet diagnosis, I understand you can't comment without seeing me in person - the challenge I'm facing is getting the right treatment whilst I'm in lockdown here away from my surgeon. I had a video call with him 2 days ago, where he assessed the ankle movement which he was very happy with. I can move it in pretty much any direction (I'd say with over 90% range of motion back). Since I've started walking on it unassisted, it's improving noticeably each day. "Fast forward 3 months to today and I've just starting walking again"
That's good progress
There isn't much more that can be said without you being in front of me, and so my internet advice stops here. Sorry.
If you can walk again, with no pus falling out of your wounds, then that would be about 80% of the job. But obviously you want 100% function to return, and the devil is in the detail.
About 50 years ago, before all the advances in trauma surgery, you would have had about a 20:80 chance of losing the leg (against you)
The real questions are: What was the Gustillo & Anderson grade of the original fracture? Is that diastasis screw staying in and what compression was applied? Is your fibular rod stable, because it doesn't look threaded? Is the medial malleolus healing and what was/is the state of the plafond? Is there another true lateral of the ankle? What is your range of movement, state of achilles, any CRPS?
I simply cannot answer any of these, and there may be no problem at all going on here.
I bring it all back to "Fast forward 3 months to today and I've just starting walking again" This is good progress.
Edited by The_Doc on Saturday 25th April 17:14
Here are a few more details if it helps you say any more.
My surgeon also said there was no hurry for me to get to the hospital for another x-ray - simply to keep walking on it and do everything except running on it.
The original diagnosis was - Grade 3A compund right ankle fracture dislocation with right shaft % distial fibula fracture with medial malleolous fracture with syndesmotic injury without DVNC.
ICD Code S82.4 - fracture of fibula alone
ICD Code S82.5 - fracture of medial malleolus
Here's the operation info:
ankle reduction +CRIF with tens nail for fibula + debridement, K Wire and partially threaded cancellous screw for medial malleolus + fully threaded cancellous screw for sydesmotic injury
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