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Hip Surgery 2.0

posted Jun 8, 2011, 6:07 PM by Dwayne Walker   [ updated Aug 11, 2011, 7:07 AM ]
Well, I wasn't happy with the hardware that they put in my left hip after my motorcycle accident (Aug 1 2010) last year so I got some new jewelry in there.
Isn't that the new trend to accessorize everything.

Ok so in reality most of the fractures healed up fine but one major fracture line at eight months after the accident was not healing. Instantly they started talking about bone grafts and other nasty painful sounding procedures. The scary part was the lack of a smoking gun as to why the fracture didn't heal. Suspects included loss of blood to the bone in that area fore to long, specifically those sections of bone. and mass trauma, there was a lot of stuff damaged in the crash so the body had a lot to work on healing and one of the prevailing theories considers the body saying "good enough" when it has many many urgent issues to deal with, and it did have many, mostly from the accident but some from the hospital deciding that I didn't need blood, just morphine. 

Maybe I was getting a bit distracted there. ok so essentially the original collection of breaks (it was broken into five major pieces) are mostly healed leaving me with one fracture turning the bone into two pieces. So now it is effectively a different type of break. The doc's decided that because the bones where held in position very firmly across this fracture line it didn't heal. The idea is that the bone will heal back together if it does flex a bit. But if the metal holds every thing very still the bone doesn't rub against it's other parts and it says "Hey we ain't grinding against each other so I guess we are healed" they blame the fact that instead of screws with threads on just the tips of the screws where not used. Instead what I would call all-thread was used mainly because they where not screwing just two pieces together but catching several pieces of bone along the way much like a shish-kabob (how fitting that the word shish-kabob has a hyphen in it,) so it was the right choice at the time but now the problem is effectively a different kind of break. Now as those
joints (fractures) have healed and now it is just two pieces. So the idea was to avoid the bone graft and change out the hardware that would allow just a bit of flex and that would promote healing of the fracture.

So two and a half weeks ago I wen't in and they cut me apart again and took out the original two plates and nine pins (collection of all threads and screws) and
 where intending to replace it with one piece of metal called a "compression hip screw" or sometimes called a "Dynamic Hip Screw" depending on who you ask. So in they go to put in this new device (which is 14mm wide at the threaded end! that seems big to me!) of course hogging out more bone. my
basic response was "ARGGGGG!!!" and I can tell you it was easer the first time to deal with the concept of having this massive surgery mainly because I didn't have much time to think about it and I was on lots of morphine but this time I got to think about it for a week and a half before hand. Any rate the surgery wen't fairly well but he (the Doc) did have to put in another screw to support it as he couldn't find a good purchase for the compression hip screw. he also had to pump in some "calcium cement" that he was not planning on putting in. in any rate this has left me with six weeks of no weight on the leg then start walking on it all over again. This is going on for a long time I think. in a couple of months it will be a year since my accident.

So here is the current work after the operation, you can see the large compression hip screw and the helper screw that he had to put in. This helper screw should not hold the joint to rigidly as it is a screw as opposed to all-thread and just the end of it is threaded and on the top side there is a washer to hold it in. The compression hip screw consists of a plate with a berral through which the large sliding screw is placed. then it can hold and secure the angle of the joint. The doc says that even with the slight complications if the healing of the joint will take place then the leg will be as strong as it ever
was. If it doesn't heal this time I am not sure what is next. some kind of bone graft I would suspect.

the saga continues...

you can click on pictures to make them larger.