Tuesday, November 17, 2009


Not a great deal to report, with continued but slow recovery of strength and mobility. Had a visit yesterday from Liz and Donna, occupational therapists from King's, to discuss aids to getting in and out of the bath, and for the time being I have to be content with showers. Except in hot countries, I hate showers, because they entrain cold air, so that one is never warm all over.

Victoria has been here all day, and we have made some good dents in the paperwork and filing. I have sat up all day, and made two trips downstairs and back, and it hasn't been painful sitting at the computer. So its all go for the polevault in 2012, and in the meanwhile to be able to join the outings with Olivia, who arrives in two weeks' time!

The operation was called 'Dynamic Hip Screw Fixation', a common procedure for an extra-capsular fracture, ie one that is sustained outside the capsular attachment of the hip.

The prosthesis consists of a large screw which is inserted into the head of the femur using continuous x-ray observations in operating theatres, and held in place by a metallic plate resting onto the side of the femur bone.

The fracture is reduced by longitudinal traction applied using a special traction operating table. The other leg is moved out of the way. The surgeon stands to the side of the affected hip joint. Using continuous, x-ray emissions from an image intensifier the reduced fracture is visualized prior to making the incision to confirm proper reduction of the fracture. Then, a 6cm to 8 cm long incision is made along the top outerside of the femur bone. This exposes the subcutaneous fat. Further dissection of the muscular layer is carried out by using a blunt instrument. The femur bone is exposed. Under the x-ray guidance of the image intensifier the procedure is visualized on television screens. A guide wire is inserted into the head of femur using a battery operated power drill. A suitably sized screw is fixed into the head. This is connected to a mechanical plate with three to five holes along its length and held in place by screws. Images confirming proper placement of the screw and plate are obtained. The wound is closed in layers using stitches and a dressing is applied prior to the patient leaving the theatre.

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