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00:01One, two, three. Whoa!
00:05Hello, mate. You understand Irish?
00:07Animals from all over the world
00:09Ah, bonjour.
00:11Come to see one extraordinary man
00:14who's known as the Bionic Vet.
00:16High five. Yes!
00:18Professor Noel Fitzpatrick.
00:21You only get one shot at this. Here we go.
00:23Noel and his team offer some of the most advanced treatments available anywhere.
00:28It's a perfect marriage in mechanics and biology.
00:31This is what we have now. A brand new knee.
00:33Oh, wow!
00:35For some, it's a last chance.
00:38It is a life or death situation because we cannot leave him like he is.
00:42I just want you to do anything you can for him, really.
00:45Sorry.
00:46As Noel continues to devise new ways of healing...
00:49You're going to be Bionic. Thank you so much.
00:52He transforms the lives of his patients.
00:55Oh, that is just unbelievable.
00:57He's raring to go.
00:58Against all the odds.
01:00Boom!
01:01One small step for a dog, one giant leap for mankind. Well done.
01:10It's early morning at Fitzpatrick Referrals
01:12and the staff are preparing for a busy day ahead.
01:15Toilets are just down there to the left-hand side. All right.
01:18I thought I saw a little one.
01:21I can't see. Oh, there you are.
01:24Oh, Lord. Hello, perfect skydives.
01:28I like your outfit.
01:31Waiting in reception are Steve and Debbie Rand and their two Carpathian Shepherd dogs,
01:36one of which, 11-month-old Molly, has a dislocated hip.
01:41Molly and Missy, well, Missy's come along for the ride, but Molly's coming because we noticed she had a limp about October time.
01:49Plasterer Steve and his wife Debbie rescued Missy and Molly from Romania, where they'd been badly mistreated.
01:59I just fell instantly in love with them. I thought they were the most beautiful little things I'd ever seen.
02:04And these two little puppies in a Moses basket just stared back at me.
02:08They were just abandoned and kicked about round a field and treated like vermin.
02:15They were full of worms and fleas and things, and quite poorly.
02:19In fact, Molly was the one that they thought wouldn't make it.
02:22Molly and Missy were adopted and restored to good health.
02:26Or that's what Steve and Debbie thought.
02:29Molly was just limping a little bit, and then by the afternoon she wouldn't put her foot down.
02:34We were at the vets that day, weren't we?
02:36They booked her in for an x-ray, and when we saw the x-rays, we knew how serious it was, yeah.
02:42One hit was just non-existent.
02:44We're helpless at the moment. We just feel helpless, yeah.
02:47There was lots of tears, but everyone that we spoke to said,
02:54Noel will sort it.
02:56And you're so worried that one's going to be left on their own.
02:59Yeah.
03:00Hi there.
03:02Hello, how are you?
03:03I'm fine, thank you.
03:04Nice to meet you.
03:05Nice to meet you.
03:07Hi Noel, good to meet you.
03:08All right guys, now I'm just waiting for your x-ray pictures to come on.
03:11Which leg is she limping on?
03:12This one.
03:13The left hand.
03:14Yeah.
03:15And your vet took the x-ray picture, and what did he or she say?
03:17Either put down, leg off, or operation, so we ask to be referred to you, because there's
03:24not an option to put her down.
03:26So your vet is absolutely correct, there are three options.
03:29One is to do some kind of surgery on the hip, one is to take the leg off, and one is euthanasia,
03:34and we're not going to talk about that.
03:35Yeah, yeah.
03:36No, she's beautiful, isn't she?
03:37She is.
03:38Now I'm going to back you up a little, I'm going to have a physical exam.
03:40Good girl.
03:41Good girl.
03:42There we go.
03:43You are a good girl, aren't you?
03:46Good girl.
03:47Okay.
03:48It's self-evident what's going on.
03:51We've got this happening.
03:52You've got no socket left.
03:53No.
03:54The head is up here somewhere.
03:56Yeah.
03:57And it's worn away because it's come out of the joint.
03:59I suspect that that's traumatic, rather than a genetic hip dysplasia.
04:04If you look at the shaft of the femur, the neck normally comes off at that angle.
04:09Look how straight it is.
04:11It's coming straight up almost.
04:13It's likely that that hip came out at age, say, two months.
04:17Yeah.
04:18Well, they were used as footballs, both of them, when they were six weeks old by teenagers.
04:21Right.
04:22Well, this hip was almost certainly traumatically dislocated.
04:27Obviously, there is still pain.
04:29Yeah.
04:30And you would need to give her medicine every day.
04:32If you could make surgery work, that would be a superior option, in my opinion.
04:36So shall I crack on and get the CT?
04:38I think so.
04:39And then we'll reconvene.
04:40I think so.
04:41All right, Bubba.
04:42Can we go through and get a CT?
04:43Before surgery can go ahead on such a severe hip dislocation, Noel needs carefully to consider
04:49what implant to use to minimise the risk of failure.
04:54The bottom line is that, yes, a total hip replacement is possible.
04:58And, yes, I would want to put a custom cup in if we were going to do it.
05:02So it's literally like an ice cream scoop made out of titanium.
05:06I won't have any problem getting this to attach to that bone, I think.
05:09I won't have any problem putting a stem in.
05:11The big risk is in getting the new head to stay in.
05:15Yeah.
05:16So that means that you'd need a big rim on here to stop it popping out.
05:21The offset distance is the distance from the centre of the head to here.
05:25And that needs to be big enough so that the muscle's tight.
05:29But as you increase the offset distance, you stretch the nerve more.
05:33But if you stretch the nerve too much, you get neuropraxia, which is palsy of the nerve
05:38and then drag the foot.
05:39And the other thing that I wanted to tell you is the kneecap's dislocating
05:42because this muscle's loose.
05:43Wow.
05:44OK, yeah, she's got problems, hasn't she?
05:45Yes.
05:46I don't think it's a no-brainer to me.
05:48Yeah, fix it, please.
05:49I'll go get her for you.
05:50Thank you very much.
05:51No worries.
05:52Pleasure.
05:53Time to go, sweetheart.
05:54Come on.
05:55Come on, Bubba.
05:56Good girl.
05:57There we go.
05:58Hello, darling.
06:01God bless, guys.
06:02Cheers.
06:03Bye-bye.
06:04Relieved that Noel can operate, the couple go home with Molly to await her surgery.
06:10He's a good man.
06:11Very impressive.
06:12Yeah, he's going to do a custom-made hip that's bolted in.
06:15To hear that she can be put right.
06:17Yeah.
06:18That he can mend her.
06:19Then she's got 15-plus years, hopefully, of a fabulous life
06:23that we could give her with her sister.
06:28It's very exciting when animals, other than a cattle dog, comes in.
06:43Everybody rushes over to them.
06:45Hello.
06:46Oh, my God, he's gorgeous.
06:49It's like a kid in a candy store, basically.
06:52You literally just want to be involved.
06:55And it's like a little mini celebrities coming in.
07:01Wildlife aid vet, Maru, has brought in an injured hedgehog, who has two broken legs and
07:06is in desperate need of Noel's orthopaedic expertise.
07:10The breaks are recent, so he was just quite painful and quite dehydrated.
07:16So we just rehydrated him and gave him some pain relief.
07:19We are quite worried about him because he has been with us for a few days
07:23and we really need to get those legs fixed.
07:32The Wildlife Aid Centre rescues and treats an array of wild and endangered species
07:38in the hope that they can be released back into their natural habitat.
07:42But sometimes the animals they rescue have such severe injuries that they have to be taken elsewhere
07:49for more specialised care.
07:51Come on, big fella.
07:53There you go.
07:54Good boy.
07:55The injured hedgehog has been brought to Fitzpatrick's, where Noel can examine him.
07:59Poor little fella.
08:00Look at you and your poorly legs.
08:02The Wildlife Centre has told us that he's broken both back legs.
08:06Looks like...
08:07Oh, you're sharp, mate.
08:08Looks like they've put a bandage on at least one of them.
08:12He's a boy.
08:13You can see his little willy there.
08:15No idea how it happened.
08:16Could be anything.
08:17Road traffic accident, a fall, a predator.
08:20We'll have to take an x-ray picture and see what we're dealing with.
08:23All right.
08:24Good.
08:25Let's get him in east of the house.
08:26As a wild animal, the hedgehog uses his natural defences for protection in this alien environment.
08:32Look at him contracting them.
08:34He's like, I will hurt you.
08:36As the anaesthetic takes effect, he begins to relax and uncurl.
08:41I think we should call him H.
08:45Horace.
08:46Harry?
08:47I was just about to say that.
08:49Once he's out for the count, Harry's taken to x-ray.
08:53Are we good?
08:55Let's rock and roll.
08:56If we lift and smooth his spines down so we don't cause trauma on his back.
09:01There you go.
09:02So I should be able to get that together pretty readily.
09:08It's going to be tough though because it looks like the ends of the fracture are beginning to heal over and I do worry about infection.
09:14So this is the other side.
09:15This is going to be much more difficult because of this very short segment next to the joint.
09:20And there's probably the potential for fissuring down through there.
09:23So that's going to be very, very difficult.
09:25That's three millimetres wide and six millimetres long.
09:29It's going to be very challenging.
09:33Harry can only be returned to the wild if Noel manages successfully to fix both his legs.
09:48Give me a blade.
09:49It's 9.30pm and Harry the Hedgehog is being prepped for the complex surgery to fix his broken hind legs.
09:56You guys okay on the anaesthetic there?
09:59Noel will drive a narrow pin from the fracture up along the tibia and out through the knee.
10:04He will then reverse it back down into the bottom part of the fracture to align the tibia bone.
10:10Four further pins will be inserted at right angles and the protruding ends will be bent to create a frame.
10:17Putty will then be moulded around the bent ends to bond them together and hold the fractured parts in place whilst it heals.
10:26Whenever we operate on hedgehogs we generally have a big audience.
10:30Hedgehogs are my favourite creatures in the entire universe.
10:33You know that 95% of all hedgehogs in the United Kingdom are gone in my lifetime of 50 years.
10:38That's a tragedy.
10:42Okay so now we're drilling down into the marrow cavity of the tibia.
10:46So we're driving this pin out through the knee now from the fracture site.
10:51We're going to cut the sharp end off and the hope is the blunt end will not penetrate into the ankle.
10:58Now this bit is tricky.
11:00Trying to lever the lower part of the broken tibia up onto the end of that pin.
11:06Come on mama, come on.
11:09You've got to be careful not to do this too quickly because you'll shatter the bone.
11:13I think that's adequate.
11:15So what we're going to do next is we're just going to put some pins into the outside of the tibia here.
11:22I'm going to drive those past the end of the pin inside the tibia.
11:30We're going to bend the pin that's down the centre inside the knee.
11:34Such a way as to not interfere with the motion of the knee.
11:37We still want the knee to be able to move.
11:43We've linked everything together now like a safety pin and operate on the other side.
11:48So this is a much more tricky fracture.
11:54We're going to drill a little hole up into the canal there.
11:58This pin is down inside this bone, approximately four millimeters.
12:02I'm hoping I've just missed the ankle with the tip of the pin,
12:05but I need to put enough pin in to hold that in position.
12:11We've got to be super careful here because we can split this little piece of bone.
12:15Already I'm seeing some gapping there, which I don't like.
12:20That's not good.
12:22We've got fissures going down into the bottom fragment,
12:25which are very difficult to see on x-ray pictures.
12:27I'm going to have to put the putty on with the wound open,
12:31because that's the only way I'm going to get alignment.
12:36The wound was already open anyway,
12:37so there may be bugs from the forest in there already.
12:40OK, so that's moving pretty good.
12:45We're going to put this ointment on there now,
12:48which is an antibiotic cream.
12:50Try and prevent bacterial colonisation.
12:55Harry is sent to x-ray to check that all of the pins are in the right place
12:59and the fractures are stable.
13:01I'm as happy as I can be with that.
13:07If we do not get infection in there and that's a big if,
13:10then that may go on to heal.
13:13Let's go.
13:15This is the first step for our little friend.
13:18Now we still need to heal that bone
13:20and hopefully he will recover well.
13:23Harry will now go back to the wildlife charity to recuperate.
13:26People travel vast distances to seek Noel's expertise.
13:37And George and Susan Stewart have made the long journey down from Scotland
13:41with their ten-year-old Labradoodle, Fletcher.
13:45Hi!
13:46Hi there, Fletcher.
13:47Stuart.
13:49Previous surgery to try to fix a bad fracture of one of his ankles has failed.
13:53We're worried about his weight and how it's going to impact him,
13:57whatever treatment he gets.
13:59This is the last chance alone really.
14:04George and Susan have fostered a number of children over the years.
14:08And for the youngsters, Fletcher's friendly and lovable nature
14:12has been an important part of their lives here.
14:16He jumps up, new person, wags a tail and they warm to him.
14:21But sadly, last year Fletcher had a serious accident.
14:28It was in the river Clyde and then I was shouting him to come out
14:31and he turned and I heard the snap, just heard it and he yelped.
14:37Fletcher had emergency surgery, but it was not successful.
14:41The first surgery for Fletcher was to put a metal plate in and that failed.
14:48Fletcher is so important to our family here and life just revolves around Fletcher.
14:55Fletcher is now ten years old.
14:58He's overweight and suffers from a heart condition.
15:01But George and Susan are hoping that Noel can still do something to help.
15:05We know there's lots of risks attached to any surgery and any treatment we do.
15:11But he's quality of life and whether he's in pain or not is the things that we're here for.
15:15So we want him to have the best chance possible for however long he's got life for this.
15:20Now Fletcher Stuart please.
15:22Fletcher Stuart, that's you.
15:24Hello Fletcher.
15:25I am Noel.
15:26Hi Noel.
15:27Susan.
15:28George.
15:29George and Susan.
15:30Okay.
15:31So take me through from the beginning please.
15:32I know he's not a spring chicken anymore.
15:34No, no.
15:35He's been pretty immobile since about March this year.
15:37Yeah.
15:38So this is now nine months ago.
15:40Yeah.
15:41He was in the river and his leg must have been between two rocks and I heard this crack and down he went it.
15:47He had a heart issue I think three years prior to that with a sack around the heart, filled up with fluid.
15:53Pericardial effusion.
15:54Yeah.
15:55Glad you said that.
15:56Okay.
15:57Alright.
15:58Let's have a look.
15:59Come on big fella.
16:00Good boy.
16:01Good boy.
16:02Come on mate.
16:03There you go.
16:04Come on.
16:05Let's be.
16:06Okay go.
16:08Keep going.
16:09Okay.
16:10So he finds it much harder to walk.
16:12Yeah.
16:13Good boy.
16:14Come on your mum.
16:15Alright big fella.
16:16Let's just go back inside.
16:19Okay.
16:20Okay.
16:23He did quite a lot of injury at that time he had his accident.
16:26Yeah.
16:27The calcaneus which is this bone here.
16:29Yeah.
16:30That's been attempted to be fixed.
16:31But that fracture hasn't healed properly.
16:33Yeah.
16:34So the plate is loose.
16:36Yeah.
16:37So what happens when the ankle collapses is all the tendons are stretched.
16:41Yeah.
16:42And his toes get contracted.
16:43Yeah.
16:44So they kind of curl up.
16:45Right.
16:46So to cut to the chase I can probably get him out of pain and I can give him good function
16:51with a full ankle fusion.
16:53It's an ethical issue for you to consider because there are some people that would say oh well
16:57he's ten and a half.
16:58And I'm just going to be honest with you there are people that would say put him to sleep.
17:01No.
17:02That's not me or you.
17:03Right.
17:04All right.
17:05Let's get his seat.
17:06Come with me mate.
17:07I'll see you in a little while guys.
17:09Take a seat outside for me.
17:10This shouldn't take too long.
17:11Okay.
17:12Thanks.
17:13All right Hock please.
17:19The scan will enable Noel to get a clearer picture of the condition of Fletcher's ankle
17:24and how best to remedy it.
17:29Waiting in reception Susan discovers a miniature version of Fletcher.
17:33I'll come over and see you for ten minutes.
17:34Keep looking at me.
17:35Hello you're gorgeous eh.
17:36There you go eh.
17:37Was it traumatic?
17:38Was it traumatic?
17:39Oh.
17:40Fletcher's folks please.
17:55Come on in.
17:57You can see here quite clearly all the screws are broken.
18:02They're all snapped.
18:03And the wire also snapped.
18:05So that's a CT from the side there.
18:07You can see where the fracture's pulled apart.
18:09Right.
18:10That means that this piece of bone is now very small and weak.
18:13Right.
18:14And the chances of me getting that attached back down there are not high.
18:19Right.
18:20Well I'm sorry I can't work miracles for you.
18:22I mean I'd love to keep that ankle moving and in an ideal world I would but I think it's
18:26too risky.
18:27Therefore I think we should go for the full fusion.
18:29Yeah.
18:30So I am a fan of the custom plate built for each dog individually to try and prevent it
18:36breaking.
18:37We're going to need to get the heart checked first and see what that says.
18:40You'll need to see that cardiologist again.
18:43Our main thing was to the pain.
18:46You know if we could limit the pain he's in at the moment.
18:49Yeah sure.
18:50That's the best result for us actually.
18:51I'll get him for you.
18:52Okay.
18:53Now mate there we go.
18:54Hi gorgeous.
18:55Good boy.
18:56How are you?
18:57Come and see me.
18:58Good.
18:59How are you?
19:00Come and see me.
19:01So I'll leave you to it guys.
19:03Alright.
19:04I haven't been called a young man for a long time so God bless.
19:07Cheers.
19:08Bye.
19:09Let's get him out of here with us.
19:11Susan and George will make the long trip back to Scotland to wait for the custom plate
19:16to be made which they hope will finally fix Fletcher's ankle and get him out of pain.
19:27Eleven month old Carpathian shepherd Molly who was rescued with her sister Missy as a puppy has arrived for her total hip replacement surgery.
19:36Hi there.
19:37How can I help you?
19:38Good morning.
19:39Molly.
19:40Molly.
19:41We're feeling really quite anxious aren't we?
19:44She's got the best possible care.
19:46We know that but you can't help but feel anxious.
19:49You know that things could go wrong and we don't really want to be going home without her but we're going to have to.
19:58Good girl.
19:59Come on Madel.
20:01Hi there how are you?
20:02Hi.
20:03Hello mate.
20:04Hi Noel how are you doing mate?
20:05Good to see you.
20:06The big day is here.
20:08Now then this is the x-ray picture from the last time you were here and there should be a cup there but it's a saucer.
20:15Yeah.
20:16So there's not enough rim on it to hold the head and we're going to physically make a rim for it that comes over here by putting this ice cream scoop on there.
20:26Wow.
20:27So that will bolt onto the side of the pelvis with five screws there.
20:31Yeah.
20:32I'll be sawing off that head.
20:33Yeah.
20:34And I'll be putting a new stem in there and that new stem will go all the way down here and then there'll be a new neck and a new head.
20:44So please God everything will go according to plan.
20:47Look after yourself.
20:48I know it's a big day.
20:50And whoever looks after her her favourite thing in the world is a belly rub.
20:53A belly rub.
20:54So is mine.
20:55Looks like mine.
20:56So is mine but I can't get that very much.
20:58I'll see you later.
20:59Bye bye.
21:00Cheers buddy.
21:01Bye bye.
21:02And then there was one.
21:03Molly is prepped for surgery.
21:08It's going to be an anxious wait not only for Steve and Debbie but for Missy who's never been separated from her sibling.
21:15I'm very worried.
21:17I think it's going to be very hard for her.
21:19I don't want her to think she's been abandoned again.
21:22That's the.
21:26That's the worst bit.
21:27No makes his incision and starts by removing Molly's damaged hip joint.
21:40OK so we just chopped off the head of the femur now.
21:43This is one of the worst sockets that I've seen.
21:46It's really horrible and gnarly.
21:48So we're now using increased size graters to try and make a new socket here.
21:55Noel will use the grated bone to help pack behind the new metal cup that will sit in what's left of the socket.
22:01Very challenging.
22:02Because we've now got nothing in the base of the hole.
22:05I can see the guts bulging up.
22:07I've got hardly any rim.
22:09And the pelvis is just a mess.
22:12See that's a massive problem if we don't support the inside of the socket.
22:17So the metal comes down here and it's very very thin rim.
22:21And hopefully it has enough flange to keep the cup in.
22:30You can see here where the handle of the ice cream scoop is down along the side of the pelvis.
22:35That bone should come out to here and doesn't.
22:38Right now.
22:40I'm putting a plastic liner into the metal cup now.
22:45And we've packed the marrow that we harvested from reaming out over the flange here to try and get new bone to grow into this metal mesh here, around here and also down here.
22:57We're now going to put a new head inside this socket by placing a stem and a neck inside the femur.
23:03The femur has become much straighter than it should be.
23:07And we've got a very dense, thick wall.
23:09So ideally I'd like to get a size 8 stem in here, but I think I'm only going to be able to fit a 7 in.
23:15Okay, so that's the stem cemented in place now.
23:22Give me a plus 3 head.
23:24So we can see the new hip moving now.
23:38This could still dislocate.
23:40We're just going to have to wait and see.
23:43Alright, let's stitch up.
23:45Without a custom implant in this case, this could have been a failure.
23:52Molly has a post-operative scan, so Noel can be sure that the custom made cup and plate is in the correct position.
24:01Hello, is that Steve?
24:03Hi, Noel.
24:04Right, so Molly's operation was very challenging, as you might imagine.
24:08Is she okay?
24:09Yes, she's absolutely fine.
24:10She's coming around from anaesthetic now.
24:12Okay.
24:13And we're just going to now have to be patient and hope for the best.
24:16Thank you, Noel.
24:17We appreciate it so much.
24:18We really do.
24:19Thanks, Noel.
24:20Cheers.
24:21Cheers, mate.
24:22Thanks, buddy.
24:23Bye-bye.
24:24It's four days since 11-month-old Carpathian Shepherd Molly had her damaged hip socket completely replaced with a custom-made titanium implant.
24:47It's been a very long weekend without her.
24:51Misses messed up terribly.
24:53I just can't wait to see her big soppy face, to be honest with you.
24:56And she can't wait to see my big soppy face, hopefully.
24:59Hi, family.
25:01Hiya.
25:02How are you doing?
25:03Nice to see you.
25:04Yeah, you too.
25:05How are you, mate?
25:06Hi, Noel.
25:07So, Molly's fine.
25:08It was a very challenging operation for very obvious reasons.
25:11Yeah.
25:12And that is that this hip had been out of place for so long that both the socket and the femur had remodelled dramatically.
25:20This is what it now looks like.
25:22Wow.
25:23A ice cream scoop with five screws in it that are curved specifically for that wing of the ilium.
25:31And if we look at the post-operative CT scan, this is the new rim.
25:36To stop that slipping out, all that is graft packed around it so that the bone should grow in around the mesh.
25:42Wow.
25:43All right.
25:44Just stunning.
25:45You're amazing, man.
25:46Well, it's just a hip replacement.
25:48It's not that amazing, but it's a complex hip replacement.
25:52You can't plaster a ceiling, though.
25:53I can't plaster a ceiling.
25:55There you go.
25:56Crap of plastering.
25:57Let's bring her in.
25:59Come on, babe.
26:00There we go.
26:01Oh, baby cow!
26:03Oh, my goodness.
26:06Hello, darling.
26:07Oh, ho, ho, ho.
26:09So, remember what I told you about the offset distance, which is this.
26:14Because the distance has increased, that means there's mild external rotation of the knee,
26:18which I'm now going to show you how to deal with.
26:20So, basically, one of you are going to hold the head end like this.
26:23Put the foot straight relative to the body.
26:25Put your thumb around there.
26:27Bring that that way and bring the knee inwards.
26:29That's it.
26:30And you push the hook out, but keep the foot on the ground.
26:32Keep the foot on the ground.
26:33So, gentle pressure downwards while you do that.
26:34That's it.
26:35Yeah, okay.
26:36That stretches these muscles back here.
26:37That's all you have to do.
26:38Okay.
26:39So, you're doing a great job there.
26:40That's a good job.
26:41Thanks, ma'am.
26:42All right, off you go.
26:43Molly can now go home, but the hard job of adhering to Noel's strict rehabilitation regime
26:49is about to begin.
26:52Very nervous about the next few weeks, if I'm honest.
26:55We've got to try and manipulate it every day.
26:58Rehab, I think I'm going to leave to Stephen.
27:00No pressure then.
27:01Yeah, it's going to be challenging.
27:06Whatever the weather, Fitzpatrick Referrals is always open for business.
27:18But when the staff have some downtime…
27:20Ready?
27:21I can't do it.
27:22Let's draw some doggies.
27:34Draw a cat instead.
27:36After battling the elements on the long journey from Scotland to Surrey, Fletcher has arrived
27:46for his revision surgery to fuse his chronically fractured ankle.
27:51Good morning.
27:52Oh, hi.
27:53Very happy doggie.
27:54That's what we like to see.
27:58But now that ten-year-old Labradoodle Fletcher's surgery is imminent, Susan has mixed feelings.
28:07We've kind of been counting down to getting it done because he needs it.
28:11But I'm terrified because he's an older dog and because he does have a heart condition.
28:15It's quality of life for him.
28:17You know, we'll do anything to get him back to the way he was.
28:21Fletcher has been our baby.
28:24Like, he was the baby I didn't have.
28:27I had fertility treatment and couldn't have children.
28:30And just shortly afterwards, that was when we got Fletcher.
28:34So, for me, he is the baby.
28:37Fletcher?
28:38Fletcher?
28:39Yeah.
28:41You got here.
28:42I thought every road in Scotland was blocked.
28:45It almost was.
28:46You fought your way through.
28:47Well done, you.
28:48Well, listen, I'm all ready to rock and roll for the right ankle.
28:52So, we've made a custom plate.
28:54I figured that if I put a keel on it, it would be significantly stronger.
28:58And if I dug a notch into the bone, recessed the keel into there,
29:03that would be super strong, wouldn't it?
29:05The keel would go into the bone.
29:06Correct.
29:07And if I coated it in hydroxyapatite, which is a bone-on-growth mineral,
29:11the bone would grow in around the keel.
29:13And that'll last him?
29:15Yeah, it should be a lifetime proposition.
29:17He's on two heart pills now, though.
29:19We're super aware of this, and we're all over it.
29:23Yeah, you're going to have to stay with me, mate.
29:25All right.
29:26Thank you, Noel.
29:27Lots of love. Take care.
29:28Look after yourself.
29:29Thanks, Noel.
29:30Look after yourselves, guys.
29:31Bye.
29:32All right, big guy. Off we go.
29:34Good boy.
29:37I feel dreadful of leaving him, but he's obviously in the best place.
29:43He's going to get the best treatment.
29:45The feeling is terrified until, like, that phone call tonight that he comes out of the anaesthetic,
29:50but therefore was at asking.
29:53Susan and George will be staying close to the practice until Fletcher has had his surgery.
29:59Let's go.
30:00Hi.
30:01Hi.
30:02Noel will aim to stabilize the chronic fracture in Fletcher's main ankle bone by fusing the entire ankle solid.
30:09So we're just cutting down on the ankle bones right now.
30:16This operation is actually quite brutal.
30:21So this is the plate and the guides.
30:23This template guide helps me because I can slide it in, and then I can take some little pins and put them on either side of the bone.
30:34And what that allows us to do is push that plate out through the dissection window.
30:40Here we go.
30:41We're going to cut the slot now.
30:43So this is the slot we've just drilled using our template.
30:52What we do first is slide the plate down.
30:55We've done the alignment.
30:56Everything is looking good.
30:58So we poke it out through the bottom, and we lever it in.
31:02And the keel goes into my notch.
31:05It makes the plate doubly strong.
31:07So now what I'm going to do is I'm just going to get a little screw here,
31:11and I'm going to pop it in there and just tighten it down to pull the plate into position.
31:17So it's rock solid on the bone.
31:19I'm not going to go in the back and take out all the implants because that would mean another incision,
31:23and they'll stay in there like a bullet in a man's leg could stay in there for all of his life.
31:28We're going to put all the rest of the screws in, and then we're done.
31:31Susan, everything is fine.
31:46Oh, thank God.
31:48Thank you very much.
31:49He's waking up now.
31:50The heart was fine during the anaesthetic.
31:52Post-op x-ray pictures look good.
31:54Hopefully it'll be okay, but we'll know in the next two, three days.
31:58Thank you very much.
31:59Okay.
32:01No worries. God bless.
32:02It's five weeks since Harry the Hedgehog received emergency surgery to fix two broken hind legs.
32:20And Noel is paying the team at Wildlife Aid a visit to assess Harry's recovery.
32:26The infection was a big concern with Harry because his fractures were open and they've been there a little while.
32:32So he had bugs in there at the time I operated.
32:35So hopefully we can take the frames off Harry today.
32:38I have my tool kit ready to go.
32:40Hi Mara, how are you doing?
32:41I'm okay, how are you?
32:42Good.
32:43How's Harry today?
32:44Well, the Hedgehog is doing well.
32:46And these are the most recent ones, are they?
32:47Yeah.
32:48Much better.
32:49Both of them look like they're healing.
32:51Good.
32:52All right, let's go.
32:59There you go.
33:01First, Noel needs to remove the putty that has been holding the frame in place.
33:07So we've got to take five pins out on each side.
33:10And ideally we want to do this as quick as we can.
33:12Just keep the anesthetic as short as possible.
33:15So we're just trying to cut the pins on the frame now.
33:18But because the frame is quite close to the skin, it's difficult to get onto them.
33:23Yeah.
33:24And I don't want to press because I might damage the bone.
33:26So we're going to get a drill and we're going to try and drill that out.
33:40We're slowly getting the putty frame off now.
33:44We've got one of five out.
33:46We're going to take a second one out now.
33:51Okay, a big one coming out now.
33:54Good.
33:56Let's have a look at this other side.
33:57Noel and the team are doing their best to limit Harry's time under the anesthetic.
34:04So he needs to remove the frame from the second leg without delay.
34:11One, two, three, four.
34:15Here we go.
34:17Good.
34:18The knee and the ankle are moving well on both sides.
34:21So that's good news.
34:26X-rays.
34:29X-ray pictures look good.
34:30That's the right leg.
34:32That was a very difficult fracture because it was near the joint.
34:35This is the left leg.
34:36Looks great.
34:37You've got a nice healing callus around the fracture there.
34:40That should do really well.
34:43All right, mate.
34:44You okay, buddy?
34:46Oh, good boy.
34:48You all set?
34:49I hope you like your new legs, mate.
34:52Harry will now convalesce until he's fit enough to be returned to the wild.
34:57You sleep it off, mate.
35:09Hello.
35:10Woo!
35:12Cold in that doorway.
35:13How can I help?
35:14Fletcher.
35:17Fletcher has had surgery to fuse his fractured ankle.
35:20Well done, Fletcher.
35:21Good boy.
35:23And Noel has been keeping a close eye on his progress.
35:27Wahey!
35:28Look at that.
35:29He's standing on the operated leg to pee.
35:32Rock on.
35:33Come on, mate.
35:35After an anxious four-day wait in Surrey, Susan and George have arrived to take Fletcher home to Scotland.
35:43Looking forward to picking him up.
35:44Looking forward to seeing him.
35:45Yeah.
35:46This is the longest we've ever been away from Fletcher.
35:48Yeah.
35:49Never left in this length of time.
35:50There's been no tears.
35:52And then, was it that night after the call?
35:55And I just exploded.
35:57And it was relief.
36:00The fact that he came through the anaesthetic.
36:03Now, Fletcher's mum and dad.
36:07Hi, guys.
36:08Hi there.
36:09Sorry about the delay.
36:10A busy morning.
36:11How are you?
36:12Oh, good to see you.
36:13Nice to see you.
36:14Hey, mate.
36:15Hello.
36:16Good to plan, thank God.
36:17Good.
36:18Here we go.
36:19This is what we started with, which will remind us just how much that was distracted.
36:23Do you see that?
36:24That's worse than I thought.
36:25So, we ended up with a situation, which we can see in 3D on the CT, whereby all the screws
36:31in the plate had either bent or broke, and the wire was snapped as well.
36:37It made taking that plate out risky.
36:40And as it transpires, I did get the plate in the front without taking the old ones out.
36:45Then I have my custom plate with the keel on it, and the keel went into the right spot.
36:50You can see the keel right there, and that makes it really strong at the bend point.
36:54All right, boys and girls, push your chair back.
36:58There we go.
36:59How are you doing?
37:00Come on, mate.
37:02There we go.
37:03Well done.
37:04Well done.
37:05Well done.
37:06Well done.
37:07Well done.
37:08All right, guy.
37:09All right.
37:10Off you go.
37:11Come on, then.
37:12So this is the kind of pace I want you to walk.
37:14Right.
37:15Robbie's taking a little weight with that sling, maybe 20%, not that much.
37:18Okay.
37:19That's incredible.
37:20And he just walks like so.
37:22He's happy to walk on it.
37:23My goodness.
37:24Isn't that nice?
37:25Good.
37:26Come on, big guy.
37:27It's a real watch this.
37:28Yep.
37:29You ready?
37:30Yep.
37:31One, two, three.
37:32Thanks.
37:33Well done.
37:34Well done.
37:35Good boy.
37:36Hey.
37:37Good boy.
37:38Hey.
37:39I think seeing him out here with a straight leg, which we haven't seen in a year because
37:45it's been bent double.
37:46It's amazing what can be done.
37:49Great.
37:50It's nice.
37:51It's six weeks since 11 month old Carpathian Shepherd Molly had a total hip replacement.
38:07She's back today for scans and a checkup, but her recovery has not been easy as she managed
38:12to lick her wound in spite of Steve and Debbie's best efforts.
38:17Unfortunately, she got an infection.
38:20So that sort of set us back a little bit.
38:23But she's doing really, really well.
38:25So I'm hoping that we'll get it all okay today.
38:29Hi, Molly.
38:30How is she?
38:31Lovely.
38:32Hello, sweetheart.
38:33All right then, Molly.
38:34Off you go.
38:35Good girl.
38:36Bye, darling.
38:37Bye, Molly Mop.
38:38Good girl.
38:39Good girl.
38:40So sit down and tell me how you've been getting on.
38:45It's been living hell is the only description.
38:48I'm sure you must hear it every time.
38:51What a nightmare.
38:53The infection, it just went on and on.
38:55The bug that they cultured from her mouth was an MRSP bug.
38:59That's a very serious bug.
39:01Now, please God, that would just stay superficial.
39:04It looks like the wound is healed.
39:06Yeah.
39:07So please God, that won't go deeper.
39:10But if MRSP got into those implants, that could scupper everything.
39:18Scans will determine if Molly's infection has been treated effectively or become an even
39:23more serious problem.
39:25No dislocation.
39:28The bones, look at that CT.
39:30That's perfect.
39:31That bone is physically growing onto that metal in six weeks.
39:34Very happy with that.
39:35Brilliant.
39:36So the moment, please God, it's just a superficial lick infection and you've gotten away with it.
39:41Bye-bye.
39:42See you later.
39:43Bye-bye.
39:44See you later.
39:45Bye-bye.
39:46Bye-bye.
39:47Bones growing nicely.
39:48Bones growing round it all fantastic, yeah.
39:51I'm a happy man.
39:56It's been 12 weeks since 10-year-old Fletcher's surgery to repair the fracture in his ankle.
40:13And Fletcher seems happy to be back.
40:19Final, final check-up.
40:23Hopefully Noel signs him off as it's been success.
40:27I think we're hoping for miracles, but we'll see.
40:30Hi, guys.
40:31Good to see you.
40:32Welcome.
40:33Good to see you.
40:34Hi, mate.
40:35You go.
40:36Let's go for a little walk.
40:37Good boy, Fletch.
40:38How do you think he's doing?
40:39His leg's doing well.
40:40Come on, big fella.
40:42Come on, gorgeous.
40:43Keep going, keep going.
40:44Back leg's working real good, isn't it?
40:46Yeah, back leg's good.
40:47Okay, let's go back in.
40:49That's fine.
40:50Noel needs to take one final x-ray picture to be sure the plate and screws have done their
40:56job and the bone is healing properly.
41:02Now, friends, grab a seat.
41:05So, the imaging shows satisfactory progression of healing on the ankle.
41:09See the bone growing through?
41:11Yep, yep.
41:12The bone is physically growing new bone.
41:15Right.
41:16In that region there that I'm enlarging.
41:18You see that?
41:19Right.
41:20This bone is now load sharing with the plate.
41:22Right, good.
41:23So, the chances of that plate breaking now at this point are incredibly slim.
41:28That's a great result.
41:29What I want is for him to be happy.
41:31Yeah.
41:32Right, sir.
41:33Look at yourself.
41:34You've got to shake your hand, young man.
41:35Thank you very much, Noel.
41:36I love it when you come in and you call me young man.
41:38There's new bone growing, which there's a lot of it.
41:48Yeah.
41:49It's healed really well.
41:50Yeah.
41:51Yeah.
41:52Well, our expectations is that he can walk better and he's a bit more comfortable and
41:56a bit happier.
41:57Eh?
41:58Yeah.
41:59Good boy.
42:04Back at home in Willingborough, Molly has been going from strength to strength.
42:09Go.
42:10Forest run.
42:11The hip has not dislocated and the infection has not recurred.
42:16Molly's doing fabulously, isn't she?
42:19Absolutely brilliant.
42:20Yeah.
42:21We're really, really pleased with her progress.
42:23Yeah.
42:24You can see her running about now.
42:25It's just fantastic.
42:26There's a massive difference.
42:27You know, she's never been off the leap before, so it's been fabulous, hasn't it?
42:32Yeah.
42:33Running around pain-free.
42:34Yeah.
42:35It's brilliant.
42:36It's lovely to see them play together.
42:39It's lovely.
42:40People don't even know which one's had the operation now.
42:43She's still a little bit gangly, but I don't mind her being gangly.
42:48Stood me in good stead.
42:56In Surrey, it's dusk.
42:59And Harry the Hedgehog is finally ready to taste freedom again.
43:04Hedgehog territory.
43:06It's been six weeks since the pins came off, so he's now ready to go back and resume
43:11his life in the wild.
43:12We brought him back to where he was found, which is the ideal release site for him,
43:16because he'll know the territory.
43:17Come on.
43:18Oh, he's very prickly.
43:19That must be a pin.
43:23I think actually he's overeaten a little bit while he's been with us,
43:26so he doesn't need to eat for about a couple of years.
43:28Come on.
43:29Come on.
43:30Do your stuff.
43:31We're very impressed, delighted that it's worked,
43:36and so lovely to see him trotting off on all four legs very well.
43:48In Scotland, Fletcher's fused ankle has healed,
43:52and he's enjoying his dotage at his own pace.
43:56The surgery has been the best thing.
44:00It's totally changed his life,
44:02and I never thought we'd ever see him walking properly,
44:05but to see him running...
44:09He's happier now.
44:10He's happier.
44:11He's not in pain.
44:12He's an old man now.
44:14He's got a bad ticker.
44:16The leg is so much better.
44:19All his issues, and he's come through it with flying colours.
44:23It's been the best thing ever.
44:25The future of all...
44:26...
44:27...
44:28The way you are...
44:29...
44:37...
44:41...
44:43...
44:47...
44:48...
44:50...
44:53Amen.
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