My toe was in agony until surgeons put a contact lens inside it

Surgery for arthritic toes can leave patients with a lifelong limp. Film director Kenny Rye, 39, from Worthing, West Sussex, underwent a pioneering technique using technology borrowed from contact lenses, which avoids these problems.

He tells DAVID HURST about the experience, and his surgeon explains the procedure...

THE PATIENT

Sport has always been a big part of my life, especially cycling and jogging, and I was a competitive body builder when I was younger. But at the age of 20, I skidded on my motorbike on a wet road, and feared my sporting days were over.

The bike was a write-off and I was in agony. For a minute I thought I was paralysed. Then slowly I started to move. By now, cars had stopped and someone must have called an ambulance. There was no visible damage, but I had a severe pain in my foot.

I was taken to the local hospital, where doctors said I'd broken a couple of joints in my foot, including my big toe - hence the terrible pain.

They wanted to put my foot in a plaster cast for a month, but in those days bodybuilding meant the world to me and I had an important to me and I had an important competition in six weeks. So I told them not to, but to bandage it instead.

The doctors reluctantly agreed, but warned I might have problems later on, such as an ache in my foot from time to time.

For 16 years it didn't give me any more cause for concern. However, three years ago I noticed the joint in my big toe looked swollen and became really painful if I walked for more than five minutes - like a sledgehammer had been bashed over my foot.

My GP thought it was a bunion, but advised against surgery because the procedure can be extremely painful and I would not be able to walk for six weeks afterwards.

Earlier this year, a friend of mine asked why I was limping so badly. When I told her, she said she'd heard of a doctor called Dieter Nollau in her home country of Germany who was doing operations on people with painful toes.

I got in touch with Dr Nollau this summer and he agreed to come to Worthing. When I saw him for the initial consultation, he took my toes in his hands, bent them a few times and said I had osteoarthritis.

I was shocked - I associated osteoarthritis with older people, but he explained it can happen to younger people too, especially if they've suffered trauma to the affected joint.

He said that within a year the joint would fuse together and I wouldn't be able to walk at all. When I told him about my motorbike accident, he was certain that was why my big toe joint was defective.

This meant that my cartilage, the protective tissue which should have ensured smooth movement, was being pushed out by the bone, causing friction and pain.

He told me that with conventional surgery I'd have the toe joint fused together using wires and metal plates. This would stop the pain, but would leave the toe rigid - and with the possibility of painful symptoms recurring.

However, he said he had a new procedure - I would be the first person in the UK to have it - which was not only less painful, but longer-lasting and would bring back total mobility to the toe.

I had the operation in August - when I woke up I was told I'd be able to walk home from the hospital in an hour, without limping. Sure enough I did. I did feel nauseous from the anaesthetic and a tenderness on my toe joint but within a week I was jogging on the treadmill at my gym.

Now I'm in training for a triathlon. I can run and walk, because the surgery has taken the pain away, and I have got my quality of life back.

THE SURGEON

Dr Dieter Nollau is a consultant orthopaedic surgeon at BMI Goring Hall Hospital, Worthing, and medical director of the European Foot Institute.

As soon as I examined Kenny it was clear that he had osteoarthritis in his toe. An X-ray showed a small piece of cartilage had been pushed out by the friction between his joints. Something needed to be done because his pain was only going to get worse.

Osteoarthritis is usually something we associate with age, but it is becoming a greater problem in younger people as a result of activities such as jogging and squash. This puts pressure on the toe joints and wears away at the cartilage.

The cartilage gradually loses its elasticity, becomes brittle, splinters and is destroyed, resulting in complete loss of motion. The small joints of the foot are often the first to be affected. The same effect is caused by accidental damage to the toe.

Up to 20 per cent of adults in the UK have osteoarthritis in their big toe joints. It can happen at any age, but is most common from the age of 40.

Conventional surgery involves fusing bones using plates and wires to hold the joint together. It doesn't work well and takes months of painful healing. It also leaves people with a lifelong limp due to their stiff toe.

Often, due to this incorrect walking, it will lead to ankle, knee and finally hip problems.

A few years ago I heard about a gel-like material called SaluCartilage, developed in America. It's made from a similar substance to that used to make soft contact lenses. Even under pressure and friction it does not wear at all.

In December 2002, I used it to operate on my best friend, who suffered from osteoarthritis in his foot, at the German Podiatry Institute in Munich.

I'm pleased to say he's walking well, and is still my best friend! Since then, I've performed 117 operations in Germany, all with excellent results. Now I'm training surgeons all over the world.

During Kenny's operation I made a 4cm incision on the top of his big toe joint, so I could see the defective cartilage causing the pain.

Next, I cut this cartilage debris with a plier-type instrument; using a drill, I created a hole in the toe bone. This is similar to when you drill a hole in a tooth before a filling - it ensures all the 'bad' pieces you are replacing are removed.

I then inserted a 1cm-diameter cylinder of SaluCartilage directly into the hole where his cartilage should have been. It plugs in securely and we make certain by pushing it down with a small hammer.

Five stitches sealed the incision and after a small dressing was put on it, Kenny was taken to a ward until the anaesthetic wore off. The operation took 25 minutes. Two hours later he was walking home.

Two days after the operation Kenny was given physio, mostly traction - pulling and stretching - to improve flexibility. His stitches were removed ten days after that and he was already able to go to the gym by then.

The speed of the surgery, the pain-free healing period and the fact that the patient can put weight on the joint immediately as well as recover mobility are all great positives for this operation.

The procedure costs £2,000 privately and should be available on the NHS next year.

• European Foot Institute, 01903 261 593; footinstitute@aol.com

Source: http://www.dailymail.co.uk/pages/live/articles/health/myoperation.html?in_article_id=506577&in_page_id=1989

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Complications & Prevention

Complications:
A compound fracture can lead to infection of the bone or bone marrow. In some cases this infection can progress to a chronic infection called osteomyelitis, requiring treatment with antibiotics and careful management in hospital.

If the bones in a fracture refuse to join up again, or if they take a particularly long time to do so, the bone may lose its blood supply and die. This is known as avascular necrosis. In some cases, surgery may be needed if the fracture refuses to join up.

Fractures near or through joints may result in the joint becoming permanently stiff or unable to bend properly.

Prevention:
To grow, develop and maintain healthy bones, it is important that you have enough calcium in your diet. Good sources of calcium include milk, cheese and yoghurt. Vitamin D helps the body to absorb calcium - you can find it in margarine and oily fish.

Because of the way bones are made, they get stronger and denser with regular exercise. It is particularly important that older people remain active, as this will help to reduce their risk of fractures.

The female hormone oestrogen regulates the use of calcium in a woman's body. After the menopause, women produce far less oestrogen, making calcium regulation more difficult. This means that it is particularly important that women make their bones as strong as possible before the menopause.

Source: http://www.nhsdirect.nhs.uk/articles/article.aspx?articleId=166&sectionId=6

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The Myths About Claiming Compensation

There are many myths around how to make a compensation claim and how to go about it, and therefore so many people are afraid to even consider making a claim when they should as they are not only suffering from their injuries caused by the accident but also the loss of earnings and medical costs they are having to pay.

I will consider the myths in which put people off in making a compensation claim these are as follows:

Compensation Claims are Complex and Take a Long Time – if there is no issues with who is liable then the case will take around 8-12 months which isn’t a long time. If the liability is disputed the case will take longer as well as serious injury cases. At the start of the claim you will need to fill out quite a lot of paperwork but once that’s done your solicitor will take care of other things and try and make the claim successful with little hassle and delay.

You have to go to Court to Claim Compensation – most compensations claims are actually settled out of court and long before a court case is necessary. Everyone knows it’s cheaper to settle out of court and it also saves time for everyone. Only around 4% of compensation claims reach court for settlement.

Compensation Claims take Years to Settle – most compensation claims take around 8 to 12 months and therefore under a year. If there are problems within the case around liability then the case may take a couple of years.

The Law Protects Big Companies – in the UK the laws that are in place protect the public more than the companies. The UK is one of the most compassionate and considerate in the world. Maintenance of roads, vehicles and work environments are all closely watched under Health & Safety Regulations.

All of the Solicitors are Out to Get What They Want with Hidden Charges – solicitors easily get a bad name with bad press surrounding them from radio to papers to news channels. But solicitors are one of the best professionals which are regulated in the UK. There are always bad press saying that solicitors hide charges especially with the basis of No Win No Fee. In 2000 the legislation of No Win No Fee came into play which solicitors will work on your case for free in England and Wales.

Making a Claim Against your Employer will get you Sacked – there are many accidents each year that happen at work but many don’t claim as they believe they will be sacked if they do. An employer cannot sack you on the grounds that you are claiming against them; if they do you should claim for unfair dismissal. The law protects workers who have been with the employer for over 12 months.

You Cannot Obtain Medical Treatment whilst Claiming Compensation – this is just silly, if you have injuries they need to be looked at and cared for so they heal up as quickly as possible. The other party’s insurers may require to see you through your recovery process so they themselves can see the injuries you have. The quicker you receive treatment the quicker you are likely to respond and recover from your injuries.

I hope this had put your mind at rest and made you think clearly about claiming compensation if you have suffered injuries mentally or physically from an accident that wasn’t your fault. Whatever the injuries may be you have a legal and civil right to claim compensation.

Article Tags: No Win No Fee, Accident Claims, Medical Treatment, Claiming Compensation, Myths Of Compensation Claims, Medical Treatmentclaiming Compensation

About the Author:
Jene Pedder is the Webmaster of Accident Consult who specialise in Making a Compensation Claim.

Article Source: http://www.articlesbase.com/law-articles/the-myths-about-claiming-compensation-295680.html

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What Should You Do When the Cast Comes Off?

Can you believe they use a saw to remove your cast? The funny thing is this saw doesn't hurt your skin at all. It might even tickle! Once the cast is off, the injured area will probably look and feel pretty weird. The body part that was in a cast might look strange at first. The skin might be pale, dry, or flaky. Body hair might look darker and the body part itself might look smaller because you might have lost some muscle while it was healing.

Don't worry. This is all temporary. Kids are great healers, so you'll be back to normal soon. In some cases, your doctor might suggest you do special exercises to improve your strength and flexibility. You'll want to go slow and ask the doctor if there are any activities you should avoid, such as hanging from the monkey bars. If you want to return to a sport, ask the doctor how soon you'll be able to do it.

How can you be sure you don't break any more bones? Accidents happen, but you often can prevent injuries by wearing safety helmets, pads, and the right protective gear for your activity or sport.

It's also a smart idea to do what you can to build strong bones. How do you do that?

Get a lot of physical activity, especially stuff like jumping and running.
Feed your bones the calcium and vitamin D they need to stay strong. That means getting your share of milk and other calcium-rich foods and drinks, such as broccoli and calcium-fortified orange juice.

Source: http://www.kidshealth.org/kid/ill_injure/aches/broken_bones.html

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