Multiple Fractures, Tib/Fib Open Wound

[Demius]

On 18 APR 2010, my little girl was in a 4 wheeler accident. The nose end of the vehicle landed on her right lower leg, crushing the Tibia and Fracturing the Fibula. She was Med-Flighted the 40+ miles to Huntsville Hospital for Women and Children in Alabama. I would have preferred that she had been flown to UAB in Birmingham, Alabama but she was losing a lot of blood, so good thinking on behalf of the Med Flight Crew. Anyway, she spent 8 hours in the Pediatric Trauma/ER before seeing a surgeon... we were told that the Ortho Surgeon was loaded down and my lil girl was in line to be seen very soon. At 2am she is finally seen and has surgery in which they attached an external fixation to the Tibia. At the time, I was under the impression that the fixation was attached to stabilize the Tib and Fib. As it turns out, it is attached only to the Tib. The Fibula is still broken and has no stability (no hard cast can be applied due to the open wound up the inner side of her leg). Is it normal for the fib not to be stabilized using a fixation or any other means? Also, the Tibia was a crushing fracture; there is a space of just over 2 inches where the bone was crushed. The Ortho Surgeon left the largest pieces of crushed bone in place and said that it would help the bone heal (a ¼ inch gap exist between the top and bottom portions of this bone. Is that normal? Can anyone tell me another method of treatment that would be more beneficial to her in this situation or is it truly a game of wait and see?

More Details:
8 year old female
4Ft. 2inches
58lbs.
Currently utilizes Hyperbaric Oxygen Therapy on a daily basis. No Physical Therapy has been recommended as of yet.
First Surgery, first broken bone, first major wound.
Right foot is starting to exhibit a darker discoloration compared to left foot, I am guessing this is due to the nature of the wound and the blood flow of the leg.

[Demius]

Just an update. After undergoing 2 more surgeries to move muscle and fix blood flow issues and another surgery to do a minor bone graft and bone marrow aspiration, there has still been no bone growth. The pain on the outer most side of her right leg has gotten worse since the Plastics dog removed 2 inches of skin to decrease the necrotised skin (this action put more pressure on the still un-fixated broken fib). Another appointment has been setup for the 23rd to determine what path we take next.

[PedroH]

It seems to be quite normal for the fibula to be left alone to heal on its own.I had tib/fib fractures and while I had ORIF with IM nail placed in my tibia my fibula was left alone.(I never had a cast either) That being said,5 months after the fact I had a bone graft done on my fibula as it was not healing. Keep in mind I was 41 @ the time,so I'm sure your daughter will do much better w/healing.  I am so terribly sorry that an 8 year old has to deal with any injury especially this one.-Bless her heart- Here's hoping for a speedy recovery!