Unique mega prosthesis used to save clients leg | Fieldfisher
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Case Study

Unique mega prosthesis used to save clients leg

Jill Greenfield represented Terence who, when she initially saw him seemed doomed to lose his leg. Read his story here about how an innovative approach and with funding through his litigation, Terence was able to access fund to rebuild his leg with a mega prosthesis.

Terence Howard was 22 when he suffered catastrophic injuries to his legs after a van driver turned right across him, causing Terence to crash into him. He was thrown several metres into the air and landed on the road in front of another vehicle.

Terence was driving home on his moped in September five years ago following a shift at Asda in Sutton. The next thing he remembers is waking up from a coma in the Royal London Hospital.

The fire brigade and police attended the scene and paramedics from the Air Ambulance crew treated Terence at the side of the road with the experimental REBOA procedure (resuscitative endovascular balloon occlusion of the aorta) that prevented him from bleeding to death. Terence is one of very few people to successfully receive such treatment on the road.

'During my long stay in hospital, I was very groggy and drifting in and out of consciousness and remember very little about that time, accept for terrible anxiety and confusion about what was happening to me.

'But I do remember the patient liaison officer from the Air Ambulance having tears in his eyes when he came to visit me in hospital and telling me they thought they'd lost me. I'll never forget that.'

After several operations and weeks in hospital, the surgeons told Terence he would either have to have his leg amputated above the knee or alternatively have it fused which would mean he would never be able to bend it again. His mum broke down in tears and Terence found it extremely difficult to come to terms with his prognosis.

'All that time, my brain was playing tricks on me, making me believe I was in some very strange situations. Luckily, staff at the hospital suggested to my mum she seek legal advice from Jill and, once she took on my case, Jill appointed me a case manager who began to manage my affairs and think about my rehabilitation package.

'The same surgeon came back into the room and said that actually, there was another option that wasn't available on the NHS, but with specialist, private care I might be a candidate for a mega prosthetic which would enable me to walk again. The worry, however, was that I didn't have enough muscles left in my leg to make it work.'

Over the next two years, Terence went in and out of hospital and underwent multiple operations to take control of the very serious fungal infection in his leg. He had been booked in for amputation surgery multiple times.

'I had no idea what to do. Even the prognosis of having a mega prosthetic fitted was that, at best, I would be able to bend my leg 20 per cent.'

Eventually, two-and-a-half years after the accident and with the infection under control, Jill delivered the good news that the defendant's insurer had agreed to fund the costs of the mega prosthetic, usually only available to people recovering from bone cancer.

Terence then underwent surgery to fit the permanent metal prosthetic that was drilled into his femur, extending it to around 27cm, and included his kneecap. Within a month, Terence confounded his surgeon and physios by being able to bend his leg 90 per cent and within months being able to walk almost perfectly.

'They genuinely don't understand how I can walk like this. My latest physio even says I'm not using the right muscles we use to walk, so he has no idea how I'm managing it.'

Over time and using electro therapy, the plan is to reactivate the correct muscles – but at the moment, the conclusion is that Terence is using sheer determination to walk. The surgery is so new, that on a recent check up, Terence had to explain the X-ray to him because he'd never seen this type of prosthetic before.

Terence does still suffer pain regularly, which can be bad. He tries to push himself quite hard to find out what he can cope with and recently tested himself by visiting Thorpe amusement Park.

'The first time was awful, the second slightly less awful and the third was definitely manageable, although the crippling fatigue that follows from a whole day out means I force myself to rest for a day or two.'

Along with ongoing physical therapy for his leg and learning how to manage pain, Terence also works hard to deal with the PTSD resulting from the trauma, not least knowing how close to death he was. His mental health is improving, but it is something he has to address every day.

'I definitely deal with a high level of anxiety most of the time.'

Thinking about a future that involves work is difficult. Currently, the thought of being at any form of job for a whole day is impossible.

'The pain would be intolerable.'

When he was at the Royal London, the psychologists would visit him regularly. Although Terence has nothing but praise and gratitude for the NHS and the Air Ambulance crew who saved his life, he says it was difficult not to feel defensive when someone who has not experienced what he went through tried to tell him what he was feeling.

'I've found the psychology very interesting. I'm gently developing an idea that somehow I can be involved to help people who've gone through similar trauma - to show them that there is light at the end of the tunnel, to help them recover.'

Around three months ago, Terence's civil case against the defendant driver, who pleaded guilty to careless driving a year after the collision, settled.

'The security it brings means the world. Even with everything I've lost, every opportunity that has been taken away from me, I'll still have a quality of life, certain opportunities, and a future. Being disabled and struggling to navigate the world without it would have been a very hard place to be.

'Being brutally honest, without a lawyer having done all this, providing so much support, I'd have to question whether life would have been worthwhile.'

Contact us

For further information about catastrophic injury compensation claims and road traffic accident claims, please call Jill Greenfield on 03304606778 or email jill.greenfield@fieldfisher.com.


All enquiries are completely free of charge and we will investigate all funding options for you including no win, no fee.