Chandrakant Kothere was 39 years old when he suffered multiple compound fractures on his right tibia, extensive soft tissue damage and skin loss following a road accident. He was advised immediate amputation of his leg in a city hospital where he had undergone initial treatment. Since the patient was determined not to compromise his life at such young age, this Hindustan Petroleum employee chose to get the fractures of the leg stabilized.
The doctors there went ahead to treat him with stabilization of the bones and subsequent plastic surgery procedures to provide a skin cover. But in a few months following the treatment, the condition worsened as the site of infection on the leg had not healed. The fracture on the leg remained un-united. Unable to bear his body weight, the broken leg bowed in disproportion and he became shortened by almost three inches on one side. The writhing pain only worsening with time, it was almost impossible for him to walk without a pronounced limp.
The surgery was performed in two stages. The first stage was to clear all the infected and un-united bone at fracture site; align the leg and fix the bone fragments using a ring shaped Ilizarov External Fixator. A further cut was made in the top bone fragment so that the middle bone segment could be moved to take up the left over defect to correct the leg length.
In three months following the first surgery, the middle bone segment was moved downwards -- 1mm a day -- to achieve complete continuity. At this stage the second surgery was performed to slip a special titanium plate from under the skin to fix all three bone fragments together to achieve a solid union. Bone grafting was done at this stage. It took further two months for these bones to heal fully and the patient finally got a straight leg with normal leg length.
