A 25-year-old man who could barely move after he suffered multiple fractures in his leg in an accident about a year ago can now walk without any support after a series of surgeries at a Gurugram hospital. He had lost "5 cm of bone and skin" from his ankle in the accident, and till recently, was walking with the support of crutches, they said.
The patient was brought to the hospital with an open "Grade-3 tibia (crushed comminuted lower end)", doctors said. In medical parlance, comminuted refers to a fracture that produces multiple bone splinters. "He underwent four surgeries within a year. In the very first surgery, an external iron fixator (a device used to keep fractured bones stabilised and in alignment) was implanted inside his skin," the Manipal Hospital in Gurugram said in a statement.
It said that a team of doctors comprising orthopedic surgeons Gurdeep Singh Ratara and Pranshul Bishnoi and plastic surgeon Asheesh Dhingra initially stabilised the fracture with an external fixator, and then decided to perform a cross-leg flap surgery followed by bone transport.
The doctors said along with this, plastic surgery was also done to attach both of his legs for around three weeks. The cross-leg flap surgery is usually preferred in such cases, they said. The hospital said after three weeks, his tibia tissue started healing and after two months of the initial surgery, the bone transport was done, wherein the doctors created an artificial cut in the bone and a monorail fixator was applied.
"Upper tibia cortectomy was done to fill the 6.8 cm bone gap in his tibia," the statement said. Bone transport started at 1 mm a day and in around two and a half months, the bone gap was filled, the doctors said, adding that after waiting for another five months post the surgery for the bone to heal and solidify, the patient was allowed to put weight on his legs and walk with crutches.
"This was a complicated case as the patient was brought to us in a very bad condition. His leg was crushed and the wounds were very deep," the hospital said.He had already lost a part of the bone and skin of his tibia during the accident and almost nothing anatomical was left in the lower end of the tibia, the statement said.
"However, it took us almost a year and four surgeries to make him stand again on his feet. We did a series of follow-ups and X-rays after the surgeries, his wound started healing and the patient was gradually allowed to put weight on the new transported bone," the hospital said. At first, he started to walk with two crutches, and in October this year he was allowed to walk without any crutches, the dcotors said.
