RISKS of LIMB SURGERY
All surgery comes with risks, but we balance these against the potential benefits of surgery.
Mr. Jabbar has had lots of experience and always aims to minimise these risks as much as possible.
The risks noted below are either common risks, potentially frequently occurring risks, or the ones with the greatest potential after-effects. You should discuss these with Mr. Jabbar before surgery if you have any questions or are unsure about the risks.
Pin site infections
You might get an infection around the pin or pins. This is fairly common and may affect one or all of the pins. It is a superficial (surface) infection and will clear up with increased cleaning of the pin sites. You may need to start oral antibiotics but this will be guided by Mr. Jabbar.
There is a risk of infection around the site where the skin or bones were cut. It can usually be treated with oral antibiotics, but you may sometimes need to be admitted for intravenous antibiotics. If this is not enough, or if the infection is deeper than this, you may need another operation. On the rare occasion this becomes necessary you will be guided through this by Mr. Jabbar. The risk of deep infections in Mr. Jabbar’s practice is approximately 0.5%.
Muscle contractures or Stiffening of joints
As the limb lengthens the muscles may become tight or the joints become stiff, due to not tolerating the lengthening. To prevent this, it is important that you keep up with your daily exercises. Mr. Jabbar will check up on this when you come to the clinic. If he feels that the muscles are getting too tight and are not coping with the lengthening then the lengthening process will be slowed down or stopped to focus on increasing the range of movement.
Nerve/vessel/soft tissue damage
There is a risk during surgery of damaging the nerves or vessels in the limb. This can lead to loss of sensation in the area of the affected nerve, and sometimes weakness of the muscles that the nerve powers. It is usually temporary and comes back but there is a very low rate of permanent nerve injury. In Mr. Jabbar’s practice this risk is approximately 0.25%.
If a vessel is damaged it is usually obvious at the operation and dealt with immediately. Slower bleeding will be picked up on the ward as swelling and pain in the limb. Occasionally vessels can develop problems later on and can present with swelling and pain. If this becomes an issue contact the office urgently.
Deep vein thrombosis/ pulmonary embolism (DVT/PE)
This is when blood clots form in veins located deep inside the body, often in the legs. These blood clots form for various reasons including damage to the veins, not moving for a long duration or general health or blood problems that can increase the risk of clots. They are usually more common in adults. DVT usually presents with some swelling and pain in the leg, especially after activity. These are common and usually can be treated by watchful waiting. If they are high in the leg you may need medication to help stop it getting bigger until it resolves. If you think you have a DVT contact the office at the earliest opportunity.
Pulmonary embolism (PE) is when one of these clots travels to the lungs. Symptoms include breathlessness, chest pain and cough. In this case please go to your nearest Emergency Department or Urgent Care Centre.
There is a risk that you develop compartment syndrome. This means there is too much swelling in a part of the limb. It is an emergency and usually needs another operation to release the pressure. Sometimes the muscle is damaged more than can be seen during emergency treatment and shows up as weakness in some movements later on which may need more operations. The risk of this happening is small but it can happen.
The bone can fracture (break) in a place different to what was intended. This usually does not mean any change to treatment, but it will be closely monitored as it heals. If there is a significant risk of this changing the way your treatment happens this will usually be discussed with you before surgery and the options given to you.
There is a risk that the lengthening or correction may not work, or the malalignment may come back after the correction has been completed. If this happens, Mr. Jabbar will discuss options for further treatment with you in clinic. Lengthening or malalignment correction can be repeated if necessary.
Non-union or Mal-union
There is a risk that the bone may not heal (non-union) or it may heal the wrong shape (mal-union). If this happens, you may need to have further surgery to help heal the bone or to correct the shape.
Metal work issues
There is a risk that if you have metal plates/ screws inserted as part of deformity correction, they can become loose or cause pain. This may mean that you need further surgery.
There is going to be scarring after surgery. The severity is dependent on the individual and how they heal. If you are unhappy with the scarring, discuss this with Mr. Jabbar in clinic and he will go through your options.
There is a risk that if a cut is made to a joint to correct the shape it may damage the cartilage. This usually gets better in time but can cause some pain and stiffness, depending on your age and how the joint was before surgery.
There is a risk of long- term pain after treatment until the nerves/soft tissue settle in the new position. Sometimes this can carry on for a long time. It can be quite hard to predict who this will happen to, especially if you haven’t had surgery before. If this happens you may need help from the Pain Team to manage this.
Need for further surgery
There is a risk that any correction or lengthening needs to be done over a period of time which will require several operations. Mr. Jabbar will discuss this with you in clinic.
This is rare. Often if we consider amputation it will be as a primary treatment or a final outcome after trying very hard to clear a limb of infection or joint problems that are affecting the whole limb.
In the rare circumstances that this is a result of treatment you will be supported through the process by Mr. Jabbar and one of the excellent rehabilitation services that work with Mr. Jabbar routinely.