Case Study: Danny Yardley

20 January 2011

On August 13 2008, Danny Yardley was cycling home from his job on the assembly line at LDV when a teenager stepped off the pavement into his path. As they collided, Mr Yardley’s head struck the back of her head before he hit the edge of the kerb, splitting his face open.

X-ray of Mr Yardley's fractured his lower jaw, upper jaw, nose, forehead and eye sockets The impact fractured his lower jaw, upper jaw, nose, forehead and eye sockets – a pan facial injury. He lost four teeth and a segment of bone from the lower jaw.

He was admitted for head injury observation and scheduled for theatre with planning for the acute treatment done with 3D CT scanning. Liaison with the maxillofacial technology lab assisted in surgery and ensured that the jaw could be reconstructed to allow new teeth to meet correctly.

The initial procedure repaired Mr Yardley’s fractures but did not address the loss of tissue. He was discharged after a few days but subsequently readmitted for further surgery which enabled surgeons to place a distraction device in the lower jaw to help align the fracture. This works by gradually moving apart two ends of the bone during the distraction phase, allowing new bone to form in the gap. It also has the benefit of simultaneously the volume of surrounding soft tissues.

In the past two years Mr Yardley has undergone six operations and made 60 visits to hospital.

He says: “My face was changing every day but after three months I looked more like myself. It’s been a life-changing experience and in some ways I feel like a completely different person but, throughout it all, the treatment I received was excellent.”

Mr Yardley with his sonMaxillofacial Consultant Mr Ian Sharp says: “Distraction osteogenesis has many applications in craniofacial surgery and is a strength of the Birmingham unit. In this case vertical augmentation of the tooth socket was obtained using distraction prior to placement of dental implants and subsequent restoration with a fixed bridge to replace the missing teeth.

“Overall the treatment brought together traditional and modern technologies and surgical techniques to deliver complete restoration and rehabilitation for this gentleman. This was achieved over two and a half years and has resulted in complete restoration of function and aesthetics following severe facial injury.”

During his rehabilitation, Mr Yardley was made redundant. He has since undertaken a brain injury rehabilitation course and is hoping to secure funding to study occupational therapy.

Personal statement

“With the accident my life changed overnight. The injuries were terrible and at first I wouldn’t even allow my parents to see me. Then the operations started and gradually, after about three months, I could look in the mirror and see someone who actually looked like me again.

“Because my injuries were so serious and complex, they literally had to cut my face off to rebuild it: I was completely stripped down. At one point I had 58 staples in my head and so, to see how far I have come since then is amazing – a real tribute to all the expertise that has gone into putting me right.

“There have been complications but at every stage there’s been another expert with another procedure to deal with what’s come up.

“I have encountered some people along the way who have reacted negatively to my appearance while I was still recovering and the whole experience has changed me. But I’ve got my confidence back now and I feel like I’m ready to move on. That really is down to the expertise and technical know-how of the medical teams, plus the support I’ve had from my wife and my son.

“I have benefited from the pioneering reconstructive surgery being delivered at the QE and I hope the results for others continue to improve as techniques are refined and research into new ones are carried out.”

Note: Photographs of Danny during his treatment are available on request