27/06/2025
*“When Amputation Wasn't the Only Option”*
Patient: 19-year-old male
Injury: Severe crush injury to left leg following a road traffic accident in Feb 2025
Initial Prognosis: Multiple tertiary care centers advised primary amputation due to extensive soft tissue and skeletal damage including bone loss, with high risk of infection, vascular compromise, and poor functional prognosis.
Intervention:
Patient was extensively counseled regarding the risks, uncertain outcomes, and prolonged recovery process.
A limb salvage approach was undertaken, involving:
- Multiple staged orthopaedic debridements and fixation procedures
- Collaboration with plastic surgery (Dr. Vivek Goswami) for soft tissue coverage (free flap/grafting)
- Rigorous physiotherapy and rehabilitation (Dr. Dinesh Thakur) from early stages
Challenges:
- Repeated wound inspections and minor revisions
- Managing infection risk and vascularity
- Maintaining patient morale during prolonged hospitalization and rehab
Outcome (5 months post-injury):
- Successful limb preservation + Independent ambulation with minimal support + Patient reports significant functional recovery and satisfaction
Key Takeaway:
This case underscores the value of *multidisciplinary collaboration, patient-centered decision-making, and perseverance in managing complex limb-threatening injuries*. Massive shout out to Dr Vivek Goswami for his splendid work !!
While not every limb can be saved, every option deserves careful consideration—sometimes, the best outcome lies just beyond the obvious choice.
