So why didn't it heal? Dr. Buchanan told us it's very difficult to know. It could be because we didn't fixate the tibia until several weeks after the trauma. We couldn't because of how bad the injury was -- there was a ton of swelling initially and a large fracture blister.
Dr. Buchanan laid down several options for us, but he hasn't decided the best option for me until Monday night. In the meantime, he's consulting with several orthopedic surgeons.
The first option is to not have surgery. The alignment isn't great, but because there's no infection. Without bearing weight, there's a good chance it will heal on its own.
The second option is a relatively minor surgery to help the bones heal without removing the broken hardware or adjusting the alignment. He'd use a new substance called OP-1 putty to help promote bone growth. I brought up the adult stem cell therapy, and he said he's done it before and that he'd consider doing that in my case as well.
The third option is a major surgery to adjust the fracture's alignment. He'd remove as much hardware as he could (the tibia screws aren't coming out), move the fractured bones back a little bit, and attach a large halo external fixator. I'd have to wear this fixator for several months. It'd be adjusted weekly to slowly align the fracture over time. Because my ankle would be locked down, it'd get extremely stiff and limit the range of motion I'd get back even further.
In both surgical cases, he plans on taking a biopsy from my bones and growing a culture in the lab to make sure nothing is going on.
I told him my number one goal is long term quality of life -- to include snowboarding and biking. If aligning the fracture and sitting in an external fixator for months will do the job, then let's go for it.
So what's next? Dr. Buchanan is going to do some work this weekend to research the options further. He'll call me Monday night to tell me what he thinks I should do. His surgery days are Monday, so he thinks I should opt for surgery, I'll probably go under on the 16th.