ILIZAROV NOTICEBOARD

 


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From: Margaret
re: experience of fixators for upper arm fractures

Has anyone out there experience of a fixator for the humerus? my friend has statistics for tibial fixators from the USA. the success rate sounds good. any advice would be helpful for my friend. it is 12 months since her accident . Thank you

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From:Linda Jorgensen
re: Ilizarov surgeons/hospitals in Omaha, NE.

I am searching for a doctor in or near my area who is experienced in the Ilizarov bone lengthening technique. My daughter was in a serious auto accident last year which caused a comminuted fracture of her right femur, a fracture to her left tibia, and several fractures of her pelvis. Her right femur was fixated with a steel rod from hip to knee. As a result of these injuries, her right leg is 1/2 to 1 inch shorter than her left. She is 15 years old and, according to our doctor, done growing based on x-rays of her growth plates. She has difficulty walking any distance without it causing her considerable pain. She also is constantly twisting her ankle or knee. We live in Omaha, NE and are not willing to return to Univ. of NE Medical Center due to negative experiences during her stay there. Are there any other doctors here or within a 500 mile radius that we can consult to determine her options?

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From:Diane Wilson
re:Opinions, feelings and advice.

I have a fifteen year old daughter who broke the growth plate of her tibia at age 8. The tibia has grown 4cm (about 1 3/4") shorter than her anatomically correct tibia.
Yesterday we had a consult with Dr. Ken Brown at BC Children's Hospital in Vancouver (a seven hour round trip for us from the island) and he recommends the Ilizarov apparatus to lengthen the shorter tibia. Here begins the problem...I could in no way pin him down to give me any help at all in making the decision to go ahead with this surgery. All he would say was "she has one leg shorter than the other doesn't she?"
Well I'm sorry, but that I already knew!! I have six different opinions from six different doctors and I am absolutely beside myself as to what to do here.
My big question...Is it necessary that she has this procedure done with only a 4 cm discrepancy? What are the long term effects of her NOT having it done. Are my worries and fears warranted (I've read about pin site infections, loose pins causing nerve damage, fractures in new bone growth that puts them back to square one, etc. etc. until I'm scared to death)!
She is a very healthy, active girl who dances several hours a week to enable her to be a member of a senior dance company. Is this surgery worth pulling her away from all her hard work and effort to get where she is???
I would really appreciate any insite from ANYONE, no matter who!
Many thanks and kind regards,
Diane
To e-mail Diane direct please click MAIL DIANE

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From:Lynne
re:Pain,Swelling & Pain!.

I have had an ilizarov frame fitted for just over a month now, following the failure of a hoffmans external fixater!
I had to have my knee fused following failure of total knee replacements; so my ilizarov goes from my thigh down to my shin.
Unfortunately I got MRSA, which is now in all my pin sites!
I am concerned about the swelling, my skin is now dinted where it digs into the frame at the back of my leg! Is this swelling normal or is it due to the MRSA?
I am unable to take any antibiotics due to a huge drug allergy problem I have! Also the pain is quite unbearable, especially during compression period, doctors told me it was more painful during distraction!
Why are my bones failing to unite? It's been four months now since the fusion and still no sign of any new bone growth, despite ten days compression and twenty days distraction; I am now on the sixth day of a ten day compression period.
Again I am unable to tolerate pain killers and I am relying on my own inner strength to get me through!
I know it's a long process and have been told I have to wear the frame for up to 18 months, surely the pain will get less as time goes by?
Hope someone can answer my questions and give me some encouragement and tips,

Thanks ..........Lynne

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From:?
re: What about rehab?
See my personal view below, Slim

This is for anyone who has gone through life with the Ilizarov.
My grandfather just recently had an Ilizarov put onto his leg. He now lies in bed for hours during the day believing that he can do nothing.
My grandmother removed the pillows from his back, and even moves his leg for him.
My family is concerned that my grandfether's laziness will only worsen his leg. Am I right?
What did you do after you had your Ilizarov?

What about rehab? (see above) My personal view, Slim

With regard to the above, which I received via the discussion page, I would like to offer my views. I would emphasise that these are purely personal. Any other views can be sent to me and I will forward them on to the, unfortunately, nameless enquirer.
I do feel however that it brings up a point raised by Pierre Filion (see The stress of Fixation) regarding the support available for frame wearers.
As supportive as families are, some times there comes a need for more professional help. I would have hoped that the gentleman mentioned above would have been given a series of physiotherapy exercises to complete unless there was a sound medical reason that he should not do so. Also that he is under regular medical assessment as to his progress
Much of course will depend on the placement of the fixator (upper, lower or whole leg) as to the degree of mobility / exercise that can be achieved. This should have been advised by the hospital carrying out the procedure.
If the gentleman is personally depressed then I can fully understand his belief that he can do nothing. Here is where professional help should be sought. Following the original work by Prof. Ilizarov, it was found that partial weight bearing actually helped the growth and repair of the bones. But again, this point should have been discussed with the medical parties involved in the fixator operation.
If he feels that he is 'TOO OLD' then, so did I, as old as I am, in my mid forties. Then I met one of the King's patients who'd had an 8 ring frame fitted to his leg IN HIS 80'S. He had not only healed 100% but was walking about better than many 'fit' people of lesser age.
He used a stick. SO WHAT!. I will very likely have recourse to a stick as my leg is still 1.5" short. But I repeat SO WHAT!. I want to walk again without the crutches.Why?
Not to get back to work, not to rejoin the rat race, but to walk my dogs, walk in my woods and fields, walk round the shops. To do all the things I once took for granted.
I can lay in bed if I want if my leg aches (as it sometimes does), but becoming totally dependant on people is just not an option.
[If my consultant ever reads this admission, he'll go mad] I've even been known to hop, with the crutches, up on one step of a 3 rung stepladder so that I can change a light bulb whilst holding the new bulb between my teeth!
I know it's stupid, but it's like Everest and a mountaineer, it's there and had to be done.
I'm not advising my sort of stupidity, but you have to push yourself. But most importantly if you feel you can't do anything, then it's time to talk to someone about it.
After the accident I was very self pitying. And, looking back to the way my (now ex-) partner dealt with my demands, I can see she was right. My hands weren't damaged, so if I wanted a cup of tea and, at that moment she didn't then why shouldn't I make it myself?. I didn't need two good legs to make and drink a cup of tea, so why should I have expected total dependancy?
Unfortunately I was so self absorbed at the time that I didn't realise she was being sensible By the time I did realise it, I'd totally alienated her by moaning at her continuously and had then thrown her out 'because she didn't care'. Probably one of the most stupid moves I ever made!
Maybe the gentleman will need a bit of a kick like I had, to get him going. Of course, as well as that he's got all the best wishes of the Ilizarov and external fixator wearers pushing him.

He CAN do it, just tell him from me!

Slim Haines

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From:Bryan.L.Greenhouse
re: Question:

My descrepancy is only 2.5-3.0 cm. I correct it with a 1" lift in the shoe but I still have considerable back tightness on my short side.
I am 27 years old now, have had the discepancy since age 20.
The tightness is moving more towards the direction of constant uncomfortableness and if it continues in this direction, I anticipate it will progress to constant pain.
The question is this, has anyone seen studies on how much a discrepancy should be compensated? My hips are pretty even, but my body certainly doesn't appear to like the correction.
Does this mean that if I were to go for the lengthening my body will still not like the correction?
I know these are medical questions, but no doctors seem to shed much light. I'm looking for personal experience. I can have the lengthening anytime I want; my insurance will cover and I have already consulted with a doctor who is very willing if I choose. So far I'm too chicken.

Thoughts??!?!

e-mail me at greeneee@att.net

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From:Miranda Evans
re: Does anyone else feel like me?

I have had my fixator on for about a month now and I am very worried about how it is effecting emotionaly.
I have become very snappy at people, people that are very close to me my boyfriend told me last night that he is getting fed up with me.
I hate it that I can't get about and do things my friends are doing I am only a 20 year old girl I just hope I wont get long term effects because of my frame.

Miranda

Email: evansmiranda@hotmail.com

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From:??????
Date: September 1999
re: Ilizarov procedures in New York

I live in the Western part of New York State and I'm wondering if anyone can tell me if there are any doctors in my area who undertake the Ilizarov procedure.
I broke my leg over a year ago and it has never healed properly. My doctor wishes to put a rod in my leg which I don't want. I would appreciate any assistance.
Thank you.

Email: FlyV59@aol.com

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From:??????
Date:October 1999
re: Are Ilizarov sponges necessary?

Is it really necessary to put sponges on the pins and rods?
My son was hit by a car and he has them on both legs. One is above the knee and goes to the ankle and the other is just below the knee to the ankle.
He was walking down the road when he was hit. He broke both arms and severed a tendon in his right arm. Both of those have skin grafts.
Two skull fractures. One temporal and the other was epidural/ bilateral which caused a brain bleed.
The right leg is broken from the knee down and the left is below the knee. He had compartment syndrome so they cut down the inner part of the legs. He had to have a bone graft, they got some from his hip and the rest from the bone bank. He also has two skin grafts on the outer parts of his calves.

E-mail Weezio@aol.com


 


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