General Consent Form

Uniting Health Care         The Wesley Hospital Booking Office 451 Coronation Drive Auchenflouer QLD 4066 Telephone: 07 3232 7200 Facsimile: 07 3232 7503

PLEASE PRINT OR AFFIX STICKER Famile Name: Given Names:                      MR/UR No: Address: DOB:  Treating Docotr: Dr Martin Lowe

PROCEDURE:     The tibia is the long shin bone in the lower leg. It is a weight bearing bone and will need to be fixed for you to walk on it. Your surgeons feel that the best way to hold the bone together is to insert a nail through the bone hence holding the two ends together and allow proper bone healing. The tibia bone is essentially a long hollow tube with marrow in the middle. A nail (or metal rod) can pass through the hollow and bridge the two broken pieces.  This means you will most likely not have to wear a cast, but you are still advised to not put any weight through the leg until advised.

 

ALTERNATIVE:   When your tibia has been broken it may be advisable to have it fixed. Not fixing may result in non-healing, delayed union or mal-union. All these can cause quite significant disability and long term problems.

There may be other options available to treat this fracture; these including external fixation or plating. However, it is the suggestion of the consultant surgeon looking after you that nailing is the best option. You are of course entitled to a second opinion.  There MAY also be a non-operative option. This would be to place the fractured leg in a cast and regularly x-ray to watch the bone healing. You will have to be non-weight bearing and there is a very high risk of non-union (when the bone ends do not fix properly of do not meet at all) in these fractures which may eventually require an operation such as the one above.

RISKS

As with all procedures, this carries some risks and complications.

 

COMMON (2-5%)

Pain: Your ankle will be painful after the operation. Keeping it up will help decrease the swelling and therefore the pain. In some rarer cases, the pain may be long term.

 Numbness: The skin around ankle may be temporarily or more permanently numb due to damage to small nerves.

 Stiffness: Stiffness and osteoarthritis may continue. This may require vigorous physiotherapy and or repeat surgery.       

        

LESS COMMON (1-2%)

Repeat surgery: This may be necessary as the swelling at time of initial operation maybe too great to proceed.

 Removal of metalwork: This may be necessary if it becomes infected, break, or painful or damages the skin. Similarly, the metalwork can be removed for better comfort and movement. If a special screw (called a diastasis) is placed, this is usually removed around 12 weeks after the initial operation. Otherwise, it is not normal to remove the metalwork.

 

RARE (Less than 1%) 

Infection: The wound site may become red, swollen and painful. There may also be discharge. If this occurs, antibiotics may need to be given. If the metalwork becomes involved, it may be removed. There may be spread of the infection to bone or blood (sepsis). Again, antibiotics may be necessary.

Bleeding: May occur if there is damage to a vessel. This is usually minimal and can be stopped at the time of operation. Very occasionally a blood product or iron tablets may be necessary.

 Abnormal wound healing: The scar may become thick, red and painful (keloid scars). This is more common in Afro- Caribbean people.

 DVT/PE: Rarely, a clot may form in the veins of the legs or in the lungs.  This may result in pain or difficulty breathing and may require medication to treat.  Even more rarely there are more serious complications from this including death.

The Patient Requests Treatment

 

I agree that I have discussed my condition (or the condition of the person for whom I am responsible), and the various ways of treating the condition with Dr Martin Lowe.

 

I confirm that:

• I have read and understand the procedure, risks and complications.
• I have asked any questions and raised any immediate concerns I might have.
• I understand that I will have the opportunity to discuss the details of anaesthesia with an anaesthetist before the procedure.
• I understand that any procedure in addition to those described on this form will only be carried out if it is necessary to save my life or to prevent serious harm to my health