Professor Nima Heidari’s intervention in this case of severe bone infection allowed Darrel to keep his leg and make a full recovery.
Whilst at work, Darrel was hit by a motorbike which broke his leg in six places. He was taken to Southend University Hospital where they put in a metal plate. He had two open wounds, which became infected and didn’t improve over the following six weeks. He was diagnosed with a bone infection and referred to Professor Nima Heidari at the Royal London Hospital.
Initially, Professor Heidari put Darrel on antibiotics as an outpatient and he had his dressings changed every 3 days at his GP, however his wounds still didn’t close up. When Professor Heidari reviewed Darrel’s wounds again, he decided that he needed to operate as Darrel had a bone infection. During this first operation the infected bone was cut out and an antibiotic loaded stabiliser block was inserted in the gap where the infected bone had been cut away. An external metal frame then secured the broken bones in Darrel’s leg.
During the next three years Darrel underwent a total of eleven operations to reconstruct his leg to aid the healing of his broken bones and he also underwent plastic surgery to deal with the dead skin which resulted from a lack of blood flow to the area. After seven months of treatment, Professor Heidari attached a Taylor Spatial frame to Darrel’s leg, which is an external fixator used by orthopaedic limb reconstruction surgeons to treat complex fractures and bone deformities. This frame was finally removed in August 2020.
Darrel’s treatment was extremely complex. During one operation, Professor Heidari had to deform Darrel’s leg to put it in a position where the skin of his leg could heal.
After each operation, Darrel spent about three weeks in hospital and was then discharged with a PICC line for him to continue with intravenous antibiotics at home.
In December 2020, Darrel explains how his leg is now: “It is still not perfect, but I can walk with an air cast boot at work and can walk short distance without crutches. I’m sure it will improve over the next six months and I have been doing regular exercises to build up my leg to build up the muscles. The pin site from original operation has only just healed up and my leg hadn’t touched the ground for almost 2 years.”
He summarises his treatment with Professor Heidari and his team: “Professor Heidari was brilliant, I couldn’t have asked for a better doctor. He’s absolutely wonderful, definitely the best in his field, as are the frame nurses he works alongside. I wouldn’t be where I am today if it wasn’t for them.”
Darrel’s advice for patients with similar injuries: “Just bear with it, there’s a lot of doom and gloom during the process which you have to deal with. I worked all the way through my treatment, it’s important to make the best of what you have and get on with life, albeit with one working leg. Overall, it was much better to go through the treatment in order to keep my own leg, whether it’s perfect or not. The team have done the best they could.”
Professor Heidari concludes: “Darrel has been on a long and difficult journey to reconstruct his leg following tibial osteomyelitis (infection in his shinbone) which had developed. I am so pleased we were able to save his leg. He has gone on to recover well with the tibia reconstructed and the skin fully healed. Cases like this have an extremely long recovery phase. Darrel’s leg will continue to improve for several years and regain the mobility of the joints and strength in the muscles. Darrel’s open outlook and very positive approach is an absolutely key factor in his recovery.”
Darrel’s leg immediately after the accident
X-ray showing the frame attached to Darrel’s leg
Darrel’s leg encased in a metal frame to keep it in position while healing
Darrel’s leg with the Taylor Spacial frame, which remained on his leg for many months
X-ray of Darrel’s leg with the Taylor Spatial frame attached
Darrel was able to remain mobile whilst his leg was in the frame
Darrel’s leg once the frame had finally been removed
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