His leg was set in plaster and like thousands of others each year it eventually healed. Then nearly thirty years later in 2009 Phil began to feel something wasn’t right.
“I was getting more and more pain in my knee. As a postman I walk miles each day and I’m fit for my age and I couldn’t put it down to any injury I had picked up.
“Eventually I went to the doctors and I was sent for a scan which revealed that my leg hadn’t been set correctly all those years ago and it was only going to get worse.”
Phil’s surgeon recommended that he undergo an operation in which the leg would be broken and then straightened using an external frame which allows the bone to heal in exactly the right alignment.
“I love my job and this would be months of living with a frame so it was the last thing I wanted to hear. On the other hand the leg was only going to worsen and I couldn’t do my round with pain like that.”
Phil bit the bullet and surgery went ahead in March 2009 and he was hoping to be back on his round before autumn. But as the weeks and months went by and Phil was coming to terms with life in a frame, which meant he could only sleep on his back and was transferred to office based duties, he got some bad news.
Scans revealed that the fracture wasn’t healing properly and Phil joined the 85,000 or so people each year who have what are known as ‘non-union’ fractures* where no healing of the bone has taken place after six months.
Non-union fractures are serious complications and in the most extreme cases may lead to amputation.
Phil’s surgeon decided to treat him by operating to take bone from Phil’s pelvis and graft it onto the fracture in his tibia (shin bone). Phil had the grafting done in the middle of 2010 and settled down to wait for the healing to begin.
Some weeks after the operation Phil had X-Rays taken which showed that the grafting had failed. His leg was no closer to being healed than it was immediately after the first surgery.
After careful consideration his surgeon decided to try to use a special glue to fix the bone in place.
“I thought, I’m in your hands, let’s get on with it” says Phil who now felt under pressure from his employer who wanted to retire him on medical grounds.
“By now I was at a low ebb. I’d had two failed operations, was using strong painkillers every day and was facing a third operation I wasn’t at all sure about. All I wanted to do was get back on my round.”
The operation to glue the fracture also failed and Phil’s options were running out. His luck changed however when his surgeon was introduced to the EXOGEN®
device. EXOGEN uses pulsed ultrasound to stimulate the bone’s natural healing process.
Patients use EXOGEN at home for 20 minutes each day, placing a transducer about the size of a £2 coin onto the skin above the fracture site. This is connected to a battery operated unit about twice the size of a mobile phone. The patient feels no sensation at all during treatment.
“I was a bit suspicious when they showed me this little thing. I’d had three operations by now so to be told that this was the answer instead, and that I could use it at home seemed too good to be true. But of course I was more than ready to give it a go.”
EXOGEN has been in use worldwide for over 10 years, has been shown to heal fractures up to 38% faster2,7 and its success rate at healing non-unions is 86%3, the same as surgery.
It is gradually coming into more widespread use in the NHS and recently NICE, the independent body which reviews medicines and treatments for the NHS reviewed the ultrasound technology* used by EXOGEN.
The guidance from NICE, which looked at a large number of clinical studies of EXOGEN, was strongly supportive of using ultrasound to treat non-unions and fresh fractures.
NICE have also published a Medical Technologies Advisory Committee (MTAC) guidance scope* on EXOGEN. This scoping document reflects that NICE wants to conduct a full health technology assessment - to assess the economic value of using EXOGEN in specific fracture types and locations.
“As you might guess by now I wasn’t expecting a miracle, but about six weeks after I started using it I went back to have new X-Rays taken.
“Previously you could see the sharp outline of the fracture, but now it was sort of cloudy where the bone was growing and suddenly everything changed. I could be optimistic.
“I carried on using EXOGEN for about 10 weeks and then I got my final X-Rays showing complete healing. I was on top of the world. I’d had two and a half years of living in a frame, taking painkillers and not sleeping properly. Now I could get back to the job I’ve loved doing for 24 years and also start doing some sport again.
“As soon as I was able I was put on a quarter postal round, then half. Now I’m back doing the full round and loving it. I’m doing karate again knowing the bone is fully healed and I’m planning to take up SCUBA diving again. It’s just brilliant! I’ve told everyone I can about EXOGEN and hope others get to benefit from my experience.”References
Clinical trials for EXOGEN have demonstrated a heal rate of 86% for non-union fractures3
. Results may vary from patient to patient due to various factors.
EXOGEN is a registered trademark of Bioventus LLC. ©2012 Bioventus LLC
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