Pioneering titanium technology has been used at a British hospital to rebuild the ribcage of a woman who suffered nine broken ribs and a punctured lung when trampled by her horse.
Northwich woman Barbara Schofield, an experienced horse rider of 20 years, was injured when she fell underneath her horse when the saddle slipped around.
Figaro, a four-year-old Dutch gelding who stands at 16.2 hands, accidentally trampled on her, leaving nine broken ribs on Schofield’s left side – six with multiple fractures. The damage also caused air and blood to go between her lung and rib cage, which was an additional complication.
Schofield, 52, was quick to jump to the defence of Figaro – named after the mischievous black and white cat in Walt Disney’s Pinocchio.
“There was no malice at all from Figaro – it was human error and the saddle slipped around and underneath him – it was just one of those things. I’m really lucky to still be here,” she said of the September 13 mishap.
She was taken by ambulance across to the Royal Liverpool University Hospital’s emergency department, where she was cared for by a trauma team and orthopaedic surgeons.
Reconstruction began using titanium plates and screws, resulting in an anxious six-hour wait for her husband, Steve, along with close family and friends.
Her rib repairs used the Synthes Matrix Rib System, which was developed in Switzerland. It uses a series of curved titanium plates around 10-20 centimetres long and 10 millimetres wide. They are sculpted in a factory and fine-tuned by a surgeon to fit the contours of the patient’s ribs – rather like a Meccano set.
Only a handful of hospitals in the country use this latest technology, which makes it possible for the ribs to heal faster with lower levels of pain.
The surgery was carried out by orthopaedic surgeons at both the Royal Liverpool University Hospital and Aintree University Hospital as part of the Cheshire and Mersey Trauma Centre Collaborative. The collaborative, which includes the Walton Centre, provides highly specialist care to patients with life – threatening major trauma injuries.
Schofield remained in the intensive care unit for seven days, her husband making twice daily visits to see her.
Within 10 weeks, Schofield – who works in the National Health Service as a part-time clinical physiologist in cardiology at Warrington Hospital, was back in the saddle for the first time since the accident.
Schofield praised the work of the trauma team and the surgery performed by Sanjay Kalra.
“He has worked wonders and I am extremely grateful to him as his expertise has resulted in a much more timely and successful recovery.
“Earlier, when I was in the ambulance I recall the crew discussing the latest technology for stabilising multiple rib fractures they’d recently introduced at the Royal – so that was where I was taken.”
Normally, broken ribs take at least six weeks to heal, but in Schofield’s case it could have taken even longer because of potential complications with multiple breaks on six of the broken ribs.
“I realised that this surgery was quite novel and I’m lucky to have had this technology and procedure on my doorstep, in Liverpool.
“It’s been a bit of a joke with friends and colleagues referring to me as ‘barbed wire’ instead of Barbara and also the ‘bionic woman’! I’ve not been through the security body scanners at an airport yet – they will probably never have seen anything quite like it!
“I have recovered very well indeed. I am still a little hindered by weakness and slight numbness down my left side due to nerve damage from the accident but am feeling confident that this will reduce with time and the help of physiotherapy at my local hospital.”
Kalra, the consultant trauma and orthopaedic surgeon, said: “The pain of multiple broken ribs is excruciating so patients naturally try not to move around much. Because taking deep breaths and coughing is painful, there’s an increased risk of pneumonia because phlegm can build up within the lungs and can often become infected.
“With this technology the procedure we use not only reduces the risk of complications but encourages a faster return to normal function. It is only recommended for patients who have suffered severe chest trauma with multiple broken ribs.
“The results and patient outcomes have been excellent for patients like Barbara at both the Royal and Aintree hospitals.”
Barbara is now riding again and carefully re-building her confidence – she says her bond is growing stronger than ever with her horse Figaro.