Dr. Bitterman examined the bump on Frank’s foot and said it was the result of diabetic Charcot arthropathy, a condition in which poor circulation in the feet can cause the bones and soft tissues in joints to disintegrate. “Because of accompanying nerve damage, patients often can’t feel how serious the injury is,” Dr. Bitterman explained, adding that without surgery, Frank’s foot would likely become increasingly malformed with a higher chance of wound breakdown and infection. It would also develop ulcers, an entry point for infection that could potentially cause him to lose his leg.
The possibility of losing his leg alarmed Frank, but he understood that surgery was his best option. In January 2018, Frank had a foot osteotomy, in which Dr. Bitterman carefully broke selected malformed bones of the right foot and realigned them. He then surgically attached a large external metal frame to the foot called a ring fixator, which stabilizes the bones so they heal correctly. The procedure took about six hours.
“I woke up and had pins in my leg, starting from maybe six inches below my knee, and I couldn't walk,” said Frank. "But Dr. Bitterman prepared me for how the fixator would look and feel, why the device was necessary and the recovery process.”
After a weeklong hospital stay, Frank moved to an inpatient rehabilitation center, where he kept weight off of his foot as it healed. When he returned home seven weeks later, he participated in physical therapy sessions through the Northwell Health At Home program, and used a walker and crutches to get around the house. A visiting nurse cleaned the fixator’s entry points on the leg and foot, and changed Frank’s bandages several times a week for about three months. He visited Dr. Bitterman for monthly follow-up appointments to ensure bones and tissue were healing properly. In April of 2018, the fixator came off and Frank wore a cast on his knee for four to five weeks.
Frank attended outpatient physical therapy to work on his mobility. After 20 visits, he started going for walks near his house. He continues to do his own physical therapy exercises at home. “Even today, if I get up quickly, my balance is not 100 percent yet,” said Frank. “Dr. Bitterman said it could take a year or more to fully recover.”