From a shattered ankle to Antarctica

The devastating impact of Dinesh Nayak’s fall down his basement stairs in February 2010 was immediately obvious in the pain he felt radiating up from his left ankle. But today, he says his choice to seek help at Christiana Care was an “outstanding” decision.

Dr. Paul Kupcha, an ankle specialist at Christiana Care Health System, became his health care partner during the 11-month journey to recovery.

The effect of landing on his left foot resulted in a pilon fracture, a diagnosis Kupcha confirmed with a CT scan shortly after the injury. A pilon fracture refers to a high-impact injury where the tibia (the larger bone in the lower half the leg) shatters at the point where it hits the bones in the ankle.

Many people who suffer a pilon fracture never walk without crutches or a limp again. But two years after that fall down the basement stairs, Nayak has returned to everything he loves doing.

“It’s really a testament to the doctor that I’m able to walk,” Nayak said. “The fact that I can walk without even a cane is truly remarkable.”  Nayak’s only lasting reminders are occasional pain and stiffness, and mild range-of-motion limitations in his ankle.

Kupcha performed  surgery at Christiana Care’s Wilmington Hospital after the original injury to repair the damage.

Over the next five months Nayak used an external fixator  — an external device of pins and rods — that is coupled with internal plates to stabilize the bone. They helped Nayak’s tibia knit back together. During weekly visits to Kupcha’s office, adjustments were made to keep the healing on track.

When the external fixator was removed – a few months early because Nayak was tired of keeping the weight off his foot — the healing process was well under way. Follow-up included various casts, splints and braces that allowed  Nayak to gradually bear weight on his foot. When those were removed, Nayak began two months of physical therapy to build strength and learn to walk again.

At that point, a celebration was in order. Nayak decided on a trip to Antarctica. Since then, he’s traveled to destinations all over the world.

Nayak thanks Kupcha for helping him achieve that return to activity.

“I chose the emergency room at Christiana Care; I chose Dr. Kupcha; I made those choices,” Nayak said. “…My experience at Christiana Care was outstandingly good.”