47-year-old accounts manager Emma was airlifted to the Royal Victoria Infirmary following a motorbike accident.
She was at work when someone said they were going for a ride on a motorbike, and she asked if she could hop on the back. “It was a beautiful ride – it was fantastic.” Says Emma. “Then we ended up colliding with a car. I remember wanting to put my foot down and they were saying you can’t put your foot down, you can’t put your foot down, so when I looked my ankle was facing completely the wrong way and there was an open wound on my shin.”
Emma has always loved bikes and even had her own little 50cc bike when she was 16 – which is why she asked to go on the back.
Her injury is quite complex, but it is orthopaedic trauma surgeon Steve Borland’s job to make it as simple and straight forward as possible.
He explains: “This is quite a nasty injury; these open fractures are quite nasty unlike fractures where the skin is not broken. The worry we have with these injuries is that they have a high rate of becoming infected and if you do get an infection, in severe cases, it can lead you to losing your leg.”
For Emma – she’ll just be glad when it’s all over: “It’s just been a roller-coaster of trying to control the pain and then I got emotional today because of the operation but the doctor was really nice and explained everything that was going to happen and I’ll be glad when the pain goes!”
Emma has two injuries on the same leg – with the majority of damage on the back of her ankle – which is dislocated and broken. The injury to her shin bone is even more serious.
Steve starts with a cut to the back of Emma’s ankle – her ankle is dislocated out the back – if they don’t fix it – it will keep doing it.
A plate will be placed at the bottom of Emma’s fibula – just above her ankle bone – the plates need to be in exactly the right position, or the ankle won’t heal correctly.
The ankle surgery has gone to plan – but the procedure to get Emma walking again is far from over – it’s time for part two.
Having repaired her ankle Steve now needs to piece together her tibia which is fractured in five places. A injury like this can be life changing.
Steve’s challenge is to create a metal cage that will immobilise Emma’s leg and allow it to heal. He explains: “We make carbon fibre rings into a frame that’s on the outside of her leg. We slide it onto her leg and fix it onto her tibia bone with pins that go all the way through the leg and fix it to the frame.”
Steve measures the distance between the rings so that they’re exactly the same length and the team place the frame onto Emma’s leg. The frame will be held in place by placing wires through Emma’s tibia bone either side of the fractures.
It’s not comfortable for patients to wear – especially with pins going through the bone. Steve uses a special tool to keep the wires under tension to make sure the cage remains fixed around Emma’s leg. Then two thicker wires are drilled through the cage and into the bone for extra support.
Final pin is in!
“My hope is that Emma can get up and about fairly quickly – we’ve got a nice stable frame, a nice well reduced fracture, a nice closed soft tissue envelope. Explains Steve. “With the bone stabilised she should be able to put her foot down to the floor quite quickly and start to walk.”
He continues: “What I say to people when we treat fractures with these frames is that your treatment starts now, and it finishes when the bone heals and the frame is off. Now we just need time to let this heal – we hope she’ll do well.”
Following surgery Emma is still wearing her frame and learning to walk with crutches.
