The Accident
On Tuesday, August 15, 1995, at around 4:00pm I had a head-on collision with a van in Seattle, WA. The van was making a left turn across our two lanes of traffic, and apparently couldn't get all the way onto the side street. It stopped in my (right) lane, and I had less than a second to stomp on the brakes of my Ford Aspire (AKA "Expire") rental before crashing into it. A combination of seatbelts and air bags "saved my bacon" (in the words of the emergency guys). I did, however, suffer a complete compound fracture of the right tibia and fibula (both bones of my lower leg). Apparently, all my weight came to bear on that leg, which was locked against the brake pedal.
The Hospital
Emergency crews got there quickly and whisked me away to Harborview Medical Center, an outstanding trauma and orthopædic hospital. After giving me pain medication and cutting off my clothes, they took lots of X-rays and prepped me for surgery. In this picture you can see where the seat belt tore the skin on my upper-left chest, and where my forehead met the air bag.
During a 2.5 hour procedure, a titanium nail was inserted into my weight-bearing tibia. Five screws were used to secure it in place. The surgery was performed by Dr. Jens Chapman, then of the University of Washington's Orthopædics Department. Three days later, the open wound above my ankle was again cleaned and finally sewn closed. My fibula was left unaffixed, and the doctors promised me it would align and heal itself in due time. The nail is intended to be permanent, and would only be removed if it caused trouble later. After some rehabilitation exercises that taught me how to use crutches, I was released after six days, on Monday, August 21.
The Recovery
During a 2.5 hour procedure, I was lucky to have several friends living in Seattle, and Jed and Allison Lengyel put me up in their house for a few days after my release. On Wednesday, August 23 I flew home to Ithaca, and began re-establishing my lifestyle (or some fraction thereof). My Mom came to visit and help me around the house for a few days. My upper body was regularly sore from using the crutches and hoisting myself around.
I was not allowed to put weight on my right leg for six weeks, during which time I wore a removable, ski-boot style light cast. I began seeing Dr. Robert Hole, an orthopædic surgeon here in Ithaca. On September 29 he gave me permission to start putting weight on my right leg. Walking on the leg as much as possible was my prescribed physical therapy. At the point when I began using my right leg again, my right leg's muscles had atrophied (and my left leg's muscles had grown), yielding the following circumference disparities:
| Left | Right | |
|---|---|---|
| Thigh | 23.0" | 21.0" |
| Quadricep | 18.5" | 17.0" |
| Calf | 15.0" | 13.5" |
The Rehabilitation
From the time I was allowed to walk, I made steady progress towards being 100% recovered. Many improvements happened slowly, and I can't say exactly when I was able to do certain things or when I didn't feel various types of pain. The following is a rough timeline of my recovery:
- 6 weeks - allowed to walk with crutches or cane
- 8 weeks - able to play six holes of golf, walking with cane
- 10 weeks - no longer using a cane
- 5 months - no longer limping, went cross country skiing
- 7 months - playing non-contact ice hockey
- 10 months - playing softball, racing for several home runs!
- 1 year - released by doctor, nearly 100% recovered and discomfort-free
These X-rays were taken at my final examination on August 15, 1996 (exactly one year after the accident!). Note the substantial bone growth on three sides of my tibia (though not as much on the front of my shin). You can also see where one of the upper screws was surgically removed to allow the bone to compress and mend more completely (this was done in November of 1995). I was cleared for any physical activity, including kicking things! I was quite pleased with the way the fibula aligned itself and healed. Quite a bit of bone grew over the head of the screw at the top of my tibia. If the rod were ever to be removed, they'd have to chisel this sucker out.
(Update in 2016) After more than twenty years, I am happy to say that my leg has not caused me any substantial problems since the break healed. There is a small patch of skin below the site of the compound fracture where I do not have any sensation, but I rarely notice it. When I ski for a day, I do have some discomfort where one of the remaining screws above my ankle presses on my skin when I lean into the ski boot. I try to relieve this by placing padding on my shin around the screw. Other than that, I have no problems and consider myself very fortunate.
Top Ten Questions About My Leg and Accident
- Is the rod going to be taken out?
Not unless it causes some problems later (such as an infection). - Have you recovered 100%?
I am pleased to say that I have. - Are you scared of driving now?
Sometimes when I pass a truck (or even if one drives by when I'm walking) I get a chill up my spine. I haven't flinched while driving, and pretty much drive the way I always did. - Does your rod set off metal detectors at airports?
No. I've been through dozens of detectors since the accident, and nothing has registered. - What happened to the marrow where the rod is?
I understand that the marrow in your large bones (like the tibia) is less dense than in smaller bones, and so it probably got compacted. Even if some was destroyed, I don't think it will affect my health. - What happens if you break the leg the same way again?
The rod is actually breakable, so certain forces might be able to break both the rod and leg. My guess is that in a similar accident the bone would hold up and my ankle or knee would sustain more damage. - Do you feel it in your leg when a storm is coming?
No. At first I couldn't tell because there was always a varying amount of pain in my ankle. Now that things have settled down, I'm sure that I don't notice the weather. - Does your leg get really cold in the winter?
No. I've heard stories of people with plates on their bones whose skin turns blue when it's cold. I haven't felt anything, as the rod is deep within my leg. - Is your leg Bionic now?
Yes. Yes, it is.
Remove the Rod?
Whether intramedullary rods should be removed or left in place is a subject of some debate in the medical community. Thomas Anthony, a visitor to this page, has compiled some information about studies and statistics related to nail removal, and kindly shared this information with me. Thank you Tom!
More Broken Leg Stories
You can read many more patient-supplied stories about broken legs at MyBrokenLeg.com.