grow a new foot
OK NOT QUITE A WHOLE NEW FOOT BUT AT LEAST HALF IN THIS CASE.
This was a very challenging case- a male in his forties had developed a significant bone infection in his foot. It was necessary to remove the major bones in the back of his foot that connected the leg to the front of the foot. This would have normally been treated with an amputation of the leg.
Here is a case presentation of a rare technique that we used to save this patients leg and allow him to walk normally after the treatment.
There is a technique called distraction osteogenesis where a bone can be cut and then the two resulting parts pulled apart from each other so that the bone can be made to grow longer.
Below is a photo of the patients foot after the removal of the infected bone. You can see the degree of deformity and unusual appearance with no heel bone.
A device called an ilizarov external fixator was attached to the patients leg. You can see this below. These surgical instruments come in a box of nuts and bolts and rings and rods that the surgeon puts together like an lego set. They can be built according to the needs of the surgery or the anatomy of the patient.
The red arrow and yellow arrows show how we planned to build this external fixator to pull the bone in order to grow a new set of bones in the patients foot and ankle. You can see nuts that the patient will turn once a day in order to have the fixator device pull and lengthen the bones.
The X-ray below shows in red color the area that we needed to fill with bone. In order to achieve this we cut the leg bone called the tibia and pulled a piece of that bone downward to lengthen the bone and then we turned the bone with the external fixator to replace the heel.
The picture below shows in the green color all of the new bone we created. Even though it will never look like the actual bones and joints it still functions to give the patient a usable limb. Under this X-ray you can see a picture of the patients foot after surgery. The patient is now over two years after surgery and can normally walk and run with his children.
It goes to show there is always hope and where there is a will there is a way. As long as there is some imagination.
We grew a new foot, almost.
