Patient Stories

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David

Strong, determined and seemingly fearless, David trained for years as a competitive BMX cyclist in Hungary before moving to England. “I started extreme mountain biking for the first time when I was fourteen. I just love to fly into the air on a bike and do tricks,” he said.

I remember waking up on the sidewalk and I couldn’t move my right leg. That’s how I knew there was a big problem.


Ironically, his job as a pizza delivery boy proved to be more dangerous.

I was on my way home. I had finished up at work, and suddenly I realized a car is turning in front of me, and it hit me on my right side,” said David. “From there, I remember waking up on the sidewalk and I couldn’t move my right leg. That’s how I knew there was a big problem.”

Every bone in David’s right leg was broken, his foot crushed, and the nerves, which provide feeling to the lower leg had been severed. Not one, but two different surgeons recommended amputating the 22-year old’s right leg. Understandably, David was devastated. “I didn’t even want to hear about it. I became withdrawn,” he said. “They told me that I probably wouldn’t be able to walk anymore, or at least stand up on my right leg and I wouldn’t be able to bike. It hit me hard.

David was desperate for another opinion. Orthopaedic Surgeon Dr. Satyagit Naique offered a glimmer of hope. Together with plastic surgeons, Dr. Naique performed multiple surgeries including a free flap procedure, where tissue and an artery from David’s scapula were used to restore the skin and blood flow to his foot. “For four straight days they secured my leg. At the end of the fourth day they said there was a chance that they could save it, but there wasn’t any guarantee that this would work,” said David.

The surgeons used the Orthofix TL-Hex system, an extremity fixation device that keeps bone segments aligned during the healing process. The system consists of circular and semi-circular external supports secured to the bones by wires and pins and interconnected by six struts.

Since the successful procedure that saved him from the amputation of his leg, David has begun to reclaim his life, doing what some said was impossible…getting back on a bike. He says he feels alive again. “It was fantastic to sit on a bike again and jump through the air,” said David. ”One of my dreams came true again. It’s an unbelievably great feeling.

Kevin’s Story

Kevin was born with Moebius syndrome, which means he’s unable to smile, blink, grimace, or make any kind of facial expression. Children with Moebius syndrome can also have club foot. Kevin has bi-lateral club foot, meaning it affects both of his feet, leaving him unable to stand.

Like many patients with club foot, physicians tried to correct his feet by placing his legs in serial casts, unfortunately this was not successful for Kevin.

We probably did about four sets of serial casting, which means up to six months of being in a cast, when we finally said, no more, he’s probably not going to walk, and he can be in a wheelchair and we will be okay with that,” said his mom Kacie.

Kevin’s parents were resigned to the reality that he would never walk, but Kevin had a different plan.

Kevin was seven when he started showing signs that he wanted to walk. He started pulling to stand, climbing onto furniture, asking for our hands to walk around, but his feet were so turned in and so deformed at that point, he did not have a good base to stand on,” said Kacie. “As we were looking for answers and searching for what to do next, we consulted a surgeon who recommended amputating Kevin’s feet because he felt that Kevin might have a better chance walking with prosthetics. We knew that wasn’t the answer.

Determined to find a solution, Kacie contacted podiatric foot and ankle surgeon Dr. Daniel Hatch with Foot and Ankle Colorado, who had treated Kevin in the past to see if anything could be done.

The procedure for Kevin that we elected to do was the use of external fixation. It’s done very gradually, with one millimeter a day adjustments and has proven to be very successful with this type of deformity,” said, Dr. Daniel Hatch.

When I first saw Kevin’s feet in the fixators I thought what did I get myself into?” said Kacie. “Adjusting the fixators for the first time was very scary. I thought I was going to hurt him, but that wasn’t the case.

With a careful therapy regiment and Kevin’s determination, a 10 year-old little boy who had never walked soon found himself up and about.

When I saw Kevin at his six month exam, I was extremely pleased with his outcome. He’s walking almost 100% independently, maybe hand holding by his mom; is it perfect? No. But he’s wearing shoes and he’s walking and he has his feet. So that’s a success,” said Dr. Hatch


If I was going talk to another parent about the fixators, I would definitely tell them that it is a long road. It is not easy but it is so worth it,” said Kacie.

James

Saving a patient’s leg — and quality of life

When James, age 68, went to the doctor for a cut on his toe, he didn’t expect to lose half his foot. But that’s what happened.

I’m diabetic and was sent to the podiatry hospital where they ended up taking a toe off,” said James. “I thought that would be it, but the infection was in my foot.

After a month in hospital to hold the infection at bay, they wanted to take my leg off below the knee. Then one of the surgeons proposed a different solution.


Instead of undergoing life-altering below-knee amputation, orthopedic surgeon Jonathan Page, Cert Ed, MBChB, MD, FRCS, had to do a partial amputation of the foot in order to save his leg. The surgeon then performed a procedure to reconstruct James’s mid-foot using a TL HEX external fixation frame and a specific bone cement that provides structure for the bones and tissue to heal around.

He emphasized that there would be no guarantees with the procedure, but I wanted to save my leg,” said James. “I didn’t see the frame until I woke up and saw all those pins in my bones. I couldn’t put down my leg. But over six months, I got used to it, and the foot was doing all right, and you don’t even think of it.”

James had to moisturize the skin around the frame twice a day, to keep it from drying out, and cleaned the pin-sites at night. Dr. Page performed scheduled strut adjustments over the course of treatment.

It’s like growing another foot,” James said. “Dr. Page kept me up to speed all the way through, showing me the X-rays and pointing out the bones that were healing.”

Before the surgery and treatment with TL-HEX, James was enjoying retirement and long walks with his new dog. Now that he’s back on his feet, he looks forward to getting back to those companionable strolls. He’s already back up to half a mile.

It still feels strange to walk barefoot, and I prefer shoes for that extra bit of support. It doesn’t hurt, it’s just awkward,” said James. “I’d advise other patients to talk to their surgeon, ask lots of questions. You’ll have a long way to go. Without a doubt, it’s been worth the effort for me.”

Once my strength is back in the ankle, I’ll attempt to walk the dog and, if I’m able to that, there’ll be no holding me back.

Q’Shaun’s Story

I knew something was wrong with Q’Shaun’s legs as a toddler because he didn’t try to start walking till he was 2 years-old, and when he did finally walk, he was clumsy and couldn’t keep his balance. The older he got, the more twisted and bowed his legs became.

Q’Shaun was diagnosed with Blount’s disease, a growth disorder of the lower leg bone that is characterized by a bowing appearance of the leg below the knee joint.

He had a substantial bowing of both legs causing pain, deformity and this limited his activities,” said Dr. Christopher Iobst, Director, Center for Limb Lengthening and Reconstruction, Nationwide Children’s Hospital and Clinical Associate Professor, Orthopaedic Surgery at The Ohio State University, College of Medicine.

The doctors we saw said to wait till he was older and stronger to try and correct his legs. It was hard to wait. He didn’t have friends; he was bullied because of his bowed legs. He missed out on a lot growing up,” said Carol. “He is a big kid, and he loves sports. Even with his legs, he was determined to play baseball and football. It was scary to see him run as it looked like his legs would just break because they were so twisted.”

After many years of struggling and waiting, it was finally time for Q’Shaun to have surgery to correct his legs.

“The doctors told us that if he didn’t have the surgery before he was 16 then he would be in a wheelchair,” said Carol. “That made the decision to have the correction done easy, there really wasn’t another option.

He had a large amount of deformity,” said Dr. Iobst. “This can be corrected gradually with the TL-Hex which is the safest method for bone healing and soft tissue healing.”

Carol was a little shocked when she first saw Q’Shaun after surgery.

It was scary at first to see it on his leg. I was very scared of tightening the system,” said Carol.

Lots of people at school ask me about the frame and if it hurt and I told them ‘no’, said Q’Shaun. If they ask why I had it on I told them ‘it was because my legs are bowed and need to be straightened.’ Most people were just curious because they had never seen anything like the frame.


Carol has a few words of advice for other parents faced with this type of procedure. “You need lots of communication and support. You can’t do it by yourself. Take it one day at a time, one step at a time because it’s worth it,” said Carol.

Now, one year after his last surgery, Q’Shaun is playing baseball, football and he’s a member of his high school’s ROTC unit where he plays the drum and marches in local parades and, just as important, he now has friends.

I am so proud, I cry when I see him march because it’s something I never thought he could do,” said Carol.

Before surgery, I couldn’t march a long way. Now I can just keep marching,” said Q’Shaun. “And when I play football and baseball, I can run straighter and faster now. My favorite part of baseball is hitting grand slams because I’m proud of myself and my team.”


The patient stories above are the experiences of these individuals. Not everyone treated with a TL-HEX device will receive the same results. If you are interested in learning more, please consult your physician to understand the benefits and risks.