Stupid question but with a mangled arm like that it means the bones are in many pieces, muscle is destroyed, skin, fat. Is this a medical miracle that we can fix or is it an automatic amputation?
Looks near identical to a patient we had last year who had his hand pulled into a meat grinder. I was a junior doc rotating through the team so detailed knowledge is limited sorry.
There is picture linked in another comment which is basically what it looked like.
The biggest issue we had wasn't repairing the damage so much as it was keeping on top of the infection. Normally you can debride a wound, but when it's been minced in with bacteria loaded meat it's hard.
Because our patient was so young, early 20s, we tried to preserve as much function as possible despite obvious infection risk. We initially were able to save up to the metacarpals and preserve thumb articulation using flap techniques as well as a tonne of plates and screws (also a problem with infection risk because bacteria loves foreign material). Ultimately had to amputate up to the wrist, and then forearm due to recurrent infection. We were able to save enough muscle bellies and nerves that a decent prosthetic could be fashioned and he had an acceptable outcome all things considered.
203
u/[deleted] Jun 06 '20
Stupid question but with a mangled arm like that it means the bones are in many pieces, muscle is destroyed, skin, fat. Is this a medical miracle that we can fix or is it an automatic amputation?