Ajman: An army veteran from Sudan with horrific blast injuries to his leg was able to walk after 23 years following a series of surgeries at Thumbay University Hospital in Ajman.
Over a period of six months, surgeons at Thumbay performed multiple surgeries to restore leg function to Robert, 58, who had suffered artillery blast injuries to his right shin bone, leaving him confined to a wheelchair for over two decades. He had a deformed lower right limb and was living in pain until he came to the UAE.
The first procedure was a complex 14-hour surgery carried out by Dr Faisal Ameer, Consultant Plastic and Reconstructive Surgeon, and Dr Amit Chaturvedi, Specialist Orthopaedic Surgeon.
Movement was restored to the patient. The surgeons used a combination of wedge osteotomy and micro vascular tissue transfer surgery. This was followed by another surgery to reinforce the impact of the first surgery. Robert then underwent extensive rehabilitation for a number of months.
Told to amputate
Dr Ameer said: “After his injuries, the patient had undergone multiple surgeries in the last one year in Sudan, which resulted in more deformities. When he came to us, he was suffering from bone infection with multiple pus pouring wounds on the leg that prevented healing of the fracture. He was unable to stand on his feet, resulting in qualitative loss to his life.”
At one point, Robert patient had to crawl to move about. Surgeons in Sudan had advised limb amputation below the knee, which he and his family could not accept, he added.
Dr Ameer said: “When Robert came to us, our biggest task was to provide accurate treatment and confidence to him because he was not in the best of his mental and physical state, as a result of which he had resorted to heavy smoking. This further complicated the situation because when the patient is a chronic smoker the success rate of micro vascular surgery is less and wound healing becomes difficult”.
The surgeons worked in tandem to prevent trauma and rehabilitate the patient while doing scans. They decided to salvage the limb with correction of the deformity.
Dr Chaturvedi and Dr Ameer took up the challenge. Dr Ameer said: “The first step was to remove all infected and dead bone and then correct the deformity, which was done by a procedure called wedge osteotomy and was fixed using a modular carbon fibre external fixation device.
“The next big issue was coverage of wound and exposed bones. This was done by using tissue from the back and shoulder of the patient and transferring by micro vascular surgery. This is a complex, delicate and multistage combination of orthopaedic and plastic surgery that requires high level of skill, magnification and specialised instrumentation.”
Straightening the limb
Wedge osteotomy helped the foot get in alignment with the leg to straighten the bone. A modular carbon fibre device was then used externally to fix the leg. Though rare, this fixation device is light weight but strong enough to bear the patient’s weight and help him start walking.
Four months later, the fixation was removed. The patient underwent extensive physiotherapy and finally stood up and started walking.
‘Nothing short of miracle’
Robert said: “What the surgical team has done for me is nothing short of a miracle. It was a tough fight, every day, every hour, but I knew one thing: if I want to walk again, I have to fight for it. With extensive care and physical therapy everything is getting better and better now.”