On the good side, a new pin was fitted, and the old infected pin was removed. That hole now has a rather unpleasant mess at skin level, but the aim is to let the infection out as the soft tissue closes up.The main aim of the operation was to move and stabilise the large chunk of shin bone that was forced out of alignment by the last set of adjustments. A hole was drilled through the piece of loose tibia and a new wire was threaded through. There's a bead fixed to the wire, and when the wire is pulled through, the bead locks against the bone. The surgeon should then have been able to pull on the wire whilst an assistant stretched the leg and so manoeuvre the bone into position. It seems that the bone was stuck and the attempt failed. Given the amount of metalwork already on the leg, it was not possible to get the wire to the ideal position.
We are now going to stretch the leg by 8mm by lengthening each of the struts by 1mm per day. The aim is to move the upper shin-bone out of the way so that the loose piece is then moved back into the correct position by the surrounding soft tissue.
I'm worried that the wire will hold the bone in the wrong position, even if it the upper shin-bone releases it. I think the wire will have to be released first, and that this will involve another visit to the theatre.
Two of the struts needed to be changed for longer versions in order to get the extra 8mm. This is done by inserting a temporary strut to hold the frame in position, then swapping the short struts with longer struts, and then removing the temporary one.When the second strut went into place, for some reason the consultant could not get the new strut to the correct length, and it is 4mm short of where it should be. The next half hour was incredibly painful. I have to get that 4mm back as quickly as possible tonight. Maybe 1mm per hour?
Where does the pain come from? The bone itself does not have any nerves... Apparently there is a close fitting sheath attached to the outside of the bone, and this has a nerve supply. When the bone breaks, the sheath can pull away from the bone, and then obviously any contact with it will cause pain. Believe me. it ******* hurts!
