Four years post-injury, the patient cycled from Norwich to Cambridge for follow-up. Walking remains more affected than cycling. X-rays show a well-formed neo-fibula, with no knee collapse despite minimal lateral support. Ankle remains painful and stiff, worsened by drop foot.
Three years post-injury, all wounds and fractures have healed with no clinical signs of infection. The patient experiences knee pain with prolonged walking or cycling, and ankle discomfort due to equinus deformity. No medial/lateral ankle instability noted. Further follow-up scheduled in one year.
Eight weeks post-cement spacer removal, the patient received an RIA bone graft from the right femur. Despite bacterial growth in micro samples, a six-week antibiotic course was completed. X-rays show promising progress, and the patient is mobilising unaided for short distances, using a stick for longer walks. No clinical signs of infection.
Four weeks post-frame removal, the fractures have united, but walking remains slow with a limp. A potential collapse in the lateral tibial condyle has been observed, with signs of “neofibula” formation. Further assessment with a CT scan is planned, along with cement removal and bone grafting.
After 27 months, the fracture has clinically united. The patient successfully removed connectors between the second and third ring and can walk without additional pain. The next step is frame removal, followed by discussions on removing cement remnants and applying bone graft.
Patient’s activity level continues to improve, still using crutches for mobility. Pin sites remain stable. The frame has been dynamised to allow vertical movement, with a review scheduled in four weeks to assess alignment.
Patient’s activity level has improved significantly, with no major pin site issues apart from one broken pin, which was removed in the clinic. CT scan confirms further progress toward union. Follow-up in six weeks to assess frame dynamisation.
Knee stability has improved, and pain is subsiding. Pin sites remain in good condition, with X-rays showing continued progress toward union. A CT scan is planned in two months to confirm further healing.
Leg alignment continues to improve with no significant increase in pain. Pin sites remain clean, and the frame is stable. The next follow-up is scheduled in four weeks.
Leg alignment is nearing normal after correcting 7 degrees of valgus, but knee pain has increased. The plan is to continue the correction into slight varus to improve knee function while monitoring pain levels.