A team led by Dr. Girish Bhalerao, Consultant Orthopaedic Surgeon, Wockhardt Hospitals, Mira Road, successfully saved the legs of a 44-year-old highway policeman who was an accident victim and suffered from polytrauma. The patient who was unable to walk for approximately 2 months now stands on his feet again after restoring his lower limbs.
Highway Policeman Sachin Dhanivire, age 44 years, a resident of underwent polytrauma. He was on duty on a Highway, and met with a ghastly accident. He was hit by a truck (heavy vehicle) at Boisar Highway. Both people on the two wheeler, the patient and the constable were severely injured and had multiple fractures. The patient suffered fracture in both thigh bones, (Femur) shaft, comminuted fracture of right proximal leg bone (tibial plateau) with degloving injury to right knee exposing bones, muscles and other side tissues and an arm fracture (Humerus shaft). The patient’s right lower limb side entire bones was shattered with open skin, bones, and vasculature. The patient was primarily treated at nearby local hospital, however looking at such grave situation they referred him to higher centres. In enquiry few suggested amputation with questionable viability of right lower limb as the neurovascular compromise had already set in.
Dr Girish Bhalerao, Consultant Orthopaedic Surgeon, Wockhardt Hospitals, Mira Road said, “On arrival in the emergency department the patient was brought in ambulance and was assessed for haemorrhagic shock like symptoms. He was primarily stabilised in accordance with ATLS (Advanced Trauma Life Support) protocol. Appropriate radiological and lab tests were done to confirm diagnosis and the patient was shifted to wards for further haemodynamic stabilisation and observation.”
Polytrauma means someone who is subjected to injuries to multiple body systems — in this case multiple fractures of musculoskeletal system, peripheral nervous system — injury to common peroneal nerve, degloving injury to superficial & deep dermal tissue of thigh and legs and hemodynamic disarray caused by this motor vehicle accidents. His entire wound was exposed to bones, muscles, and blood vessels.
His bones were protected and his lower limb has been restored to normalcy. He was operated in sequential manner with multiple surgeries one after another to maintain hemodynamic status and normal physiology. Both Thigh bone (Femur) fractures were fixed using a long Interlocking intra – medullary Nail, proximal Leg bone( Tibia ) was fixed using bicolumnar plating with bone grafting, the degloving injury was fixed in assistance with Dr. Sushil Nehte, Plastic Surgeon. He has been recovering with Physiotherapy and Rehabilitation. The common peroneal nerve is still recovering under supervised nerve simulations and Physiotherapy. His legs were saved and now he is completely functional for activities of daily living Before discharge he was able to maintain his gait, he walked with the help of a walker and then became independent. He can now even ride two or four-wheelers. It was difficult to salvage the limb but we did it. Such polytrauma patients need timely care at a tertiary care centre to help gain complete recovery. Unfortunately such patients get delayed in their commute to reach and may end up losing the chance to salvage a viable limb. Many times such patients may have to undergo amputations. These could be very detrimental and would change the entire aspects of life. Also, timely intervention with multi- disciplinary approach gives a better fighting chance to save life in various aspects. He could walk independently before leaving the hospital.
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