Revathi Shanmugam can now lift her right hand, eat and brush her hair with it, just as she used to until June 5, 2010. On that day, the 25-year-old was riding her bicycle to her workplace in Perambur, when a private bus knocked her down and ran over her arm.

She was rushed to a private hospital where doctors administered first-aid and sent her to Rajiv Gandhi Government General Hospital (GH). She underwent treatment for a month and was discharged. Her sister Viji said: “We wanted her to return to a normal life and sought treatment in private hospitals. Then we were advised to go to Stanley Hospital. Doctors of the plastic surgery department created a flap for her elbow, covering her wounds. The arm was intact but not usable.”

Revathi depended on her mother to feed and groom her. During a review at Stanley, doctors referred her to the orthopaedics department of GH. Last December, she was admitted to GH and doctors decided to provide a stainless steel implant which would act in place of her damaged elbow.

“It was a complicated case as her elbow was covered with a flap. Usually, there is just the skin and we operate directly but in this case, we had to go through the flap which is supplied by nerves and blood vessels. It is risky as it could cause infection,” said orthopaedic surgeon N. Deen Mohamed Ismail, who performed the surgery.

Revathi underwent physiotherapy for 10 months to strengthen her hand muscles. Dr. Ismail said she will have to undergo another surgery to replace the implant after 15 years. “That may last longer depending on the improvement in the implants then,” he added. According to him, two other patients had earlier been provided elbow implants but Revathi was the first to undergo such a complicated surgery.

Dean V. Kanagasabai said the cost of the implant, around Rs. 1 lakh, was not passed on to the patient. “The hip and knee replacement procedures are covered under the CM’s health insurance scheme but elbow replacement is rare. We have written to the insurance company asking them to cover this case,” Dr. Kanagasabai said.

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