It was just another day in the life of Orthopaedic Surgeon Vijay Sharma who happened to be on call duty at the Trauma Centre of the All-India Institute of Medical Sciences here when his phone rang around 5-30 a.m. on Thursday. The call informed him of an accident case of a 30-year-old auto-rickshaw driver Amrik Singh who had been admitted with a iron rod impalement injury in his right leg.
What followed over the next four hours was nothing short of a miracle involving extraction of the nearly 2-foot-long and 2.5-kg heavy iron rod from the patient's leg, where the slightest mistake or error of judgment could have rendered the patient permanently handicapped from waist below. The rare surgery, performed by a team of nine doctors from the orthopaedic and anaesthetic departments was successfully completed within two hours while the patient was fully conscious and aware.
However, since the wound could not be closed properly due to the risk of infection, the patient would have to undergo an additional surgery for skin grafting in another week after which he would be fit for discharge. But the bone healing could take another six to eight weeks after which the patient should be able to walk normally.
According to Dr. Sharma, the main challenge was planning the surgery through several rounds of hectic consultations to salvage the limb by isolating the affected blood vessels instead of straightaway approaching to extract the rod in the emergency room itself.
“The patient had been driving his auto behind an overloaded truck carrying iron rods. In a bid to overtake the truck, the auto collided with the truck and the iron rails started falling. One rod pierced through the auto chassis to the driver's leg leaving him transfixed in the auto and unable to move as the rod was extremely long and heavy. It was only after the fire brigade arrived and cut the rod that the patient was able to move out and reach AIIMS,” he added
AIIMS Trauma Centre chief Dr. M. C. Misra said: “After exposing the rod from its point of entry and exit in the leg, the entire bundle of nerves, arteries and veins covering the skin was isolated and removed and only then was the rod extracted. The patient had also suffered an ankle dislocation and fractured both his leg bones which had to be fixed through re-alignment and application of external fixators including frames of stainless steel rods and screws to stabilise the joints.”
“However, if any attempt had been made by others to extract the rod on their own or move it around even a little bit, it could have left the patient's limbs lifeless as the rod had pierced merely a couple of millimetres away from the neuro-vascular bundle containing the blood arteries, nerves and veins which regulate blood supply to the legs and could have got cut and permanently damaged,” he added.