Labor Day Fun

Well, Labor Day weekend 2011 did not turn out as we had hoped. Tara and I were planning a full weekend of projects around the house such as cleaning out the garages, organizing the basement, and taking care of a recently broken limb in the backyard that had partially broken and crashed into the neighbors backyard. As it turned out, the limb ended up taking care of us, or more specifically Tara's left ankle.

Monday morning we were out in the backyard cutting the initial small branches and twigs from the limb. We both were under the impression the limb was partially broken and hanging by some unbroken wood along the lower margin of the branch. As I was removing a few small branches, the limb suddenly fell from the tree trunk. Tara unfortunately was near the trunk at the time. The limb (that in total probably weighed more than a hundred pounds) fell and struck Tara's left thigh along the outside margin. It continued down taking Tara with it, finally landing on the outside margin of her left ankle. I turned just in time to see the whole awful scenario in slow motion - I could do nothing but watch. At this point I count my blessings that it hit Tara on the leg and not on the head or spine. Needless to say, I ran to her and removed the limb as quickly as I could (my wife adds in "superhero like fashion, all he was missing was the cape"). There was immediately swelling at her ankle, and I initially held out some false hope that it was a bad sprain. I soon could tell I was wrong. Her pain was too great, plus the writhing in agony, waves of nausea and semi-lucid speech were good indicators something was seriously amiss. When she told me to tell the kids she loved them, I knew there was something bad wrong. I ended up driving the car into the backyard, scooping her off the ground, and plopping her into the passenger seat of my car.

I guess I'm glad I know telephone numbers and all the ER guys by first name. We were met at the door at the ER. Tara was back with an IV and pain meds on board and becoming comfortable within twenty minutes of getting into the car. We were fortunate that one of the best foot and ankle ortho guys in town was on-call for the ER that weekend. I talked to him on the phone within 30 minutes of arrival and he was bedside in under an hour. We reviewed her imaging and we were scheduled for the OR around three in the afternoon. Typically, these things get splinted and go to the OR the next day. As it turned out, it was a busy holiday weekend with limited OR staff. We didn't get to the OR until 5:30 PM. We got home at about 10:00 that night.

For the medically inclined members of our audience, I'll discuss Tara's injury in detail. She has suffered a Maisonneuve fracture of the proximal fibula and distal tibia. This injury is named for a French surgeon that first described the mechanism in the 1840's. This injury consists of a fracture of the proximal third of the fibula with disruption of the intraosseous membrane between the tibia and fibula, and finally exiting of the force along the medial aspect of the distal tibia resulting in either fracture or ligamentous disruption at the deltoid ligaments of the medial ankle. In other words, this really sucks.

As demonstrated on the intraoperative radiograph above, it required placement of two screws through the medial malleolus (which I might add are perfectly positioned; the fracture line is barely perceptible). One screw was placed from the anterior to posterior aspect of the ankle to fix the posterior malleolar fracture (seen above on the lateral view of the ankle). Lastly, two screws were placed across the distal tibiofibular intraosseous syndesmosis to support the ligament as it heals. Unfortunately, these last two screws will need to be removed about eight weeks after placement, requiring another minor surgery.

For the time being, Tara is completely non-weight bearing on the the left lower leg. She's hobbling about on crutches. I recently rented her a knee scooter. It looks kind of like a Razor scooter with a padded rest for her casted left lower leg. Our church family has mobilized and thus far we are scheduled for nightly meals for two weeks. Our dear friend Jan Lira from church has been on Tara duty all week - shuttling kids, helping with daily living duties (Mommy, Mommy I need some juice!!!), and generally filling in where a completely mobile Mommy is needed. Jan and husband Danny will play a crucial role next week in shuttling kids, as well as other dear friends from church. I'm off the third week of healing. Hopefully, by then she will start to be a little more mobile, and able to drive.

Well, that's our situation. It's shaping up to be a challenging Fall. Nevertheless, we continue to count our blessings and thank God for our dear friends. We'll keep you updated. Maybe if I'm lucky I can snag some radiographs when she gets her screws out where you can see the drill and everything!

BB