Fearfully and Wonderfully made

Living with Fixators and their Challenges!
December 12, 2008, 8:17 pm
Filed under: A mother's heart, Life with. . ., Sugeries | Tags: ,

After after having 2 fixators, I have learned a few things.  Simplicity is generally the best option – at least when it comes to dressing and having a fixator.  There are not many options really.  Giovanna has 2 pair of pants that snap up the outside of the both legs and that fit over the fixator.  So the bottom half is taken care of, which leaves the top half.  Since Giovanna tends to like to wear “pretty pink” things, it is helpful that the botton half is a neutral color (black or blue).  She has had fun picking out her tops to go with the bottoms.

But when it comes to going to church, Giovanna loves to wear very girly dresses – the frillier the better!  So different from her mother!  And we live in Minnesota which makes it even more of a challenge to figure out how to make the dress look “Pretty.” 

Sunday was the first time we were home since Advent began and she wanted to wear her new dress for Christmas and wouldn’t you know, it was one of the coldest mornings on record for this year!  So the task of figuring out how to get tights on her to keep her warm was given full attention.  But no matter how I tried to get the tights on, they would not go over the fixator – it was just too big and the wires were sure to put holes in the tights!  So we improvised and cut one leg of the tights off – it was a long dress and you couldn’t tell!  She was all smiles at church with her new dress, tights and nice girl shoes, not tenneys!

However going to play in the snow with a fixator are totally different.  We have lots of new snow which was just calling out to Giovanna to come play in the snow.  So the process of getting her dressed for the outside play time was begun.  First the regualr fleece fixator bag went over her foot, leg and fixator – this was for warmth.  Then came two target bags – to keep things dry and the snow stuff.  Her older brothers pulled her on the sled.  They were going fast enough that she fell into the snow.  She was laughing and having a ball.  It was a glorious time for her.

When she finally got cold, about 90 minutes and 2 brothers completely tired out later, she came in for hot chocolate and then a warm shower.  Life is good for her! 

As I watched her having so much fun, I was reminded of two statements that have been with regard to Giovanna at different points in her life.  When Giovanna first joined our family, we were told that she might never walk.  She has proved the naysayers wrong on this account.  Two years ago when she had her first fixator surgery and went sledding, the therapists said, “is there anything that slows her down?”  God’s fingerprints are all over her life and the evidences of Grace to her from God are amazing.  There is much to be thankful for


What is a Fixator?
November 11, 2008, 9:26 pm
Filed under: Surgeries | Tags:

I have been asked that question many times over the past three weeks.  It generally heps to have a picture to help explain what it is and what it does.  Below are pictures of the two fixators that Giovanna has had.  The procedure on the left leg was performed two years ago. 

Left leg done 2006

Left leg done 2006











Right Leg currently in fixator
Right Leg currently in fixator

This procedure is a surgical procedure used to lengthen limbs or reshape bones which in Giovanna’s case is being used to lower her heel and reshape her foot.  The procedure was originally invented by Professor Gavril Abramovitch Ilizarov using bicycle spokes in the 1950’s.  It was introduced to the west via Italian doctors and is now used routinely for treating bone and limb deformities.

For bone lengthening or reshaping (both of which have been needed by Giovanna), an external fixator made of stainless steel circle the leg externally is held in place with a series of wires (called pins) and bolted into the bones.  Stainless steel rings are fixed to the bone via stainless steel heavy-gauge wire (called “pins”). The rings are connected to each other with threaded rods attached through adjustable nuts. The circular construction and tensioned wires of the Ilizarov apparatus provide a great deal of structural support. 

During surgery, the bone is broken around the perimeter of the bone not totally separting it.  The bone marrow and blood vessels need to be left in tack so that they can provide the nutrients for the new bone as it is laid down.  While the bone is growing, the frame is adjusted by means of turning the nuts, thus increasing the space between two rings. As the rings are connected to opposite sides of the fracture, this adjustment, done daily, moves the now-healing fracture apart by approximately one millimetre per day.

In Giovanna’s case, there are two bolts by her heel which when turned push the heel down.  There is also one in front of the foot that brings the toes up.  As the process continues the heel lowers and the toes come up and in time they meet in the middle making her foot flat.  This will improver her gait and make walking less painful.  Giovanna also had an osteotomy in the mid foot to straighten her foot.  At her post op check ups the surgeon turns the bolt  to straighten her foot.  So going in for post op check ups is a bit painful for her as this turn tends to be more painful as it is not as incremental as the others. 

Her left leg/foot which was done in November 2006 took almost 8 weeks of pin turns before the position of the foot was correct.  The right leg/foot which is currently in the fixator should be done with pin turns in 3 weeks.  Once the foot is in the correct position, she will be in a holding position for about 4 weeks and then the fixator is removed and cast put on for another 4-6 weeks. 

We can see the end of the tunnel at this point.  I will be completing the final turns of her pins on Friday.  She will have another post op check up next week and the doctor will make any final corrections before she enters into the holding pattern.  The fixator should be off around Christmas time.