For Rachel Holden to walk again, she had to risk one good leg to save the other.
The Wellington 43-year-old's leg was saved by a complex and experimental operation, performed by Wellington surgeons Peter Devane and Professor Swee Tan, in which a bone in her lower left leg was removed, cut in two, and wedged into a 10cm gap in her right leg.
Ten months later, she can walk freely on both legs despite not having quite enough bone in either.
Holden was riding her motorbike home to Stokes Valley over the Rimutakas on May 23 last year when she edged over the centre line and collided head-on with a car.
"I honestly wasn't an experienced rider. It was really, really silly."
In the crash she broke her left arm so badly it was nearly amputated. As she hit the road, her right femur snapped, the bone piercing the skin and grinding down into a shattered mess against the asphalt.
"I just remember waking up in ICU. I don't recall having an accident, I just recall waking up and hearing my family's voices."
Devane operated on Holden that night after she was flown to Wellington Hospital.
"She had pretty horrific injuries," he said. "About 10 centimetres of the bone had just been turned into confetti. It was all floating around in little bits."
Devane cleaned out the broken bone and stuck metal scaffolding and filler into the leg to hold it together, while another surgeon took a piece of Holden's pelvis and used it to plug the gap in her arm.
However, with a 10cm gap in the biggest bone in Holden's body, Devane's work was only ever a temporary measure.
Holden remembers while she was recovering in intensive care for two months hearing doctors discussing whether to amputate her leg.
"I remember saying to a girlfriend, ‘They can take anything else but my leg'. I was determined."
In the months that followed, Devane searched for innovative ways to save Holden's leg - even travelling to the United States to consult experts there.
Eventually he turned to Tan, a plastic surgeon at Hutt Hospital, who suggested trying an operation neither of them had ever performed.
Tan wanted to remove 21cm of Holden's fibula - the skinny bone on the outside of her lower leg - and use it to fill the gap in her femur. Because the femur was so much thicker, the fibula would be snapped in two and doubled over to increase its strength.
Not only would the bone be moved and reconnected but so would the veins and arteries, to restore blood flow and speed-up healing.
The hope was the new bone would eventually join up and the femur would heal itself, while the other leg would work almost as well minus most of a bone.
As far as Tan was aware the operation had never been performed, something Holden said terrified her.
"I thought, I've got a buggered leg and now I am going to have two buggered legs. I was really concerned about my ability to walk."
Holden went into theatre on July 22 last year, with Devane and Tan working on her for most of the day.
Within days, she could walk on her left leg and three months later she was able to walk unaided.
Today, she can even manage a brisk power walk.
"If I'm crossing the road I have to be careful because I can't run."
Holden's right femur still looks a little thin but Devane said it was already healing and eventually should resemble a normal bone.
Tan said much of the credit should go to Holden, whose fitness before the accident and determination to keep her leg was vital to her recovery.
Holden was just happy to be alive and walking.
- The Dominion Post
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