Quiet Blog Question Duck Two: Duck Harder

PeterDuckie 2 Warning: Contains X-rays of spines and hips and if you know what you’re looking for, even some intestines filled with what intestines are filled with. Yup, that stuff.

In other news, according to Jon’s orthopaedic surgeon it’s the end of an era for Jon’s hips. Jon was recently examined for both the state of his hips (the first surgery for which started this blog so many years ago) and his more recently-occurring scoliosis. The scoliosis is now the major concern, as he still has a couple years of potential growing to do, and we need to keep watch to see if any surgery might yet be required. His spine has curved ever so slightly more this year, 15 months since his last x-ray, but not enough to set the surgeon into action.

current state of Jon's scoliosis back curvature

Mind you, we’ve already been in to contact with our wheelchair vendor and Jon’s board-assigned occupational therapist to get them alter some aspects of his wheelchair. Due to bad timing, this latest chair arrived during the summer of 2010, and his previous occupational therapist and vendor rep changed when he arrived at his high school, so there was no continuity to ensure that what they had originally recommended nine months before was working—and as it turns out, some of the new touches weren’t appropriate. (We understand this aspect; every individual with CP has unique issues, and what works for one will not necessarily work for others. Therefore, more attention is needed.) And now, with a second school move, we’ll be changing therapists again. So we’ll have to stay proactive on this one.

But in end-of-an-era news, Jon’s hips got their final major x-ray. The hip’s growth plates are now fused, so there’s little likelihood for the metal hardware buried inside his femurs to shift. Both the pelvis and the femurs look good, have finished growing nicely since his most recent surgeries of five years ago. And with that, this particular worry in life is over. Any further growth will be in his legs or his torso (adding more strain to his back). So while the hips fade away in concern, we must be vigilant about his back (as much as we can, in any case)

Let’s take a tour down Hip-storical Avenue, shall we?

(pun copyright ©2012 Peter Cook)



As we’ve said before, femurs don’t grow bent, they and the hip socket grow and develop that way by the toddler owner running around on them. Jon didn’t stand or run enough, so they never could set properly.
Hip x-ray before any operations

Surgeon Plans

This is the surgeon’s quick sketch of his plans (made for inquiring parents. Notice the number of IKEA standard parts is reasonably low.)
The surgeon's sketch of his plan


Afterwords. It looks a little drastic at this point, but notice the cool rebuild.
Hip x-ray after operation at 5 years old

…And 6 weeks later

It’s all looking way better. At this point, all concerned had hoped that Jon could have enough physiotherapy to achieve proper development in time. (Note: that was about the time Mike Harris took over Ontario, introduced massive cutbacks in education and instituted that physiotherapists for special needs kids could only advise—no hands-on therapy. Jon’s school had 5 or 6 therapists, and after his first year they could no longer directly participate in the their physical therapy.)

Hip x-ray two months later

The intervening five years were a bit of a blur hip-checkup-wise, but at some point we were offered the chance to go to Bloorview MacMillan to get Jon’s X-ray instead Sick Kid’s orthopaedic clinic (imagine 30-40 folks in one room, milling staff, long lineups for X-rays, etc.). We were told that each X-ray taken was forwarded to Sick Kid’s for examination by our surgeon, but somewhere along the way, be it before or after we were assigned a different surgeon, the X-rays just stopped getting to where they had to get to, and Jon’s growth was shifting the blade plate…


The Leg Break

It won’t go into the detail of the break-on-vacation, the misdiagnosis by Vancouver Children’s Hospital, or the eventual-but-delayed surgery at Sick Kids in Toronto…
Hip x-ray after break returning from British Columbia at age 10

…but to say that Jon’s right leg was repaired, and it became clear via the X-rays that it was time do his other one too. They did that about six months later.


Hip x-ray after fixing break, and redefining Jon's other hip

Late 2011

Jon's hips at 15 years old
And here we are. In shots like this, remember that you are viewing it three-dimensionally so that the upper part of the “L-Bracket”, called the blade plate, is entirely embedded in the bone. Nothing is jutting out. The side portion of the bracket is on the outside, affixed by screws.

So that’s it for Jon’s physionogmy for a while. Let’s hope! 🙂