Luis

On April 3rd, 2020, at the start of the pandemic, I had an accident with a ladder and shattered my left ankle, leaving an open fracture. It was a very complicated fracture where the tibia and fibula shattered, and the bone remaining above went all the way down to my foot. I went to the OR for irrigation and decompression, and the next day, I went back into surgery for ORIF (open reduction and internal fixation) of the tibia and fibula with an external fixator. Within two weeks, I had an infection and started on IV antibiotics. Within another two weeks, I had necrosis of the inner ankle going all the way to the Achilles’ tendon due to the damage to my circulatory system resulting from the injury. I underwent a debridement and was left with a bad defect. Healing was slow due to the trauma to the vessels. I was put in contact with a plastic surgeon for wound grafting. I had many surgeries to help the wound heal and did hyperbaric treatment for many months. I had a few infections throughout this time and so many surgeries. The plastic surgeon recommended a surgical procedure using a flap of the peroneus muscle to help close the wound. At the hospital, a wound culture showed a rare fungal infection, and I had to have some hardware removed.

After many months of not being able to walk plus kidney injury due to so many strong antibiotics, I was at a point where I thought amputation of the foot would be in my best interest in order to start walking again. I had a consultation with Dr. Mario Cala in Miami, Florida, who was gracious enough to take on my complicated case, and he was sure that he could save my foot and combat the new diagnosis of osteomyelitis. I underwent my first surgery, during which they put in bone grafts and antibiotic-infused cement —things were finally starting to go well.

Then I had another complication when my bone was not fusing on its own. A piece of my fibula came out of place and started protruding from the skin, requiring yet another surgery. I was so heartbroken at this outcome that I was determined to move forward with the amputation. One last option was proposed to save my foot: it was recommended to insert a rod that would span from the heel to the mid tibia in order to reinforce the remaining bone. This procedure was especially complicated because I had shattered my calcaneus bone several years prior and now had metal holding it together. They were able to get around the metal in the calcaneus to insert the rod. I underwent a few more weeks of antibiotics to ensure there was no recurrent infection.

I have not needed any additional surgery since this procedure. I would like for others to hear my story to know that there are options available for instances of serious injury like my own. I have very high respect for my surgeon and his medical knowledge, and I know for a fact that I would have amputated my foot if it weren't for his efforts.