Nailesh, major lower limb trauma
Consultant: Professor Nima Heidari
Lower Limb Deformity Correction
Nailesh is able to resume his life following treatment by Professor Nima Heidari for serious trauma following a major car accident.
Nailesh was involved in a serious car accident in June 2019. It was a head on collision at 50 miles an hour while he was on his way to a family meal. He was taken to hospital in Peterborough where they manipulated his leg to correct the dislocation which had occurred. The next day he had an X-fix device fitted on his leg. This is similar to an external frame but more of a short-term measure. Four days later he was told that it was a temporary fix and that a further, more permanent frame was needed, which would have to take place at a major trauma hospital. He was warned that his leg may need to be amputated if his condition didn’t show signs of improvement sooner rather than later. Nailesh lives in in Enfield so chose The Royal London Hospital, which was the most convenient.
A month later, Nailesh underwent surgery was to remove the X-fix and replace it with a Taylor Spatial Frame (TSF). A TSF is an external device for limb correction, lengthening and/or straightening the limb. This external fixator takes advantage of the body’s natural ability to grow healthy new bone tissue and gives the surgeon the ability to accurately move bones to their correct precise anatomic alignment. It fits around the limb and is attached to the bone with pins or wires that extend from the rings, through the skin and bone to the other side.
A week after having the frame fitted, Nailesh was able to go home. He explains what it was like: “With the frame on it’s very inconvenient. It is screwed into your leg. I had 3 pins just below my knee at 2-inch intervals and they go through skin and into bone. Where the fracture was in my ankle, I had 3 rings fitted with a horse-shoe shape frame. 12 pins went through my leg at this point. This made it uncomfortable trying to sleep at night – I had 3 kilos of metal in my leg. I got used to it after a while but because of the open wounds I was not allowed to get it wet so had to shower with a black bin bag over my leg for 12 months. Walking was impossible to start with, I was on crutches for quite some time. I couldn’t put my foot on the floor until the horseshoe was removed. Getting dressed was difficult – I had to have trousers altered to make them fit over the frame.”
For the first 6 weeks, Nailesh had weekly check-ups, which then became fortnightly, then as and when required. Around six months after the surgery, in January 2020, Professor Heidari informed Nailesh that he thought the leg wouldn’t heal any further and he recommended a bone graft. Surgery was planned to take place, which work around the frame. They would remove bone from around the hip and insert it into the ankle to repair the gap in the ankle to strengthen it for when the frame was removed.
Nailesh was waiting for a date for the operation when the Covid-19 lockdown began. As result, his leg was in the frame for a few more months, which resulted in the bone graft not being required. Professor Heidari was very pleased with the improvement and the frame was now ready to be removed.
Following the frame removal Nailesh says: “I am a lot more mobile, I can now go outside for walks, restart physio and get back to work after 13 months, albeit part time initially. The ankle itself is fine, I am gradually being able to put my full weight on it. The wounds have healed externally but the interior of the bone is still painful when wearing shoes.”
He sums up his treatment with Professor Heidari: ”Throughout the 9 months of seeing Professor Heidari and his team it was totally amazing, his general manner of communication and expertise were unbelievable. I was so glad to have been referred to him and I’m really grateful as I don’t think I would have received this level of care and expertise elsewhere. He never once rushed to make decisions, he always listened, answered my questions, and put my mind at rest. He was very reassuring in everything he did. He always had time to listen and explain and put our minds at rest. I am truly grateful to him and his team. They were absolutely amazing. Because of him I am making good progress with my recovery, which is 85-90% complete and I am able to resume my life as it was 12 months ago.”
Professor Heidari concludes: “Nailesh suffered a serious trauma to his tibia and ankle and I am delighted that his treatment has allowed him to return to work and his daily life.”