Hospital visit. Latest X-ray.

Today I was back at the hospital. The purpose was to get an x-ray and see if, in the two weeks since the struts on my frame were loosened, the bone has bent at all. 

If it had, then the tension would have to be put back in the struts and the position adjusted back to what it was after the final adjustment. I wasn't sure whether or not it had shifted. I could convince myself it had, but from looking at photographs I had taken before the struts were loosened and since, it seems as though the frame has definitely moved but my leg hasn't. So I knew if it had bent at all, it must be a small amount. I figured I would also feel it on the floor with my foot if it had bent much.

X-ray from 9 July 2012. Front view.

As it turned out, it hasn't moved. My knee and ankle are still in the correct alignment, so that's a good thing! I think that maybe my consultant was a bit worried that I would take this as a sign that the frame should come off, but I'm more sensible than that (I know!). I think we should leave the frame on until the break is almost completely healed. Last time, when the ex-fix came off and I went into plaster, my leg gradually bent over until it was in the state it was in. So this time, let's be ultra-cautious.

There is definitely some healing on the outside of my leg (right side on the x-ray), even though on the x-ray it does kind of look like the bone's in two pieces still with a big gap. It's clear when zoomed in that there is cloudiness across about a half to two thirds of it. The metric we're going to use now is 'whiteness', meaning very cloudy and probably healed up (yes, quite vague). It is probably about 20% white now on the cross section, and when it is 60-70% white the frame will come off. But I know from past experience that bone healing is non-linear, so it could take another two months to get there, or another six months. Either way, the frame stays on until we're sure it's two-thirds knitted.

In two weeks, I will go back again for another x-ray. I will go back now every two weeks to monitor if the bone is bending at all. If at some point the x-ray shows that healing has slowed down or stopped, there are some things we can do using the frame. We can compress the bone a bit to promote the healing, then stretch it out again afterwards. Another advantage of the Taylor Spatial frame I guess :)

Comparing back with my x-ray from October 2010, when I had the previous external fixator fitted, it's amazing how my tibia has changed. It seems to be a lot thicker now and the area where the main break is is quite a mess now compared to then. But, if it heals up, fine, and being thicker is better because now I've got no fibula. I don't have a picture of the October 2010 x-ray, I'll get one next time so you can see the difference.

Since the struts were loosened, my leg and ankle have been more swollen and more painful. The frame rattles a lot and moves if I knock it on something, which hurts. I'm not really sleeping properly at the moment, I keep waking up with a sore ankle :( The swelling is very variable - the other day it looked less swollen than ever before, then a day later it was more swollen than ever before!

So it's not particularly pleasant having the frame still on - clearly I'd much rather it was off - but I get why it has to stay on and I agree with that. If my consultant had said he wanted to take it off now, I would have objected! I really don't want to run the risk of it bending again and then needing another operation later on. What's an extra few months now, after more than two years?!

I also feel like I've got a good relationship with my consultant. I think he trusts me to look after it and my pin sites etc. (which are still all quite clean and dry), and I trust him to tell me the truth about what's going on and make the right decisions.

I'm very tired now after having gone to Preston and back today, but I will get a rest day tomorrow where I don't do much except tap on my computer and get some work done.