A limb reconstructive team will help facilitate your care and enhance the success of your treatment. This group includes you, a family member or close friend, your doctor, your nurse, and a case manager.
You – Your participation is most important for success of the limb correction process. You will be required to assist with external fixator adjustments and care for the frame on a daily basis. We need your dedicated commitment and important feedback along the way.
Significant Other – It is important that a family member or close friend be involved in the process. They also need to understand the procedure and what to expect. This person may assist with daily strut adjustments and pin site care, so they also need to participate in the planning process.
Orthopaedic Surgeon – Limb correction requires that your surgeon be involved in every phase of the process. He will make the initial evaluation, perform the surgery, plan your recovery, and closely follow your progress.
Orthopaedic Nurse – Your clinic nurse will coordinate the work of the entire team through each phase of your treatment. Your nurse is often the first person to answer questions, listen to concerns, and advise you about problems.
Case Manager – A care discharge planner will talk to you after surgery about your concerns. They can help you arrange transportation and medical equipment such as wheelchairs and/or crutches.
KEEPING A POSITIVE ATTITUDE
Although you will have a great deal of support available during the process, you are your own biggest advocate. Wearing an external fixator can be annoying and stressful. Keep these things in mind while you're going through the process:
- The discomfort associated with wearing an external fixator is usually mild.
- Anticipate and strive for early mobility.
- Keep a good attitude and have a sense of humor.
- Actively participate in your care.
- Allow enough time for normal activities which will likely take a little longer.
- Stay active. Go to the movies, go out for dinner, and visit family and friends.
- Stay busy. Read books, listen to music, finish projects you've put off.
The limb restoration process takes preparation and personal commitment. Here are some points to consider before you receive your frame:
- Hospitalization: You will likely stay in the hospital one or two nights.
- External Fixator Adjustments: Commit to following your prescription of daily strut adjustments.
- Scheduling Considerations: Plan ahead for time away from school or work, clinic visits, time of year, and transportation issues.
- Physical Limitations: Understand your limitations. Talk to your surgeon about expectations.
- Changes to Normal Activities: More time, energy, and rest will be needed for normal activities.
- Clothing Adaptations: Arrange for clothing that will fit over the frame.
- Insurance Coverage: Be familiar with your insurance and secure approvals prior to surgery. Consider medical equipment you may need.
Generally, you will be discharged from hospital on post-operative day 1 or 2. The frame will be wrapped in ace-bandages. Leave the bandages in place until your first office visit. The nurse at the clinic will remove your first bandages and pin site dressings. You do not start your own pin site care and dressing changes until instructed on how to do so by the nurse at your first office visit which is usually 7-10 days after surgery. The surgical extremity should be elevated above the level of your heart to avoid swelling for at least the first week you are home. Place pillows under your leg so your knee is extended and recline so you leg is elevated above your chest.
Prior to each of your clinic visits, make a list of your questions for the doctor. You may need help with transportation and your home-based team member should try to accompany you to each visit. Early in your treatment, you may visit the clinic every two weeks. Later on, your visits may become less frequent. Clinic sessions may range from a few minutes to a couple of hours. At your clinic visits you will have x-rays taken to determine the amount of correction or new bone growth. It may be necessary to repeat x-rays or obtain additional views at the same visit. Sometimes we make adjustments to the frame or have to tighten loose parts during clinic. If you have other appointments or are traveling from out of town please allow for these possible delays. Ask the staff for all necessary prescriptions prior to leaving the clinic. Please be patient and plan for extra time at clinic appointments.
Follow-up visits may include:
- Assessing the range of motion of the joints above and below the external fixator for contractures. (Without exercise the tendons and muscles shorten causing, stiffness and pain.)
- Checking the pin sites for infection.
- Checking the frame for loose parts.
- Checking radiographs for progress of the correction