CASE HISTORY
Hello and welcome to my story. As a child I was diagnosed with possible Rickets, my parents made
many visits to specialists but were told it would clear up of it's own accord (unfortunately it didn't).
I started having problems with my legs not long after I left school so I went to my doctor who sent
me for blood tests which came back normal. I then went to see specialists in Oswestry who
suggested that my most prevalent problem (pains in my shins when walking) was possibly due to
compartment syndrome. I didn't agree with the diagnosis so paid for a private assessment from a
specialist in Droitwich Spa who concluded that my problems were being caused by my legs being
bowed in appearance but treatment was very expensive and drastic. He proposed doing an
osteotomy on the tibia and fitting an Ilizarov device, and then an external bar fixator on the femur.
Thankfully he very kindly wrote me a letter to my GP explaining my problems and possible courses of
treatment to try instead of surgery, this involved shoe inserts and physio sessions for a few months.
These solutions didn't work so I went back to my GP who referred me back to Oswestry, where the
specialist again suggested possible compartment syndrome and wanted to operate to remove some
muscle tissue. I wasn't happy with this as the physio I had seen previously suggested that my pain
was neurological rather than muscular and was probably being caused by the bowing of the shins. I
started to look online for a solution to my problem, that's when I encountered the Nuffield
Orthopaedic Centre website and read about their work and the referral process. I emailed Marion
(Maz) Sutherland and told her about my problems and she told me that they would see me in their
clinic and that they did lots of procedures for congenital defects, all on the NHS. So I went to my GP
with the referral details and he arranged it for me through the choose and book system. For some
reason they arranged for me to see a different clinic so I again contacted Maz and she was very
helpful in re-arranging the appointment so that I could see Mr Martin McNally in February 2011.
THE DIAGNOSIS
I made the trip down to Oxford from Birmingham on the train and upon arrival at the hospital I was
sent for x-rays before seeing the consultant Mr McNally who explained that the outward curvature
of my shin bones was causing my weight to be spread unevenly across my joints which was causing
the pains and would eventually lead to severe joint problems and an increased chance of needing
new joints later in life. He described the medical procedure for correcting the deformity and with my
consent he booked me in for an operation to fit Ilizarov external fixators to both legs below the
knee. Mr McNally explained that although doing both legs at the same time would be difficult in the
short term, it would reduce the amount of time I would be off work and in frames. I then met Maz in
her office and she went over the procedure and associated risks in more detail as well as the
benefits.
THE OPERATION
Before the operation date I had my pre-op and met Mr McNally and the clinical team once again and
they answered a few questions as well as recapping on what would be happening during the
operation as well as offering invaluable advice on coping with the frames.
After the operation on Friday 20th May 2011 I was moved to Ward D and Mr McNally kindly took
time to visit me on the Saturday to tell me the op had been a success. The ward was very clean and
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the nurses were all very nice and receptive to patient needs. The food was good but the anaesthetic
made me a bit ill for a few days. My family were only able to visit on the Saturday due to work and
the distance involved. I did suffer a bit from homesickness which was made worse by not being able
to get out of bed much due to the operation. Thankfully Maz visited me regularly which kept my
spirits up and my girlfriend made the long journey to see me later in the week. The hospital physio
staff came every day to assess my condition and try to get me walking a bit at a time as I would need
to be able to manage walking short distances in order to manage at home. I was discharged after a
week and went home where arrangements had been made for me to sleep downstairs because the
physio didn't think I could safely negotiate the stairs and I agreed as I found my legs were really
weak, the frames were rather cumbersome and I had very little balance.
THE REAL JOURNEY STARTS HERE
I had begun distraction whilst on the ward after Maz had carefully explained it to me, it involved
using a small spanner in order to turn the nut which was dice like in appearance with four numbered
positions which corresponded to the four turns I needed to preform each day in order to slowly
open up the distraction site in order to lengthen the bones thus correcting the deformity. The
process itself is painless as each turn was only 1/4 of a millimetre, the real pain came from the
muscles which are being stretched and are also weak from lack of activity! The clinic had provided
me with plenty of painkillers but I couldn't take anti-inflammatory drugs like Ibuprofen as they
inhibit bone growth so I had Tramadol and Codeine. Everyday life at home was hard work both
mentally and physically because it was impossible to do normal tasks by myself such as carry things
like cups due to having crutches even going to the toilet was complicated but the physio department
did provide me with a very useful toilet stand and a bath board which were lifesavers and my family
(in particular my mum) did their best to help me with most tasks and keep me sane.
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After around 30 days I returned to the clinic and had a check-up with Maz and Mr McNally and they
were happy with my progress and replaced one of my lengthening bars on the frame with a solid bar
and explained I just needed to a few more turns on the other leg and the legs would be correctly
aligned. So I went home and did as they asked along with doing my exercises in order to stretch the
muscles and keep them healthy. Sleeping was becoming easier as I no longer needed to sleep on my
back which I found very uncomfortable, and the pains became less intense. I could also manage the
stairs but I still had problems with the pin sites, some of them tended to leak fluid all day and others
would try to heal over and stick to the metal pins which was quite painful! So regular cleaning of the
pins sites was essential but Maz had provided me with a large amount of dressings and cleaning
supplies which was a big help. On my next visit to the clinic I saw Mr Stubbs who changed the one
remaining lengthening bar and encouraged me to try and get about a bit more in order to stimulate
bone growth and strengthen the muscles. I was gradually able to do more and more for myself and
eventually I found I could manage without the crutches. After a few more visits to the clinic and
plenty of protein rich foods (as suggested by Maz and Mr McNally) I was given a fantastic piece of
news by Mr McNally as he informed me that the frames could now be removed just before
Christmas.
Operation Number Two
I got down to Oxford very early in the morning on 16th December 2011 and saw the nurses in Ward
A who got me ready for surgery. I went down later in the day and woke up in the recovery room free
of the frames at last! I now had some braces on both legs but they felt much better than the fixators.
Again the anaesthetic made me feel quite ill and I unfortunately was sick but the ward nurse was
very understanding. I went home the same day and started to mobilise more and after a while I
could walk unaided and sleep without them on. Eventually Mr Stubbs said he was happy for me to
walk around the house without them on but to be careful when going outdoors as it was winter and
I could slip and break my legs, so I should wear the braces. After a few more weeks I returned to the
clinic and saw Maz and Dr Ferguson who said they were pleased with my progress and discharged
me from the clinic. I still have a few more physio sessions to attend locally in order to be completely
fit but the journey is almost over.
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I honestly cannot thank Maz or Mr McNally enough for everything they have done for me, I feel like
I've been given brand new legs as well as closing a chapter of uncertainty over my future health
which in turn has given me a massive confidence boost. I would whole heartedly recommend them
to anyone who has any orthopaedic problems, the hospital is clean and modern, the staff are
friendly and Maz and Martin are two of the best people I've ever met. They both have amazingly
positive personalities, are extremely knowledgeable, calm and professional and always genuinely
interested in the patients well being. Although it has been a lot of hard work and even some tears, I
will actually miss going to see them both in the clinic because they are wonderful people, thank you
so much Maz and Martin!!!
Standing X-rays before starting surgery
Standing X-rays after removal of the frames
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