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Kathy's Orthotic Shoes

Bespoke orthotic shoes allow limb reconstruction patient Kathy to walk her dogs again

20/04/2021/in Patient Stories

In 2009 Kathy suffered a very serious fracture to her right ankle after falling from a horse. The break was so severe that it was touch and go whether or not her leg could be saved. But, under the care of her local hospital, her leg was in plaster for six weeks, and then in an external fixator for a further six months. However she was referred to the limb reconstruction unit at Kings College Hospital for a bone graft, and was there fitted with a Tailor Spatial Frame (TSF), which she wore for another six months. In December 2013 she had her last surgery, and was fitted with her second, and final, TSF which she had to wear until May 2014. Her treatment was very successful.

But the injury had left Kathy with a right leg two centimetres shorter than her left, and a flat foot, due to the way the bones had fused. Consequently she needed specialist orthotic shoes to adjust her gait and minimise the pain. It was a problem to find footwear which was functional and comfortable, let alone aesthetically pleasing. The standard orthotic shoes available didn’t really provide the solution that Kathy needed.

The options are extremely limited for everyone, but it’s especially difficult for women who might need different footwear for different occasions – wearing a skirt or for formal occasions, for example. For many years, Kathy wore Fly wedges https://flylondonshop.co.uk/womens/wedges?filter=1&category%5B%5D=12, for the extra bounce they have in the sole, adding a thick insole in the right shoe for balance, but it was not an ideal solution, and didn’t lessen the discomfort. She found herself wearing Crocs clogs https://www.crocs.co.uk/on/demandware.store/Sites-crocs_gb-Site/en_GB/Home-Show or even mismatched shoes. Once, in desperation, Kathy went to a ball with trainers on her feet!

After five years of struggling on (and spending a fortune on footwear which didn’t ever really do what she needed), at the suggestion of REBUILD Kathy spoke to the London Orthotics Consultancy https://www.londonorthotics.co.uk/orthotics/ about options to create bespoke shoes to match exactly her requirements. It was important to find a right shoe which not only had a small raise but which rocked a little, giving her the gentle placement and lift she needed. Rebuild undertook to cover the cost.

As she really wanted to be able to walk outside on muddy terrain, in all weathers, Kathy needed supportive footwear which kept her feet dry and enabled her to walk with stability. She managed to find on ebay https://www.ebay.co.uk/b/MBT-Womens-Shoes/3034/bn_774468 a pair of MBT walking boots https://uk.mbt.com/mbt-technology – a very rare find! – which it was possible for LOC to customise for her: right shoe at optimum height and rock for her shortened leg, left shoe flattened to accommodate.

The result was amazing.

Kathy says, “The LOC did a fantastic job, and the boots they created for me are out of this world – I am really pleased. It’s made a huge difference to me. I so wanted to be able to walk with my dogs again in the countryside and never dreamed I would be able to do so. It would not have been possible without the involvement of REBUILD”.

Since then, Kathy herself has had a pair of suede boots adapted, which means that she can wear skirts and dresses in the winter. She now knows exactly which shoes can and can’t be altered, which presents many opportunities for the future for orthotic shoes which look attractive.

“It seems such a small thing”, says Kathy. “No one really thinks about footwear after a nasty accident and limb reconstruction surgery to your leg. After all, the most important thing is the successful healing of the injury. But without shoes which fit properly and lessen the pain, and enable you to do what you want to, life can be so limiting. Your world becomes much smaller, and you’re unable to do so many of the things which get you out and about – the things which give you joy. I am eternally grateful to REBUILD for paying for my first pair of customised orthotic shoes – it changed my life and gave me back some of the normality I had lost.”

https://rebuildcharity.org/wp-content/uploads/sites/11/2021/04/IMG_3788.jpg 427 640 marek https://rebuildcharity.org/wp-content/uploads/sites/11/2018/11/rebuild-logo-small.png marek2021-04-20 16:38:232021-04-20 17:38:38Bespoke orthotic shoes allow limb reconstruction patient Kathy to walk her dogs again

A Soldier’s Experience

17/11/2018/in Patient Stories

Robert’s Story
I was granted ‘membership’ of the KCH Limb Reconstruction Club in 2009. I arrived at King’s as a military patient, having been transferred from Selly Oak Hospital, Birmingham. I had been injured whilst serving on operations the year before. Unfortunately, the vehicle that my team and I were in hit an improvised explosive device (IED) which destroyed the vehicle and left three of us badly injured. Having received emergency medical treatment on the ground and been extracted back to one of the main NATO bases, we were all flown to the UK for further treatment. It was the end of our tour.

It’s an odd thing, coming round a number of days later, not realising where you are or what’s happened to you, with nurses asking you if you are aware of your own current whereabouts. Those seriously injured were moved to Selly Oak and, although a NHS hospital, certain wards housed injured military personnel. During that period, the number of soldiers treated at the hospital was significant.

Those who have been injured in IED incidents typically have complex breaks which aren’t always easy to fix. Many are irreparable, hence the high number of amputees. Time spent at Selly Oak varies, depending on the nature and severity of the injuries. Some soldiers move quickly from Selly Oak to Headly Court (the military’s rehabilitation facility), others are there for longer. Ultimately, almost all end up at Headly Court for a period of rehabilitation. Unfortunately, some soldiers’ injuries are so severe they are medically discharged from the Army. Sadly for some, although they made it home, they succumbed to their injuries in hospital surrounded by heart-broken family.

I was under the care of Selly Oak for almost a year and a half, during which time I had numerous operations to try and fix the damage to my legs. Unfortunately, they never quite managed to fix my left leg, and a decision was made to move my treatment to King’s Limb Reconstruction Unit and, specifically, under the care of Mr Graham Groom. It was quickly determined that, in order for my leg to have a chance to heal, the previously inserted metal rod in my leg would need to be removed and a Taylor Spatial Stack Frame applied. Subsequently, after 18 months of treatment, a frame was applied and remained on my left leg for nine months.

During the preceding 18 months there had been a few peaks and troughs. The rest of my injuries had healed well, and my body had regained strength. I was also taking less pain medication, which resulted in me feeling better and more normal. However, my left leg was not playing the game due to the complexity of the injury and the fact that it had been left infected for such a long time. Frustrations can set in, compounded often by pain, the effects of the medication one takes and, for many, the physical restrictions injuries and treatments place on your life. These ‘down’ periods can be cyclical in nature or can remain for protracted periods. Either way, it is not just the patient who suffers frustration but also his family. It is at these times when speaking to others, sharing those frustrations and, for some, going to church can make a real difference. For me and my wife, it was our church and faith that provided us needed support.

Whether it was due to having an occupation that required a high level of physical fitness, genetics, the amazing skill and dedication of Mr Groom and his team or faith – or a combination of all these factors – my leg healed quickly with the frame on. Soon after the frame was taken off, I began a rehabilitation programme at Headly Court and I was signed off fully medically fit again.
The staff at King’s Orthopaedics Department, and particularly those within the Limb Reconstruction Unit, are an amazing group of people, utterly dedicated to their patients, restoring people’s lives and the continuation of the service they are devoted to. I truly feel blessed to have come under their care, not just because I can run again, but because of the care and friendship they extended to my wife and me during that period of our lives.

https://rebuildcharity.org/wp-content/uploads/sites/11/2018/11/Soldier.jpg 427 640 Mark Devlin https://rebuildcharity.org/wp-content/uploads/sites/11/2018/11/rebuild-logo-small.png Mark Devlin2018-11-17 19:29:332021-04-20 16:39:09A Soldier’s Experience

I am grateful for every step I take

17/11/2018/in Patient Stories
David’s Story

On 14 January, 2007, I hit a road sign at 60 mph on my motorbike. According to the discharge notice I suffered: multiple facial fractures – Lefort III, crushed T4, 5, 6, spinal cord contusion, pulmonary contusions, small splenic laceration, # L 5th and 4th MC distal phalanx, L tibial #, undisplaced, ruptured ACL with distal avulsion #, MCL L knee.

I’m not sure what all that means, but I can tell you that I have five metal plates in my face, I get a bit of backache and I’m about an inch shorter than I used to be. It’s not the big things that have caused the biggest problems for me. Despite breaking most of the bones in my face and breaking my back, it was a clean break to my tibia and twisting my knee that kept me in a wheelchair for 18 months.

Due to nerve damage around my knee, I was unable to move my foot or put it flat on the floor. My Achilles tendon was released and I had a Taylor Spatial Frame (TSF) fitted. The frame was used to move and hold my foot in the right position so I could put it flat on the floor.
The limb reconstruction team at King’s College Hospital made it possible for me to walk through the use of a TSF.

https://rebuildcharity.org/wp-content/uploads/sites/11/2018/11/Motorbike.jpeg 426 640 Mark Devlin https://rebuildcharity.org/wp-content/uploads/sites/11/2018/11/rebuild-logo-small.png Mark Devlin2018-11-17 19:19:542019-02-06 19:54:38I am grateful for every step I take

I will be back, fighting fit

17/11/2018/in Patient Stories

Adrian’s Story
On 9 February, 2003, while in France, I broke my right leg in a snowboarding accident. It was a spiral fracture. I broke the right fibula and tibia. At the time it didn’t seem too serious as far as broken legs go.
I had an operation in France to have a plate put in the leg, then was treated in my local hospital. After about seven months the plate snapped. When they operated to replace the broken plate, serious problems started, with infection plus non-union. I was transferred to King’s College Hospital and have been undergoing treatment there ever since. I had three frames put on between 2005 and 2009, first an Ilizarov, then two Taylor Spatial frames.
To keep busy and stay in shape while enjoying the fine weather, I started weight training with a bench and a couple of dumbbells in the garden. I used to put my leg up and just did whatever I could. I would work around my injury and do things at my own pace. I also tried swimming , but this was the one sport I could never really get the hang of, even before the accident. It was only while in the Taylor Spatial frames that I really started to make progress. It was hard work with all that metal but, over two years, I went from struggling to do five lengths to doing 100.
I was a bricklayer and, at the time of the accident, had a good job working for a small retail maintenance firm.
Six months after the accident, when things weren’t going to plan, I started to think what else I could train as, just in case my leg didn’t heal. I used the time to go to free adult education classes. I did maths and English courses for the first year, then paid for various bookkeeping, accounting and ECDL (European Computer Driving License) computer courses.
While in my second frame and doing an NVQ accounting course, I won a career development award, but was not able to go to the ceremony as I was in hospital having an operation.
Starting something new
My final frame came off in February 2009 after more than six years of treatment. If it weren’t for the encouragement and care I received at King’s College Hospital, I would not be in the position I am now.
Within four months of the frame being taken off, I competed in my first ever triathlon, a novice event in which I came seventh out of about 50. I received an Outstanding Achievement Award from Ashford Tri Club head coach Christine Johnson. So a big thank you from me to everyone who has looked after me over the years. I have continued with the triathlon and joined my local club, Ashford Tri. They have encouraged me, made me feel very welcome and part of the group.
I would like to say a big thank you to Marjorie and Mark, my mum, dad and brother Philip, who have always been there for me through some quite tough times.
Back in a frame
Due to an accident on the 13 August, 2009, my leg has refractured. I was cycling to a hospital appointment when the chain came off the bike. The leg was a mess with a big compound fracture.
I had an operation at Ashford’s William Harvey Hospital where they just washed out the wound and the leg was put in a back slab. I had already requested, and was transferred to King’s the following day, where my fourth frame was put on, on 15 August, one day before a planned triathlon in Worthing.
I had only been back at work full time for eight weeks of a three month trial, and lost that job. But they were good to me, and paid me full pay up to the end of September, for which they had no obligation. This has given me breathing space and time to fill out all those lovely forms.
I have started swimming again. It is still hard, slow work even after so many years of swimming with the frames, and I still get a great sense of achievement from every little goal I achieve.
I think for me the key is to achieve small weekly goals, then the long-term goals will follow.
I am back to doing physio sessions two to three times a day. They are the key to success if you want to go back to an active life once the frames are removed. I completed two triathlons, did lots of long runs, some cross-country over the South Downs and some distance bike rides, and think this is due to keeping active while in the frames.
I do know I will be back, fighting fit.

https://rebuildcharity.org/wp-content/uploads/sites/11/2018/11/Snowboard.jpeg 428 640 Mark Devlin https://rebuildcharity.org/wp-content/uploads/sites/11/2018/11/rebuild-logo-small.png Mark Devlin2018-11-17 19:13:402018-11-17 19:13:40I will be back, fighting fit

Things we used to do as family had to stop

17/11/2018/in Patient Stories

Billy’s Story
My Mummy hurt her leg and had to wear a frame for a long time. While she was in hospital, it was very strange because Daddy had to take time off work to take my sister and me to school, and so many of the things we used to do as a family had to stop. I was four and my sister was six.
We had to get an au pair when Mummy came home because she couldn’t stand to cook, and I have to eat four times a day. Sometimes it was fun to have an au pair as she helped us to get out and about while Daddy was with Mummy. But sometimes it wasn’t fun because Mummy couldn’t play with us unless it didn’t involve moving.
Mummy wasn’t very happy at the time because she wasn’t doing anything interesting and because her leg often hurt and she could not move it easily. Daddy found it hard because he had to miss work a lot to look after us all.
The best moment was when the frame came off – we went to a lovely restaurant and stayed up very late.

https://rebuildcharity.org/wp-content/uploads/sites/11/2018/11/Mother-and-boy.jpeg 426 640 Mark Devlin https://rebuildcharity.org/wp-content/uploads/sites/11/2018/11/rebuild-logo-small.png Mark Devlin2018-11-17 19:07:072018-11-17 19:07:07Things we used to do as family had to stop

Medical accident led to limb reconstruction

17/11/2018/in Patient Stories

Tony’s story
My introduction to the Limb Reconstruction Unit came as a result of a medical accident. Over a period of two or three years I had had continual knee problems, largely as a result of sports injuries. In 1999, at the age of 47, it was suggested that I should have an upper tibial osteotomy operation. The cartilage in my left knee was breaking up and the operation would straighten the leg and remove the pressure, I would be able to play tennis again and continue to cycle.
In November that year, an orthopaedic surgeon in Kent preformed the operation. It require a cut to the tibia and fibula, but rather more happened. The tibia and fibula were cut right through and the deep peroneal nerve was severed. I left hospital with a leg that could swing from left to right, and a drop foot.
After several months of painful physiotherapy my physiotherapist insisted I got a second opinion. This is when I discovered to my horror that I had a very unstable disunited fracture of the tibia and fibula. If the limb could not be reconstructed I would need amputation. I was referred to Mr Graeme Groom at King’s College Hospital.
An Ilizarov frame was put on to my leg. After four months it was removed, the tibia and fibula had reunited and I had recovered some nerve sensation, which restored dorsiflexion to my foot. Some follow-on complications were resolved and two years after I entered hospital for the initial botched operation, I was able to return to work.
Although I can no longer play sport, mainly because of the peroneal nerve, not to mention advancing years and girth, I have been able to resume swimming and cycling.
The unit is doing fine work and I am proud to be a Founder Trustee and Deputy Chair of this charity.

https://rebuildcharity.org/wp-content/uploads/sites/11/2018/11/Knee-injury.jpeg 427 640 Mark Devlin https://rebuildcharity.org/wp-content/uploads/sites/11/2018/11/rebuild-logo-small.png Mark Devlin2018-11-17 18:34:142018-11-17 18:34:14Medical accident led to limb reconstruction

Getting married with a Meccano set on my leg

17/11/2018/in Patient Stories

Sarah’s Story
My wedding day was a wonderful day, very small and quiet, but magical. Aaron, my husband, and I had wanted to wait until I was off crutches and had the Taylor Spatial Frame (TSF) removed, but it has disrupted my (our) life so much already that we decided to defy the obstacles and go for it. The dress hid the frame perfectly. Lots of people who have seen the photos say that they had no idea that I was sporting a massive Meccano set around my right leg!
I broke my ankle in February 2008. It was a bad fracture and made all the worse by me being in the wrong hospital and under the care of the wrong surgeon. Things got so bad that, at one stage, three months after breaking my ankle, the consultant advised me that amputation may be necessary.
Thank goodness I was then referred to King’s and found the people who have cared for me to be a joy. Mr Groom is a wonderful, highly skilled and kind gentleman. Sister Bond is reassuring, a whirlwind of energy and a mine of information. Mr Rashid is gentle and patient and Helen, the physiotherapist, is wonderful – a hugely encouraging, lovely person.
I had a period of watchful waiting between June 2008 and June 2009. Mr Groom then decided the time was right to fit a TSF, which has been in situ ever since.
Hygiene is of paramount importance where TSFs are concerned, so that was a new element to be undertaken, as was learning to walk with crutches and slowly but surely, started to bear weigh again. Walking is painful as obviously your body is out of kilter, so your hips and back hurt – but when you’re told that there are visible signs of improvement, you try to get the pain out of your mind.
It isn’t much fun undergoing limb reconstruction, but the level of care and expertise offered by the limb reconstruction unit is outstanding. Individually they have buyoued me up when I really felt that this was never-ending and encouraged me that things are improving. It’s a long process, but the teams unremitting care and personal input has made a huge difference. I am not just an NHS number. I am Sarah, and that means an awful lot.
We live in Crystal Palace, South London. I work as a freelance financial researcher. I am pretty limited as I used to drive and then walk (sometimes for miles) to get to various appointments. My work has had to be cut down hugely, due to the limitations of my mobility. Aaron has helped an exercise bike or me, so that one of the pedals is wider to take the size of my TSF. That helps to get dormant muscles working again and also helps to shift some of the weight that inevitably goes on when your ability to be as active as I once was is curtailed.
I think when you are faced with a situation like this, you have to be patient. Patience is absolutely essential. There are down days…days when you really want to go for a long walk or a run or play tennis. But there is light at the end of the tunnel and if you put your mind to it, goals can be achieved. I never thought I’d get married with a TSF in place, and crutches by my side, but I’m here to tell that tale, and many more in the future too, I hope.

https://rebuildcharity.org/wp-content/uploads/sites/11/2018/11/bride-groom-broken-leg-crutches.jpg 600 900 Mark Devlin https://rebuildcharity.org/wp-content/uploads/sites/11/2018/11/rebuild-logo-small.png Mark Devlin2018-11-17 17:58:522018-11-17 17:58:52Getting married with a Meccano set on my leg

An encounter with a Rhino

17/11/2018/in Patient Stories

While a guest on a television production just over 20 years ago I had a run-in with a rhino, which caused me considerable damage, including a badly broken leg. The first orthopaedic surgeon treated the leg with a simple plaster cast. After a year it had failed to affect a union.
The second surgeon decided on a new piece of equipment named after its inventor, Ilizarov. Unfortunately, as this equipment was very much in the experimental stage in 1988, it was removed before a full union had been effected.
The third orthopaedic team based in Harley Street, London, endeavoured to repair the leg by grafting bone from my hips. Five years and three failures later, we went ‘orthopaedic shopping’, consulting 16 experts in the UK, Switzerland and the US.
As a result of reading some papers presented by a surgeon, and having experience the Ilizarov equipment and believing in its efficacy, I decided to return to that treatment in the hands of a Sheffield surgeon who claimed to have a success rate of 80%.
This treatment started in September 1993, with the fitting of a more complex Ilizarov frame consisting of five wheels to allow two areas for adjustment: near the ankle by the original break to straighten it, and nearer the knee to allow for the major leg bones to be osteometised (cut or broken) before being extended.
Over the next two years the adjustment straightened the distal or ankle break and allowed for the broken ends to be trimmed so that they could unite properly. The proximal area where it had been cut was extended by 105mm so that the leg was now more or less straight and the correct length.
Unfortunately about this time several of the wires that supported this system broke, causing the frame to weaken. Surgeons replaced the Ilizarov with a bar fixator (Orthofix), attached with bolts to the bone. However, the bone that had been extended by 4 inches was soft. The bolts into the bone loosened and allowed the leg to bend, placing my foot at a strange angle, which was inconvenient and painful to walk on. The surgeon suggested that I live with it until the bone consolidated. This was in 1995.
After some years I returned to Sheffield to have the simple wedge removed, as suggested in 1995. The treating surgeon suggested Ilizarov and oseotemised at the same two sites to straighten the foot and lengthen the leg. This was done at the same Sheffield hospital from August 20013 and August 2004.
As my foot was realigned incorrectly I returned in May 2005. However, my health insurance cover had stopped in 1995 and I could not afford surgeon and private hospital fees.
My London GP (Dr Gordon Cochran) referred me to Mr Graeme Groom, head of the orthopaedic department of King’s College Hospital. Under the NHS Mr Groom has taken just two and half years to correct my leg, obtaining union and straightening the limb to a remarkable degree. At last I am now able to walk without the aid of any stick or crutches, and more importantly, WITHOUT PAIN.

https://rebuildcharity.org/wp-content/uploads/sites/11/2018/11/Rhino.jpg 426 640 Mark Devlin https://rebuildcharity.org/wp-content/uploads/sites/11/2018/11/rebuild-logo-small.png Mark Devlin2018-11-17 17:43:272018-11-17 17:43:27An encounter with a Rhino

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This website has information for anyone considering, or going through, limb reconstruction surgery. However we cannot provide opinions on treatment. If you require more information but are not a patient of King’s College Hospital, you should contact your own medical team for advice.

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