Tuesday, September 25, 2012

Decision: Take Fixator Off or Get New Pins

Since the clindamycin hasn't cleared up the 3rd infection Dr. Scott gave Mary 2 options:
  1. He can take out the two pins where the current infection is and put 2 new pins in above the current 2 pins. The fixator would be a little shorter than it is now.
  2. He can completely take off the fixator and put on a full leg cast (top of thigh down to her toes). It would most likely be on for 4 weeks while her bone continues to consolidate.
Her bone looks good so we would probably be taking off the fixator in 6 weeks if we didn't have the complication of infections and limitations with antibiotics. The current antibiotic is knocking back the infection but it should be working better than it is and we are 99% sure Mary is allergic to the next antibiotic: Bactrum. So if she were to stop the current antibiotic the infection would just come back if we left the current pins in.

Dr. Scott explained we would continue to take an antibiotic (We are going to try Keflex as of today), put the cast on even if the infection is still there and it will clear up once the pins are removed. He can make a window in the cast to check on it if need be.

He did confirm if the antibiotic isn't working at all she would develop a fever. She has NOT.

Current status- 8 days after we noticed the infection
Pen marks indicate where it was a couple of days ago

Either procedure we pick will be done on October 4 and takes less than an hour.

New pins: pro: keep range of motion/ Con: risk of another infection, complication with antibiotics and end up in a cast anyway. (Mary really doesn't want 2 new pins power drilled into her bone.)

Cast: pro: removes risk of infection complications/ cons: lose range of motion

We are leaning toward the cast. If we didn't have possible complications with infections I would actually choose a fixator over a cast but it's not worth it.

Dr. Scott explained that if a bone gets infected it takes a long time for it to recover.

I learned Mary does not have an ACL. It typically doesn't grow with this condition. Never knew...

Close up of bone growth

Close up of pins where infection is

front view

side view

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