::Griffblog::

I came across an photograph taken a few days after the frame was fitted and noticed the difference in the gaps between the rings before the lengthening had begun and now with it all finished.

I’ve taken a quick snap as close to the original as possible for direct comparison but it’s immediately obvious how much lengthening has been achieved in less than a month. You can also see a gap between one part of the frame/pin and the skin has appeared where before, the leg was so swollen that it was tight against the frame metalwork.

The red sections are the lengthening rods, compare before and after! The blue box highlights the area where the surgeons made the incision to break the bone, look how tight it was against the skin whereas now there is an inch or so gap!

All but two of the pins have stabilised so much now that they require just the daily cleansing, no dressings needed. Only one wire pin at the top of my thigh (and which goes straight through the leg exiting in my buttock) requires dressing still, mainly because the skin around it is being moved each time I sit or stand.

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On Tuesday I finally saw my consultant to check on the length of my leg and bone growth.

I was delighted to be told that the leg was physically at the right length (+25mm) now and I would therefore not need to continue with the daily nut turning spanner exercise. The bone however has not quite met growth expectations having grown only about 15mm since the surgical fracture.

Not unusual I was told and so I am am now waiting for it to grow to close the gap of approximately 1cm. To that end I have been told to move to using one crutch only and fully weight bear on the right leg, this encourages bone growth.

I’ve started doing just that today but it’s incredibly hard work. Two factors being the mental block that tells you not to put all your weight on the leg and the other being the leg muscles, unused to weight, which scream at you every time you apply pressure and trigger the mental process that questions whether you should be doing this at all!

I’ve a review in three weeks and if I can help speed up the bone growth by walking then walk I shall, that and the gallons of milk, multi-vitamins and orange juice I’m being fed should do the job!

Tuesday was supposed to be my clinic appointment to measure the bone growth. Last Sunday was the tentative 25mm goal point assuming the bone has grown as planned so the clinic appointment was already late.

What with all that happened over the weekend Tuesday just appeared. The appointment at St Peters was for 2.30pm and so just as we were about to leave the house at 1.15pm the phone rang. It was St Peters cancelling the clinic as the Consultant had just rang in sick!

So I was left in Limbo. If I stop turning the nuts and the bone has grown as planned it will begin to knit. Fine if the leg is the right length, not so good if it’s short. If I continue to turn I risk having the leg too long!

We tried calling our liaison Sister at St Peters on Wed and despite being promised a call-back, none came. called again Thursday and got through. The cancelled clinic has caused turmoil so the best advice they could give me is to turn the nuts twice a day rather than 4 times and I’ll be seen on Tuesday 6th, a full week later and 10 days after I should have stopped turning the nuts.

Apparently the bone rarely grows at the ideal 1mm/day and even if it is longer, the bone is still soft and so can be compressed back a bit, indeed this is often planned as otherwise when it settles and knits you lose a few mm of length.

So now we’re keeping our fingers crossed for Tuesday. Hopefully the bone will have grown well and we can have a date when the lengthening stops and it is all locked off. Then the consolidation/knitting phase can begin.

A huge problem for ilizarov and TSF frame wearers is clothing. Frames on the lower leg are perhaps slightly easier to cater for but troublesome nevertheless and femoral frames, being the largest and most bulky present a quite literally ‘huge’ problem.

As we had prepared long in advance we had purchased a couple of pairs of running shorts, the type with the slits up each side. The inner mesh lining was removed and we were relatively confident that underpants and these shorts would stretch over a frame. That was before I had the frame fitted!

When I awoke to see how big the frame actually was it was clear that we had underestimated the size. I managed to don pants and a pair of shorts with great difficulty and in the meantime Sue hastily modified a pair of shorts by cutting up the side and sewing on snap fasteners.

This made the shorts much easier to fit and so she then moved on to applying the same modification to underpants. No longer did I have to struggle to get them over the frame where they would catch on every nut and bolt!

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Ilizarov frame patients will be familiar with the daily ritual of pin site cleaning.

Every morning after removing old dressings and showering I have to clean all 15 pin sites using saline fluid and special polygon ‘lollipop’ cleaning sticks and any pin sites that are weeping or bleed have to be covered with a non-adhesive padded dressing.

Whilst I was in hospital this was no problem, I was provided each day with a kit of the fluid, lollipop sticks and dressings as required. And when I was discharged I was issued with a small stock of them to keep me going.

Back at home I researched the dressings and cleaning sticks I needed and it threw up some nasty surprises! The 5cm x 5cm Allevyn Non-Adhesive dressings cost £18 per box of 10. Even though I only have 5 pin sites that require dressing that is nearly £9/day for dressings alone or £270 per month!

The polygon lollipop sticks however, are only available in bulk packs of 300 and these cost £60+. I can’t be sure of the exact price as I can’t find anyone who sells to the general public.

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