Doctors Can Prevent More Amputations With Limb-Saving Surgery

Doctors have been working for decades to find better ways to save people’s damaged or diseased arms and legs and avoid amputations.

Their work paid off for Jeff Bopp, a passenger in a sport utility vehicle near Columbia, Missouri. The Columbia Missourian, a community news organization, reported that the day had been going well for the 47-year-old Bopp.

“We were leading a group of about 10 ATVs [all terrain vehicles] down a wooded trail,” Bopp was quoted as saying, “When we got to the end, the person driving our vehicle turned the wheel very sharply, and I saw his foot mashed on the accelerator. I knew it wasn’t going to be good.”

“The driver thought he was going to whip the back end around, show off maybe a little bit or whatever, but it happened so fast,” Bopp said.

The vehicle flipped, and Bopp’s arm snapped — the muscle and skin torn away. He was flown to the University of Missouri Health Care’s Trauma Center.

“The way they described it in the medical reports, it was a near-field amputation,” Bopp said.

Dr. Jay Bridgeman, a limb reconstruction specialist, met Bopp in the emergency room.

“We were concerned we may not be able to save his arm,” Bridgeman said.

At a trauma center, there’s a team of specialists who could include plastic surgeons, micro surgeons, vascular specialists and more.

Bridgeman said the surgeons took a muscle from Bopp’s back and laid it over the areas that had lost tissue. “And, then, that required the skill of the micro surgeon to sew the blood vessels together and the nerves together.”

With a high-powered microscope, Bridgeman connected the blood vessels of the piece of back muscle with the remaining muscles in Bopp’s arm. The transplanted tissue is now part of his arm.

Bopp had more than a dozen surgeries to finish the job, but he has sensation, he can feel objects and use his hand.

Limb preservation teams are getting better at these procedures, according to Dr. Lee Kirksey,

At the Cleveland Clinic, Dr. Lee Kirksey says at least 80 percent of patients who need this surgery have diabetes.

“About one third of diabetics at some point will develop an ulcer when they’re on their feet. And so where I see this area of limb salvage progressing is that we’ll become better and more skilled, and have more technology, for restoring blood flow for these patients.”

Kirksey is vascular surgeon and vice chair of the Cleveland Clinic’s department of vascular surgery.

 

When his team can’t save a limb, he says the focus shifts to amputating the limb so the patient can use a well-fitting prosthetic, “and then they’re wildly surprised about how they’re able to achieve a normal activity level in their life.”




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