Operations Concerning Nerve Damage In Thailand

[bailly]

I Broke my leg 5 years ago and suffered a severe medical emergency, the hospital messed it up and now refuse to touch it again, I am wondering if anybody has had any operations in Thailand concerning nerve damage and if not what are the best Hospitals ?

Thanks in Advance,

Bailly

Sorry the original hospital was in the UK not suprisingly

Edited February 6, 2009 by bailly

[Sheryl]

Can you be a bit more specific as to the nature of the problem? E.g. which nerve is affected, what tests have been done to confirm this, what are the symptoms (?chronic pain? functional impairment?) etc?

[bailly]

I had a spiral break going round up my Tib and Fib, 4 breaks in total, after a 9 hour operation i developed compartment syndrome, which if you don't know is swelling of the compartments in your leg if left untreated results in basically crushing the nerves and muscles, i was left for 3 hours in agony, then when my leg went black and doubled in size the nurse finally believed me something was wrong, i had an emergency fasciotomy and the surgeon sliced through a nerve but instead of repairing, cortorising or what ever they should of done he left it in my leg, i later had a skin graft to cover both scars which cover about 30% of my lower leg, and the new skin is now growing deeper into my leg and attaching onto bones and muscles, the scar part restricts my movement but it is the loose nerve floating around my leg which is giving me trouble (Shooting pains and loss of feeling in my foot) the hospital have pretty much said well at least you can walk, I live on an Island which has only one hospital and is known for messing things up, we are part of the uk but have to be recommended by surgeons to get a second opinion in England, and i can guess why they don't want to send me,

Sorry if it's too specific got a bit carried away

Bailly

[Sheryl]

The best advise I can give you is to get more detailed information, prefarrably a medical summatry from teh hospital (making sure it details the nerve damage including name of nerve, location at which it was severed, etc) and then scan it and send an email inquiry to the following hospitals asking them to have one of their orthopeic surgeons who specialize in microsurgery review it and advise if they think they can help. 5 years is a long time and I am not at all sure that much can be done surgically at this point but no harm in asking.

These hospitals are all quite pricey but don't worry about that at this stage, what you need to do first is to get an idea of whether or not anything can be done, period.

[email protected]

[email protected]

[email protected]

[email protected]

[bailly]

Thanks for your help I'll get onto my hospital for info and then ask about.

[Who, me ?]

Don't forget the BNH hospital

www.bnhhospital.com

[zzdocxx]

Let me also suggest that a consultation with a "pain management" specialist might be in worthwhile.

[BWPattaya]

Sorry to read about your problem, nasty injury.

A tibial compartment decompression is necessary when blood loss occurs from soft tissues which have been damaged, with the consequent blood loss pooling into the compartments that contain other structures. These compartments are not very flexible so leakage of blood into them raises the pressure above acceptable limits. Untreated this will lead to damage to nerves, restriction to the blood supply to the extremities, and the subsequent loss of limb due to the lack of oxygen/nutrients.

Multiple fractures, especially spiraland compound fractures often lead to complicated fractures. Complicated, in this case, means that it involves other tissues, organs, nerves, muscles, etc. These lead to a higher risk of suffering from such compression.

However, it can be difficult to spot after an operation as any pain you would complain about may easily be interpreted as post-operative pain. This is especially so if the limb is not easily observable (by such as the application of a splint etc). It usually requires measurements of the limb and comparison to the other leg.

I am unsure why you think the surgeon sliced through the nerve. Were you told this? Or assumed it? If so, which nerve do you believe is affected. The Sciatic Nerve

The Tibial Nerve

The Common Peroneal Nerve

Have you got movement in all of your toes? Can you flex your ankle? What feeling have you go in your foot/toes?

Your comment about "repairing, cortorising" during the operation. If the nerve was injured then the correct thing to do is leave it. Cauterisation would simply burn it. Useful when a blood vessel is leaking but it does nothing for a nerve except destroy it. Repairing may not have been practical during your fasciotomy. Remember that at the time the primary goal was to prevent loss of your leg (which they did).

Repair of damaged nerves. Nerves can, but not always, regrow at the rate of one millimetre per day, or about one inch per month. As it is five years now since your injury I doubt that it will repair itself.

So, what can you do? You have two options. Accept it, or contact a neurosurgeon. I guess that you don't want to accept it as you are asking for advice. So get the name of a neurosurgean here and ask for an opinion. The ask for another opinion somewhere else. Whilst the surgeon may want to help you, and in Thai style try to avoid giving you bad news, he may persaude you to foolow a course of action which does nothing good for you but costs a lot of money. It is tempting to listen to the surgeon who says he can repair it rather than the surgeon who says nothing can be done.

I personally believe that five years is too long a delay to effect a successful repair.

Finally, why did you require skin grafts? 30% is a large area. The incisions on each side of the leg ater a fascootomy are usually quite small.

Good luck.

[bailly]

Sorry to read about your problem, nasty injury.

A tibial compartment decompression is necessary when blood loss occurs from soft tissues which have been damaged, with the consequent blood loss pooling into the compartments that contain other structures. These compartments are not very flexible so leakage of blood into them raises the pressure above acceptable limits. Untreated this will lead to damage to nerves, restriction to the blood supply to the extremities, and the subsequent loss of limb due to the lack of oxygen/nutrients.

Multiple fractures, especially spiraland compound fractures often lead to complicated fractures. Complicated, in this case, means that it involves other tissues, organs, nerves, muscles, etc. These lead to a higher risk of suffering from such compression.

However, it can be difficult to spot after an operation as any pain you would complain about may easily be interpreted as post-operative pain. This is especially so if the limb is not easily observable (by such as the application of a splint etc). It usually requires measurements of the limb and comparison to the other leg.

I am unsure why you think the surgeon sliced through the nerve. Were you told this? Or assumed it? If so, which nerve do you believe is affected. The Sciatic Nerve

The Tibial Nerve

The Common Peroneal Nerve

Have you got movement in all of your toes? Can you flex your ankle? What feeling have you go in your foot/toes?

Your comment about "repairing, cortorising" during the operation. If the nerve was injured then the correct thing to do is leave it. Cauterisation would simply burn it. Useful when a blood vessel is leaking but it does nothing for a nerve except destroy it. Repairing may not have been practical during your fasciotomy. Remember that at the time the primary goal was to prevent loss of your leg (which they did).

Repair of damaged nerves. Nerves can, but not always, regrow at the rate of one millimetre per day, or about one inch per month. As it is five years now since your injury I doubt that it will repair itself.

So, what can you do? You have two options. Accept it, or contact a neurosurgeon. I guess that you don't want to accept it as you are asking for advice. So get the name of a neurosurgean here and ask for an opinion. The ask for another opinion somewhere else. Whilst the surgeon may want to help you, and in Thai style try to avoid giving you bad news, he may persaude you to foolow a course of action which does nothing good for you but costs a lot of money. It is tempting to listen to the surgeon who says he can repair it rather than the surgeon who says nothing can be done.

I personally believe that five years is too long a delay to effect a successful repair.

Finally, why did you require skin grafts? 30% is a large area. The incisions on each side of the leg ater a fascootomy are usually quite small.

Good luck.

Hey BW cheers for your answer, the surgeon said he did cut through a nerve and was going to bury it deep inside my leg to stop further irritation then told me i would have to live with it, google image the faciotomy scars for compartment syndrome and i'm sure you will see they are not that small , i have limited feeling in my foot, i cannot feel the top and right side and the front of my leg has no feeling either, if the hospital had explained everything to me i would be ok with it, but i had 1 doctor say quit your job as if you don't you will never walk again and another saying keep working and push yourself. everything they have said has contradicted what they said before so it's more of i need a second opinion but i can't have one where i am from.

[Maverell]

I wish the OP luck - my facial nerve on the right side was badly damaged ( not severed so I am told ) back in 1989 during the removal of an acoustic neuroma (brain tumour ).The docs hoped the nerve would repair itself but it never did. I blame it on drinking too much alcohol

[bailly]

I wish the OP luck - my facial nerve on the right side was badly damaged ( not severed so I am told ) back in 1989 during the removal of an acoustic neuroma (brain tumour ).The docs hoped the nerve would repair itself but it never did. I blame it on drinking too much alcohol

Thanks Maverell, sorry to hear about all your trouble good to know you survived though

[Maverell]

I wish the OP luck - my facial nerve on the right side was badly damaged ( not severed so I am told ) back in 1989 during the removal of an acoustic neuroma (brain tumour ).The docs hoped the nerve would repair itself but it never did. I blame it on drinking too much alcohol

Thanks Maverell, sorry to hear about all your trouble good to know you survived though

Thanks for that For the first few years I was pretty pissed about it, but then when you think of the alternative life becomes clearer.

[bailly]

I wish the OP luck - my facial nerve on the right side was badly damaged ( not severed so I am told ) back in 1989 during the removal of an acoustic neuroma (brain tumour ).The docs hoped the nerve would repair itself but it never did. I blame it on drinking too much alcohol

Thanks Maverell, sorry to hear about all your trouble good to know you survived though

Thanks for that For the first few years I was pretty pissed about it, but then when you think of the alternative life becomes clearer.

I know what you mean, i should have lost my leg really and at least i am lucky i can walk, but just need to make sure i am not making it worst or anything.

[bailly]

Here is a dodgy pic if it helps