This little 4 year old boy was run down by a Garbage truck, while
walking on side of the road outside his playgroup school. Little could
he have comprehended about the incident that had scarred his life
forever. He was immediately shifted to Municipal Hospital for primary
care.
The surgeons at Municipal Hospital advised him amputation, but his
father was did not give consent and brought him to Saifee Hospital
with a hope for a miraculous salvage of the limb.
On admission, it was noted that there was a crush-avulsion injury of
the right leg extending from the gluteal region to the mid calf. His
distal part of the femur, remnants of patella and the knee joint were
exposed with slough and pus discharging through the wound; the sciatic
nerve had been avulsed too. External Fixators had been placed at the
primary hospital to stabilize his leg at the knee joint.
The Femoral artery was thrombosed as diagnosed on the Angiograph,
however, capillary reflux of the toes were normal.
After thorough debridement and removal of the necrotic bone fragments,
cross leg flap was done to cover the exposed distal end of femur and
the knee joint.
The limb is shorter but viable and patient is walking with a limp. An
expandable knee joint replacement is being considered now.
