Close-Enough Body Repair

March 6th, 2009 by Harrumpher Leave a reply »

Another veil of illusion fell yesterday during the first follow-up visit following my broken-leg surgery. I had honestly and truly bought into the proposition that orthopedic surgeons were flawless, perfectionist artists.

Instead, I discovered very visually that they seem to share the same fundamental belief that most adults arrive at — doctors don’t heal people; the human body in its almost magical power does…or not. (Pix note: click an image below for a larger view.)

While I had envisioned my tibia and fibular breaks to have been realigned and repaired with great precision, I was naive and ignorant. The reality of surgical craftsmanship was both coarse and close-enough. I had imagined a Super Glue®-style pottery repair, showing only a fine crack where the adhered pieces pressed together. Instead, my bones are still broken and my body is left to its devices to grow enough grout-like material to fill the gaps and in effect create a larger set of bones.

Even at what feels like a patriarchal age in this repair period, I learned something yesterday. That was both disappointing and clarifying. It does me no harm to discard the delusion that surgeons are somehow different in type from other physicians. In mind and conversation, I had held that they were craftsmen and artists, in no small part because they could see and manipulate the body parts needing attention.

Yesterday was my first look at my leg x-rays. I should have asked to see the pre-surgery ones. They must have been grim. That would have given me additional perspective when I saw the post-operation, pre-fill-in-the-gaps ones.

leb topThe short of it is that both bones remain separated. My body has some serious rebuilding to do. I understand now why they speak of it being realistically a year to get my leg back. It also humanizes the surgeons for me.

Consider the tibia (the larger of the two lower leg bones). I now have a permanent titanium rod the length of it, with two screws top and two bottom holding it in place and keeping the two major pieces together.

There is a large, visible, pointy split left with no apparent effort to bring the splinters close enough to glue.  The next time I see the jolly cutters, I’ll ask whether leaving the gap and making the body fill in the space creates more ossified material, hence a stronger tibia, than had it been pressed together. In other words, was it expedience or wise planning to leave me with an obvious break?

Then just above the ankle, the broken fibula is in pieces still. The two surgeons I saw yesterday fairly giggled in pooh-poohing my questions about that jumble of pieces.

leg bottom

Basically, their version is that the bone itself is wee, not particularly weight supporting and fairly vestigial. One said that they let broken lower fibulae repair themselves or not. The other added that if docs need a spare bone piece to repair a more functional osteal unit, they cannibalize (my word) the fibula to get one.

So, what can I learn from this? Most obviously, my master craftsmen are more like pretty skilled weekend repairmen. In my case, they seem to have done a quite serviceable job that needs only to work, not be pretty.

From the outside, once the red, purple, wrinkled and muscle-toneless leg returns to its glory with use, there will be only a few external scars. I’ll set off airport and courthouse alarms and then have to pull up my trousers for wanding, but my beautiful calf and skin will look fine again.

 

Wonderful skills of our corporal factories

Inside, it is a combination of surgical skill but more of the body’s gross and fine powers to make itself whole and functional. Apparently, the shattered bone pieces need only to have been brought close enough in a couple hours of surgery. Then the major work of correcting and the real repair is, as the expression goes, afoot.

The flippant surgeons in the hospital did the over-the-wall thing. They said I could walk on the leg the next day…if I wanted. That is literally true in a structural sense. The rod in the bone is in effect an internal splint, giving me the physical capacity to stand even while the bones remain in multiple segments.

Of course, the reality is that even for someone who doesn’t wallow in the emotional aspect of pain (a family trained trait), I needed a couple of days and physical therapy sessions to be able to 1) use a walker at all while standing with eye-flooding pain, and 2) to shuffle and thump my way down a long hall to a set of stairs, and then stumble up and down a flight of stairs on crutches.

The surgeons came clean yesterday. Unlike the in-hospital glibness of I’d have my leg full back in six months and could hit the stationary bikes at maybe four months, the follow-up estimates are twice that. I go back in six weeks to see if I am lucky and healthy enough of the body to be a quick bone-generating sort.

I end up with my intrinsic and learned faith in my body as self-repairing. I’ll be sure to get printouts of the x-rays toward the end of next month. I’m hoping for some ossification in the big gap, my body’s own grout.

So, far better than centuries ago when a break like this would get a splint to heal or not having surgeons pound a rod from the knee down the ankle is good. Yet, it’s not great and works only because of the wonderful skills of our corporal factories.

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2 Responses

  1. Uncle says:

    Keep this coming, because I may send some colleagues browsing this way for some solid first-person reporting on this adventure.

    Not to be discouraging, but it does take a while. I’m ending my seventh month post-op on the shoulder, and I just graduated to a 5 lb free weight and can do about 20 easy minutes on an elliptical. When they finished with my shoulder, I had no AC joint (q.v.) as well as damn little labrum left, so I have to build rotator cuff muscle mass slowly to compensate…whilst glowering at the gym rats tossing around 50 lb weights like marshmallows.

    The other cheat is that at our age we don’t acquire bone mass as readily as young persons (drink your milk). The milestones, small as they are, look better when you let yourself reflect on what you were unable to do at each previous stage.

    I’m not hard on surgeons, partly because their foibles help provide my salary. The best ones remember that they are mortals too. And those films don’t look half bad for your stage of recovery. Press on.

  2. Harrumpher says:

    Hmm, reflect on previous stages sounds sensible and zen. I’ll try to install that unit in my brain. Thanks.

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