The consultants were pleased with the progress the wounds were making and the 'Exit' wound where the bone came through almost looks 'Sealed' with scar tissue and I'd imagine that by this time next week it will be fully sealed. The 'Hole' is slowly healing and everytime I see it has improved and this looks as though in another couple of weeks it's going to be pretty much sealed like the 'Exit' wound? The impact wound still has the scab over it, but the scab does seem to reduce in size each time.
The consultant did a test where he tapped with his fingers along the length of the Tibia, asking Joe if it hurt and Joe said 'Nah'. He then put his fist against his heel and banged that fist with the palm of his hand sending force up through the length of the bone. They checked the mobility of the ankle and seemed very happy with that too. The consultant Mr Wakeman said that he was a little disappointed with the progress of the bones as indicated by the Xray (See below).
But then tempered that with the warning he'd made in week 1... The nature of the impact had meant that the energy that had transfered from the car through the fracture has basically mean that the tissue that surrounds the bone had become very seperated - he pointed out on the Xray that at least half of the bone in the section in this image above the crack in the Tibia was exposed and sticking out of Joes leg. What this means is that the tissue that then would have supplied the calcium and the blood cells that affect the repairs to the bone have to repair and grow back to thier place surrounding the bone before it can start to knit together. He said "All along we've been aware of the fact that this was going to be far worse than a normal (Sports/accident) style break and would be eight weeks as an absolute minimum to knit together well, so I'm not surprised that it still looks like this and it's going to take some time as we expected".
Despite this though he then went on to say that he now wanted Joe to get some scales and weigh himself. Then say if he was 8 stone, he then wanted him to press down on the bad leg onto the scales so that it would register 50% of his weight (4 Stone), make a mental note of what that feels like and then start to using the leg with that amount of pressure. So, that's a good development. The open wounds seen below are all coming along well and I've been given the dressings to do on Monday due to the Bank Holiday, so I may give you all a treat and video it and what happens in the clinic when they clean and dress it!
Next visit... Six weeks! Six weeks still with the stinky boot and that takes him right up to when he breaks up from school. By then though I'd have expected that the wounds would have all sealed and Joe would have been able to get in a bath without any protection on his leg? Fingers crossed eh?
'The Hole' Looking pretty good - two weeks maybe and it'llbe looking like the wound below?
The 'Impact' wound, this is the one where they're trying to slowly remove the scab to encourage a better re-growth of the tissue which creates lesser scars.
Overall everything is coming along really well.
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