Utah Attorney General Mark Shurtleff has undergone his sixth surgery to his left leg sustained in a motorcycle accident he had in September 2007.  His left leg was badly fractured when he was riding his Harley in preparation for a motorcycle rally to raise money for a memorial for murdered Utah police officers.  Shurtleff hit a patch of gravel and his bike landed on his left leg shattering it.

Originally the surgery was thought to be a success however recurrent infections occurred.  These infections in and around the metal plates, screws and pins retarded healing finally leading to a condition doctors refer to as nonunion."

Nonunion is a serious complication of a fracture and may occur when the fracture moves too much, has a poor blood supply or gets infected.  The normal process of bone healing is interrupted or stalled.  In some cases the pseudo-joint (pseudarthrosis) develops between the two fragments with cartilage formation and a joint cavity.  More commonly the tissue between the non-united fragments is scar tissue.  Generally a nonunion, if showing no signs of bone scab formation or healing for greater than 6 months chances are the nonunion is not going to heal without more surgery.

Nonunion can be very painful and treatment may be limited.  Essentially there are two options -  surgery that may or may not work and amputation.  Oftentimes an external fixator is used to hold wires absolutely stable - the wires pass through each end of the bone and new bone is hoped to heal between the two healthy bone ends.  This technique was developed by Gavril Ilizarov during WWII and consists of the Ilizarov Apparatus.  This is probably a last hope measure for Shurtleff.  We hope it works for him.

I bring all of this up for two reasons.  First many motorcycle accidents involve bone fractures especially of the long bones of the leg - the femur and the tibia.  Sometimes these fractures are open fractures - meaning the fractured bone penetrates and sticks out of the skin.  This means the bone is often contaminated and the risk for bone infection is high.  With a relatively high rate of infection there is a distinct possibility that the bone will not heal yielding nonunion.  Nonunion will result in a long convalescence.

The second reason I bring this up is that nonunion is usually not diagnosed for at least 6 months after the initial injury.  This means that an injured motorcycle rider may settle their claim too early only to find out later that the injury will cause their leg will need extended care at best and be amputated at worst.  If you settle too early you will not get another bite at the apple.  What I mean by this is that once you settle with an insurance company they insist that you sign a waiver or release.  This document will bar you from bringing a legal action forward to seek recovery from the"unforeseen" extended recovery or amputation.

In summary, if you have any suspicion whatsoever that your injury will cause you extended healing that may eventually result in an amputation wait to settle your claim.  Be absolutely clear that you are what is often termed MMI (maximum medical improvement) before you settle.  Also make sure the possibilities of future complications are calculated into the value of the settlement.  You need to be patient and work with your attorney to make sure you make one good claim that addressed all of the losses already incurred and all those losses that will occur in the future.

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