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For the voyeuristic among you, some edited highlights from the consultants notes for the operation (plus my translation
Dr: Serious nature, limb threatening nature and risk of AVM(100%) explained along with their risks
Translation : Dr told Nick he had done a proper job on the ankle and it was quite possible he would lose the foot. There was a 100% risk of AVN (losing the blood supply to the bone) which is not good. Isn't 100% risk a certainty [pedant]?
Dr : Completely displaced rotated and dislocated talas body located behind tibial platform
Translation : The big bit of the talus bone was very definitely in the wrong place and hiding behind the leg bone instead of being fixed underneath it. This is sub-optimal
Dr : Commimuted + multi fragmentary fracture
Translation : Lots of chips, fragments and generally a messy break with lots of debris.
Dr : Eventual reduction with combination of pointed reduction clamps to pull body fragment from impacted position in hind foot
Translation : Eventually got most the bits of bone back together with pointy pliers to pull the bits out that were stuck in the back of the heel.
Dr : Trethowan ring handled retractors around body fragment to protect tibialis posterior flexar digitomy NV bundle which were all very firmly compressed but appeared intact
Translation : Hooky tools with looped handles used to protect the main leg muscle, toe wiggling bit and Neurovascular bundle, a term applied to the body nerves, arteries, veins and lymphatic that tend to travel together in the body, which looked squashed but not broken.
Dr : Very difficult reduction and unstable as severe comminution and anterior and medial bone loss
Translation : Very hard to put this lot back together as there was lots of bits of bone debris and bone just plain missing from the front and middle
Dr : Medial malleolar osteotomy performed with combination of 2.5mm drill holes and microsagittal saw and osteotome
Translation : Used a drill and saw to get stuff in the right place
Dr : Talus reduced by closest alignment with direct visualisation of neck and medial surface
Translation : Put the talus bits back together judging their position by eye.
Dr : Orientation best for bone stock available and mechanics of fracture
Translation : Might not be in the best position but it is the best given what we had to work with.
Bet you're glad you weren't last on the list on a Friday...
With an injury like that you get top priority and are rushed past all those malingerers with nothing worse than a gaping flesh-wound, as my wife found out when she did something similar.
Good luck with the healing WCA.
Sounds like you got the best outcome from something very nasty and bravo to the surgeon.
Good luck and healing vibes to you.
Mostly Balanced - Hope the wife is okay. Your right about queu jumping, from the op notes:
Dr : GA ("crash induction" - requested theatre ASAP)
Translation : Nick's back, take him to his usual theatre and start work immediately
Nick : Saturday afternoon in the theatre and I slept through the whole show 🙁
So, would you class yourself a a regular customer at your local A&E? Have they given you a frequent flyer card yet?
On Friday I'm going to Laandon to visit an overseas customer whose lower leg got broken by a motorcycle taxi. They gave him a nice metal plate to hold the bone together but also gave him a nasty African bacterial infection, at one point he nearly died but is now on the mend in London after three more operations.
How many Nectar points is that one worth?
globalti - I hope you client gets well. I had an infection scare last week (see previous photos) but got away with a week of penecillin
Nick. Wifey says thanks. Her break was 6 years ago now and also inolved a dislocation. She still has restricted movement in the ankle and it stiffens up badly overnight or after an hour or more sat down.
Did he actually say "you may wake up missing a foot" .. ?
I feel for you mate! I have never met you but you always seemed like a nice chap on here.
I fell 7m 10 years ago and smashed my calcaneum and broke the talus into 4 piece's.
Not been riding for about a year to give my foot/back a rest.
Here are my pics to help try and cheer you up! You are not alone!!!
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Just thought I'd post a 'wishing you a speedy recovery' note, and add that I share the slightly voyeristic interest in how you get on. Putting the pain element aside, what you've posted is very interesting, as someone who is known to hurt myself fairly regularly (not to that extreme though!) Good luck with the healing, and keep posting the updates. Let us know when you're back on the bike...
Oh my eyes; enough already!
There are some things you can't unsee.
Well I think you are being very chipper about the whole thing.
I do have a question though - this truly was a 'World Class Accident' but that was now so what was then?
[i] this truly was a 'World Class Accident' but that was now so what was then?[/i]
I think you are asking how I got the name originally.
I wrote an article for the STW magazine describing how I moved from being 'No Spokes' to 'WorldClassAccident' but apparently it was too long so the abbreviated version was published as 'The Hard Way to become a Poet"
A long story but basically I came round after one crash and the guys were say "Top crash", "Best of the Day" and similar.
I was riding with a group in Wales a few weeks later and had a slight disagreement with gravity and they said "Better than the last crash" "How come you are still moving"
I managed to crash again with a few people from both groups there and they said it was definitely more spectacular than the others they had seen and was truly "World Class". WorldClassAccident seemed to stick.
This coincided with the project manager from one of my clients recognising me from my cuts and the cast (the last accident) and asking if I was NoSpokes. When I confessed he got quite angry about the time I spent on STW and out riding when I should have been working on his project. Fortunately I remembered a thread where he had revealed some intimate details about personal shaving so could shut him up quickly.
It seemed a good time to lose the No Spokes name and so I because WorldClassAccident.
I first remember you for setting your garage on fire whilst experimenting with DIY lighting.
Diane. WCA's catalogue of 'accidents' could probably fill a thread of their own. The one I was closest witness to was the 'crowd surfing without a crowd' incident at the Big Bike Bash. There was a crowd, but they all saw the size of him and parted like the Red Sea in front of Moses when he dived.
Neither of those made the printed article: http://singletrackmag.com/magarchive/issue-23/
I am glad that the shoulders are better after the stage dive. It took over a year after I dislocated them both before I could lift my arms above my head. I wouldn't fancy using crutches at the moment with bad shoulders, it is painful enough with the broken wrist.
Haha WCA - wot u like? 😀
Glad to see you're on the mend WCA, looks like an horrific injury - hope you're recovery ends with the best case scenario! (Although SPD attachments would be cool, doctors don't seem to like the idea of amputating painful limbs and replacing them with something superior! 😉 )
these pics are making my balls retract
<table style="width:auto;"><tr><td><img src="https://lh6.googleusercontent.com/-3z4hnWkea0c/UJOyhZlZSlI/AAAAAAAADeM/dGrgsQAEGu0/s800/image.jpg" height="800" width="598" /></td></tr><tr><td style="font-family:arial,sans-serif; font-size:11px; text-align:right">From Ankle</td></tr></table>
That's looking a lot better WCA! 🙂 How are you doing now?
This may sound crazy.. but with the restricted movement, future constant pain etc did you ever consider the better option would be to lose the foot?
Reason I ask is that I fell 30ft when I was 16.. landed stood up and broke both my legs pretty bad.
Luckily they both fixed and I had a pretty full sporting life (only restriction being running distance). Even 30 years on my left ankle often gives me pain, leaving me wondering if in older life it would be better not to have it there.
Yeah.. weird, but have you considered it?
WCA. Any updates?
Just showed this thread and the pictures to my wife and, after she stopped feeling sick, she's thinking her leg is not so bad now.
No real update. I am just sat waiting for the next meeting with the consultant on December 17th.
The novelty of crutches and a cast has really worn off. I managed 4 days working in London last week staying in a hotel but it was hard. I hadn't realised how tiring walking with crutches is when you cannot put one foot down at all. I have blisters on the hands from the crutches and my good ankle and both shoulders ache from the strain.
Main problems are boredom and moving around.
A few people have asked about keeping the foot if it is painful and useless and to be honest I am not too worried about losing it if that is the better choice. The is something called the Erti technique that basically cuts the bottom half of the lower leg off and the joins all the loose ends up nicely so it remains a viable limb rather than a messy stump. This reduces the risk of a lot of the future medical issues traditionally associated with leg stumps.
Mind you, the price of feet is phenomenal. You could get a decent mountain bike for the cost of a foot!
the price of feet is phenomenal
What would you get 'trade-in' for your old one? 😉
Good to hear you're staying positive. Can't imagine how I'd be if it was me
The Proprio foot cost about £15,000
I want to keep the original foot, hollow out the ankle and make a nice desk tidy
Strange, I was just going to hobble upstairs to search for this very article from print versions.
My left leg is in cast as I broke both tibia and fibule six weeks ago on a stupid bike crash. I can't wait that the cast will be taken off Monday (if x-rays are OK). My bones were bolted together back with the help of couple of nails, handful of screws and some plates but this seems like a minor injury compared to WCA's injuries. Good luck with recovery!
Still, my injury really pisses me off as I was just going for easy ride with mates. I did couple of DH sessions in the summer riding fairly close to my limits but somehow managing to break the leg about 2km's from home is just really bad luck?
My accident was trivial and if the ladder hadn't pulled my leg backwards the foot probably wouldn't have com off.
The real problem is that I bust the same ankle seven years ago and lost the blood supply to the front of the talus. This meant that bit of the bone was pretty.much dead so when the leg bone hit it, it just crumbled. There no isn't enough bone to fix the ankle back together. The hope is that the bone will reform or bond somehow before I get the scan at Christmas.
Here's hoping!*
* or possibly hopping
😯 😯The Proprio foot cost about £15,000
Even more basic ones are a couple of grand for anything k3 or k4 level (k ratings for reasonably active people)
There's a few lefties on [url= http://www.ebay.co.uk/sch/i.html?_odkw=prosthetic+foot&_osacat=0&_from=R40&_trksid=p2045573.m570.l1313&_nkw=prosthetic+foot&_sacat=0 ]Ebay[/url]
I felt humbled at the physio after two month non-weight bearing.
I'm balanced on the parallel bars - complaining about lack of mobility - 'look over my shoulder to see a fella with a whole bag of different style prosthetic legs - as they struggle to get any to fit. 😳
I am 2 months into zero load bearing. It really sucks. Another month to the decision and then another three months which ever way the decision goes. Not looking forward to the rest of this winter.
Chin up man. The way that modern medicine is going, you'll be able to regrow a new foot soon. After all, they grew that ear on a mouse's back, so why not a foot on a wallaby or something? My wife nearly lost her mind being at home when her leg meant she could not drive. I was really glad when she finally got the second cast off and she could actually get in to work. I think she was even glad to be back!
Keep us up to date ok?
I've go to say WCA I find your attitude very inspiring. All the best for the future.
Wca, sounds like you need a few hours talking crap with some silly people!
The other Mr hoppy might be around for a little trip if you are this week 😉
Willard - fortunately I can still do my job (mostly) so that helps a bit. Still spend the whole day sat or laid in front of the computer doing work at home and then at the weekend I do much the same, especially in this shitty weather.
Chipsandgravy - thanks for the complement. Not sure i am doing much that is inspirational, just sharing my story because I am a bored attention whore. ;-).
Cider - I need to check but I might be able to find a window in my schedule for you to visit next Wednesday. Feel free to bring the tribute act
Missed this WCA, don't look at STW much any more, but... get well soon!! Ouch x
The Proprio foot cost about £15,000
blimey - an arm and a leg for a foot!!
good luck mate - i hope to see you back on your feet/stump/peg/other at BBB2013!!
I've go to say WCA I find your attitude very inspiring. All the best for the future.
+1. Kudos. Good luck.
Wca, sounds like you need a few hours talking crap with some silly people!
Hiya! (-:
The Proprio foot cost about £15,000
You can almost get a workshop for that sort of money.....
Seconded wanting you to be better for BBB2013. We were going to come this year but I had an operation on my ankle for a broken Tibia. I can't imagine being off the foot for as long as you will be, 5 weeks of no weight bearing was hell for me. I wish you all the good luck in getting better.
It was the crunch day meeting with the consultant.
Has the ankle shown enough sign of recovery?
Will it survive!
Amputate or Fuse?
Woot!
Woot!
Woot!
It is Fuse.
I am being referred to an ankle specialist consultant (well, two actually) to get their views on exactly what the best option is. Possibly a nail up through the heel, talus and into the leg. Possibly a Pan-talur fusion. just got to wait for the next appointments some time in January.
What ever, I will still be able to count past 15 which is the result I wanted.
Good to hear that in time for Christmas. Have a good one.
Great news.
Loving the "take it on the chin" attitude, I'd probably have gone off a bridge.
You sir are a superstar.
BOL.
Keep us informed.
Didn't realise you could go past 10 let alone get to more than 15! Good news though mate but still sounds like a lot to go through. Hope it less horrible than it sounds
Slippers for Christmas after all then 😉 . Fantastic news!
Top news 🙂
Mama dirt - save money and find some one with a duff left leg. One pair of slippers equals two presents!
Fingers and toes gives 20. 21 if you are a clever dick
Brilliant news WCA, so pleased for you. 😀
Just hang in there, January isn't far away!
Great news!! 😀
Great news fella! I was concerned you were going to end up even more legless than last time I saw you!
A scary prospect 😉
On the downside, if you were to get a set of acme rocket powered roller skates, it's going to cost you potentially twice as much in fuel
Fused ankle better than no ankle eh ..hopefully the pantalar fusion will take all the pain away as everything will be fixed together in there ....good luck
Excellent news!
Good news!
Jeez WCA, thats great news, hang on in there tiger, all the very best to you.
[i]On the downside, if you were to get a set of acme rocket powered roller skates[/i]
Bloody hell, don't give him ideas! Especially when he's got inventing time on his hands!
Great news Nick... We await the photos of the hammer & nail treatment 🙂
Anyone heard from Nick recently? Any news?
good news apparently
[url= http://singletrackmag.com/forum/topic/wca-ankle-update-doctors-got-it-wrong ]http://singletrackmag.com/forum/topic/wca-ankle-update-doctors-got-it-wrong[/url]
MB - had a liquid lunch with him yesterday, and can confirm the news is excellent!
The car purchase plans are starting again too 😆