KIMS doctors salvaged the limb of a farmer with three kinds of surgeries

• Farmer's foot crushed, bones fractured and arteries damaged
• Amputation was almost inevitable
• KIMS doctors took a risk and salvaged the entire limb and foot

Hyderabad, 28th January 2021: Doctors at KIMS hospitals have salvaged the foot and limb of a farmer, who has multiple injuries due to a road accident. He has a fracture in the long bone, foot crushed, arteries damaged badly. So the blood flow to the limb was affected. Usually, on such occasions, amputation of the leg is the only way for the doctors. But, Dr. Srinivas Kasha, Consultant Orthopaedic Surgeon at KIMS hospitals, along with Vascular Surgeon and Plastic Surgeon have co-ordinated well, performed three types of surgeries, and salvaged the patient's foot and limb. Dr. Srinivas Kasha has explained the details to the media.

While the 47-year-old farmer was going on his two-wheeler,  a vehicle came in the wrong route and almost hit him. He turned his two-wheeler and hit a pillar strongly. The accident happened at Madanapalli of Sangareddy district. His leg was damaged badly in the accident. When he was taken to the other hospitals, they suggested amputation. His relatives opted for first aid and shifted him to KIMS hospitals. He came to the hospital with bleeding in the right foot and severe pain. Doctors in the emergency ward have tested him completely and identified that he has a fracture in the long bone of the right leg, arteries damaged, foot crushed and muscles damaged, arteries in the foot also damaged. Usually, in such cases delay will cause more loss, blood flow to the part is arrested and that part is permanently damaged. So, without any delay, experts from Orthopaedic, Plastic Surgery, and Vascular Surgery met, discussed thoroughly, and decided to salvage his leg. They have counseled the patient about the condition.

Initially, the Orthopaedic and Vascular Surgeons have performed the surgeries. Debridement with K- wire fixation for right 1st, 2nd, 3rd, and 4th metatarsal fractures was done.

Debridement and knee and ankle bridging external fixation done for right proximal tibia fracture,  Popliteal thrombectomy, and Fasciotomy of the right leg done under Spinal and Epidural anesthesia.  Following the surgery, he was under observation for the survival of the right leg. If the blood flow to the leg has not been restored, his leg has to be amputated. And no more plastic surgery would have been possible. But, as the doctors at KIMS hospitals have done all the surgeries with utmost expertise and experience, they were successful. So, a delayed primary free flap was also done to cover the right foot defect by the plastic surgeon. For this, he has taken a piece of muscle from the thigh. There was a gap of one week between these surgeries. After 3 weeks he underwent external fixator removal and plating for the Right leg. Following the surgery, the patient was started on physiotherapy for knee bending and was made to walk with a walker.