From Cast to Splint and Staple Removal

14 December 2011

"Having staples removed is always fun" was a quote posted on my Facebook page! Well, I guess I was about to find out. After having the cast cut away with that macabre looking saw tool, I lay on the bed for the nurse to "whip out" my 24 staples. For anyone who has never had the pleasure of this experience, I would say, really don't worry, its not as bad as it sounds. A few tiny stings at the worst and most of them I didn't feel at all. Just don't make my mistake and Google it first, as pictures of the little blighters will make their extraction appear excruciating, if not impossible!

This is my scar 2 weeks after the staples had been removed

The deed done, I was taken to Xray to find out how things were doing 16 days after surgery. Ouch! Why do Radiographers always require broken bones to be placed into the most inconvenient positions for their snapshots?! I think my words were, "this really isn't feeling good right now" before he moved it into a slightly more bearable position. Very polite I thought, given the circumstances.

I didn't get to see the consultant back at the clinic, but he apparently surveyed my Xrays and his registrar came to deliver the news. Not the exact words, but it went something like this .....

"Yes, it was a very bad fracture, but the surgeon has done his best to repair it. Expect to experience early onset of osteo-arthritis though as the underneath of the bone is not quite smooth enough"

Didn't exactly fill me with glee to be honest, but I was relieved to know that my, by now, throbbing joint was going to put into a splint and left alone for the next four weeks ... well, apart from a little "gentle" PT (Physio Therapy) that is.

Surgery and after ...

28 November 2011

At 10am the next morning I was taken to the operating theatre. The surgery lasted 2 hours. My shattered knee cap was fixed with 3 pins and an arrangement of surgical wire around its circumferance to hold the displaced fragments together. The wound was closed using 24 metal staples and my leg was immobilised in a velcro splint to allow time for the swelling to go down. I was dosed up with painkillers and prescribed a course of 4 antibiotic shots to keep away any potential infection in the wound. Also, due to my mother's medical history, it was decided that I was at high risk of developing a DVT and I was given an anticoagulant shot to try to prevent this. I was told that I should be able to leave the hospital the following day, once the antibiotics course was complete. The orthopedic specialist came to see me and told me that the trauma team had been divide over whether or not the damage was too much to try to repair, but that the surgeon had felt it was worth a try. They appeared to be very pleased with the results and he was very complimentary to the surgeon for managing to repair the mess inside my knee.

The next morning, my leg was put in a full cast, from just above my ankle right up to the top of my thigh. Some more Xrays were taken and I was able to see my "before" and "after" images to see for myself what the fuss was about. A physio therapist came to see me to show me how to walk on crutches, partial weight bearing on my injured leg. Crutches forward, bad leg, good leg, crutches forward, bad leg, good leg ...

My case notes and Xrays were forwarded to the hospital in my home town, a supply of painkillers provided and at 4pm I was discharged. Unable to fit my immobilised leg into our own car, my aunt and uncle travelled to collect me and I was propped up with pillows and duvets on their back seat to commence the four hour journey home.

The Fall

Sunday, 27 November 2011

Away for a weekend break with my hubby and friends, having a brilliant time! Decided to go and grab some food before settling down to watch another entertainment act. We ate our food and were just leaving the fast food diner when the accident happened. The step was shallow and unmarked and the lighting inside the food hall was poor. I didn't notice that it was even there when my left foot unbalanced on the edge of the step and my ankle twisted, sending me crashing down onto the floor below the step with my right knee taking the brunt of the fall. I rolled back into a sitting position with my knees bent up in front of me, and this is when I noticed the jagged lumps on my knee cap protruding underneath the material of my skinny jeans. We didn't need to be medical experts to know that this was going to need more than an ice pack to fix it!

A First Aider was called who took one look and telephoned for an ambulance immediately. Unfortunately, there was no ambulance in the area at the time - the nearest A&E department being over an hours drive away, so a paramedic was sent to assess the situation in the meantime. He checked my knee, my pain levels and made sure I was kept as comfortable as possible until the ambulance arrived, two diversions and an hour and a half later. I was stretchered into the ambulance and given entinox as pain relief whilst the knee was examined. By this time, my knee had a swelling the size of a tennis ball on the knee cap and was already bruising nicely. The initial protrusions were no longer visible due to the swelling and the ambulance medic suspected that my patella was dislocated. The entinox was increased whilst he tried to manipulate it back into place.

Over an hour later, with the help of the entinox we made through the winding lanes to the hospital A&E department. A doctor made a quick assessment and two Xrays were taken. I was told that I'd "made a good job of it". An orthopedic doctor was sent for to explain further.

Fractures of the Patella.
(Mine was a comminuted displaced fracture similar to the 4th diagram here)

I was diagnosed with a comminuted displaced patella fracture, which basically meant my knee cap was broken into at least four pieces. I would require surgery as soon as possible to pin and wire it back together. I was put on the trauma list for the following morning, my leg was put in a plaster of paris half cast splint and I was taken to the orthopedic ward where I was given diamorphine, ibuprofen, paracetamol and codeine for pain relief. It was a very long night, and the beginning of a long road to recovery.