Australia’s ‘bionic man’ has turned out to be an inspiration for Iraqis who have lost limbs in the country’s ongoing fighting.
When Iraqi-Australian orthopaedic surgeon Dr Munjed Al Muderis recently returned to Iraq at the invitation of the country’s PM to help amputees there, he took with him videos of of his previous patients walking freely with their new robotic legs.
One of those patients was Darren Wilson. This is his story.
A normal ride home gone wrong
It was about 5:30pm in late October 2012 and, as usual, Darren was riding his motorcycle home. Bikes have been a passion for as long as he can remember.
He’d had the odd bingle over the years, but with a wife and family at home, he didn’t take any risks.
He remembers a pretty normal journey through commuter traffic in Adelaide, his home town, and he was thinking about nothing particular.
There was an almighty bang. And then nothing.
He doesn’t remember how a white SUV suddenly turned into his path and hit him.
He doesn’t remember how his left leg became entangled with the motorbike and was torn off, that the bike then careered off, hitting a tree and then a wall.
He doesn’t remember that’s how he lost his right leg as well.
When he finally woke up in hospital, it was to the shocking realisation he was now a bilateral amputee. At the age of 43, Darren had lost both his legs and very nearly his arm.
It took six months of rehabilitation before Darren could go home. At first he was confined to a wheelchair and then, slowly, he began the incredibly arduous task of adapting to life with prosthetic legs.
Learning to walk again
Determined to walk as well as he could, Darren started to talk to other amputees about what to do.
He was told to start off with a pair of “stubbies” or short legs, which would allow him to find his new centre of gravity.
“It got me moving and out of the wheelchair. People stared, but I didn’t care,” he said.
After six months of learning how to walk with the “stubbies”, Darren was ready to try his tall legs. It wasn’t an easy transition.
When Darren put on the longer prosthetics, he found it harder to get up and walk.
He would fall over a lot. The sheer effort needed to move was exhausting, and no wonder.
Bilateral amputees expend 300 per cent more energy to use prosthetic legs than an able-bodied person walking.
It was a dark time for Darren.
Both the short and long prosthetic legs were an ongoing problem for him.
“Sockets are a living hell, that’s putting it nicely,” he said.
Traditional socket prostheses work by a process of suction and vacuum.
As he walked, Darren would sweat. This would affect the volume around his prosthetic limb and reduce the amount of suction he had, making it feel loose and unstable.
On really hot days, it became almost impossible to leave home.
Darren also found it painful to stand for any length of time, which meant he was virtually housebound and feeling incredibly frustrated.
Osseointegration, a new surgical technique
Darren was told about Dr Munjed Al Muderis, one of Australia’s leading orthopaedic surgeons.
Based in Sydney, Dr Al Muderis is an expert in the relatively new surgical technique called “osseointegration”, which involves placing a titanium implant directly into the residual bone.
In the upper limb the nerves are reorganised and attached to muscles that are no longer used.
Instead of the centuries-old style of prostheses, where a socket is fitted over a stump, patients receive new “robotic” legs which attach to the implant.
Darren underwent osseointegration surgery with Dr Munjed Al Muderis after weighing it up for a few years. (Supplied: Darren Wilson)
These are smart limbs with internal gyroscopes that read the individual’s manner of walking or body position.
The patient must actively remember which muscles they used for walking and re-learn how to engage them.
Gradually the process becomes more straightforward and almost spontaneous. This type of surgery also allows for direct contact with the ground, greater stability and more control.
It also minimises the energy required to move. The patient can once again feel the type of surface they’re walking on and distinguish between pavements, sand or pebbles.
Darren took a few years weighing up osseointegration surgery. But in 2015, he went ahead.
Back to his old self
After months of physiotherapy, hard work and a few tears, Darren faced his first big test.
He and his wife took a trip to Broken Hill where daily temperatures climbed as high as 45 degrees Celsius. With his new legs, he managed 24,000 steps. He had passed with flying colours.
It’s been two years since Darren’s surgery and he is now almost as mobile as he was before his accident.
He has been able to return to work part time as a truck driver, and he’s back helping his wife do the weekly shop.
Darren is now almost as mobile as he was before his accident, with his new osseointegration prostheses. (Supplied: Darren Wilson)
He still travels to Sydney to see Dr Al Muderis for help with a recurring problem which nearly all amputees struggle with — neuromas.
A neuroma is a bundle of nerve endings which forms under the skin of the residual limb and can press against the new implant. It can be painful and usually requires further surgery.
Darren has also suffered greatly from Phantom Limb Pain (PLP), an ongoing painful sensation that feels like it comes from the part of the limb that is no longer there.
It’s thought to be caused by mixed signals from the brain or spinal cord.
His experience since osseointegration implant surgery is his PLP has been significantly reduced, and he’s hopeful it will continue to dissipate over time.
Darren Wilson is a happy man. He loves his wife, his kids and being able to play an active role in his community once more.