now he put external fixator for 3 months...?

mehwsh,

Do you mean DISH? Which is diffuse idiopathic skeletal hyperostosis. RA and DISH can co-exist. Unfortunately, both are incurable and can lead to very unhealthy bone. But, both can be treated.

Unfortunately, once an injury occurs, all you can do is treat it the best way possible with the type of bone present. The placement of an external fixator is not the end of the world. In fact, it is much better than what used to be done. It was not too many years ago that your mother would have been placed in skeletal traction. This would have meant total bed rest, which is not good for the body. At least with an ex fix she will be able to get up into a chair.

Take care of your mother as best you can. She has a long road ahead. Best wishes and good luck.

Hi Gaelic,

In February 2009, I had a head-on collision because a driver decided to cross into my lane at a very high speed.. I was trapped for an hour in my car and was airlifted to hospital.
My injuries were: Grade 1 Splenic lacerations, Liver lacerations, kidney lacerations and large adrenal gland hematoma. Fracture shaft of right femur, fracture of proximal fibula, fracture of right medial malleolus, a fracture of 11th rib left side posterior, right thumb fracture, a comminuted fracture of right calcaneus and a non-displaced fracture of the inferior and superior pubic rami.
I underwent leg traction (my femur snapped in half and both parts of bones went side by side) and had a leg reconstruction (femur-IM nail; ankle and calcaneus-plate and screws). A year after my femur was still non-union and I underwent surgery again for a dynamization and a release of tendons on the toes (right foot). In October 2010, my femur was still non-union so I underwent a IM nail revision in the femur. In March 2010, callus has started forming but its still not fully healed. Despite all the physio and efforts, I am still not able to put full weight on my leg, when I do my knee lets go and feels like its getting ripped out on the side. It’s excrutiating. I have post-traumatic arthritis in my ankle already, my joints are degenerating (x-ray results), my calcaneus is deformed and had flattened and I have a leg discrepancy since the accident (+2cm).
Since January 2010, I started having this lump forming (coming out) on my upper thigh (at the incision site) the mass is the size of a grapefruit. Its extremely painful at the touch and when I move it feels like its jamming in my sciatica. I went for ultra sounds and they couldn’t see anything… were now in May 2010 and the lump has just gotten bigger…. They sent me for another ultra sound and still nothing….
I’m in pain 24-7, I barely have mobility and no matter what things just don’t seem to get better… I was a very very active person (sports, hiking, going out etc..) and I had a very physical job. I was in great shape and now my body feels like its 100 yrs old… I don’t know what to do anymore and no doctor seem to have an answer either. All I know is that im 24 now (I was 22 at the accident)…and I’m loosing the best years of my life for someones carelessness…
I read the post and seen that you seem very knowledgeable. I hope that you might have a little idea or have seen a similar case in your carreer.
Thank you!
Regards,
Claudia

Claudia698,

Welcome to eHealth. Just a note, if you have a new topic it is best to start a new post. But, anyways.


Oh my goodness, with all those injuries, you are very lucky to be alive. In the days before the trauma systems, you may have passed just waiting for an ambulance to arrive.

You have had significant trauma to all the systems within your body. The injuries you have sustained are similar to those seen in the wounded warriors returning from the war.

This amount of trauma will take a long time to recover from, often as much as 4 or 5 years. You are young and athletic, so you have that on your side. You know how much it takes, both physically and mentally, to achieve what you want in sports and life.

Unfortunately, the body often robs Peter to pay Paul, so to speak. The body will take reserves from the uninjured tissues to heal the damaged ones. So muscles will atrophy and the bones will become osteoporotic. The heart, lungs, and immune systems are stressed to the max. The skin wants to break down and the GI tract just doesn't want to work.

As you have noted, any time you fracture into a joint you will develop traumatic arthritis. Calcaneus fractures are very difficult to treat, and widening is often a problem. This makes shoe wear very difficult and lends to leg length discrepancy. Even though the pubic rami fractures were nondisplaced, patients still occasionally have problems with dyspareunia.

The reason your knee is giving way is due to extreme weakness of the quad muscles. These muscles have been severely damaged by the fractured femur and the following surgeries. So, they have healed with a lot of scar tissue, that is not great in terms of contractile ability. They also have not had to do any work for two years, so the have deconditioned to the max. You have to start from zero and get them back into playing condition.

The mass in your thigh could be from several different things. Two that it could be; is a muscle hernia through the fascia (which would not look any different than muscle on an ultrasound) or the early stage of myositis ossificans (this is where bone actually forms within traumatized muscle. In the early stage, before it calcifies, it may not show up on ultrasound). Other causes of the mass would show up on the ultrasound, like infection, seroma, hematoma, AV malformation, granuloma, foreign body reaction, etc.

One issue that people often do not want to address is that of depression. You have been severely injured in an event that was no fault of your own. You have a long road ahead of you. You are missing out on things that you should be doing at your age. But, it is well known that depression makes pain significantly worse and it can lead to problems with the immune system and tissue healing. So, it is very important to address and treat.



So, you still have that long road ahead of you. But, you are young and strong, so you have a good chance of getting back to a happy, productive life. I know that after my fourth knee replacement and thirty-fifth knee surgery, I got out a poem that my Da gave me when I was 16 and read it again and again. It was the poem "If" by Rudyard Kipling. You might want to get a copy.


Wishing you the very best in your future rehab work. Good luck.

Hi Gaelic,

Thank you so very much for your prompt response and for all the information.
Your words are very encouraging.
wow you sure had a lot of surgeries.
Thank you again for everything, and I will definitly look for that poem!
Kind regards,

Claudia