Elan’s surgery yesterday went well.
The fixator was removed and replaced by a brace. The brace keeps Elan’s legs abducted or spread apart. Doing this allows the reforming femoral head to grow nicely into the hip socket. Elan will wear the brace full-time for 2 months. Then, only at night. He will continue to use the walker and wheelchair. There is some discomfort from surgery and the brace but, that should improve.
In addition to removing the fixator, the surgeon did an arthrogram or shot dye into Elan’s body and took x-rays of his hip in real time. This offers a better picture of where the hip is in relation to regrowth. He also injected Botox to loosen the muscles some. Because Elan’s range of motion is so good, he didn’t have to release the tendons again or do an osteotomy.
The news is all good. The pictures show a perfectly round ball that is forming. They also show nice spacing between the femoral head and acetum or hip socket. Elan’s ROM or range of motion is excellent. ROM is critical and includes his ability to lead an active & pain free life. Dr. Standard, Elan’s surgeon and a leader in this field, said that the pictures are the best he’s ever seen. He characterized the progress as fantastic. He also said that, if this continues, Elan will become his poster child.
We ran into a Resident/Fellow in recovery that remembered us from one of our earlier, fact finding trips. Turns out that he was at Shriner’s Hospital in St Louis and in the room with us as the Drs. were reviewing Elan’s case. He said that Elan’s progress with the fixator was ‘stunning’. While this is good news, it’s also interesting. The external fixators use for Perthes is relatively new and controversial with many in the established medical community favoring tried and true treatments such as long term casting & more invasive surgery.
Elan is slowly getting used to a fixator free life. He remains anxious and doesn’t want to do anything that will jeopardize the progress that he’s made. He remains on valium for muscle spasms and Tylenol laced with codeine for the time being. Jan and I are relieved. Once again, we’re very thankful.
The last six months have been grueling but there is a light at the end of the tunnel. We are trying to impress upon Elan that however painful, the experience is worthwhile if it returns him to good health. Elan has a long road ahead but, we’re off to a very good start. We’ll be staying in Baltimore for the next 2 weeks while Elan undergoes extensive physical therapy. Then, we’re back to PT three times a week and lots of work at home.