2024-07-10 05:32:20
“The tragic beginning of Meda’s story led to a successful treatment atomazga. This is truly an extraordinary result of all our efforts, so we want to make sense of it not only in the medical documentation, but also to tell this extraordinary story to others, – said Prof. Justinas Stučinskas, Head of Orthopedic Traumatological Infection Sector of Kaunas Clinics. “Meda has always shown an extraordinary determination to try to achieve the maximum result, which encouraged and encouraged the entire medical team to take on this extraordinary challenge.”
27-year-old Medai’s accident happened on December 25, 2021, the eve of the holiday. The girl said that after having breakfast with her mother, she went to the village to celebrate Christmas.
“I stopped at the intersection to let the oncoming cars pass so I could turn left.” Suddenly I felt a blow to the back of my car. I got out of the car, asked if anyone was okay, and a minute later another car hit us. My leg was squeezed between two cars,” the girl shared painful memories.
While waiting for the emergency medical crew to arrive at the scene, Meda was given first aid by an anesthesiologist and resuscitator from Kaunas Clinics who happened to be passing by and used what she had at hand at the time – she fixed the girl’s leg with a scarf.
“Our doctor colleague gave Meda first aid and immediately informed us on the phone about the accident, which allowed us to quickly assemble a trauma team and quickly make the best decisions,” said the professor.
Little chance of success
Meda said that at the beginning, no one in the clinics in Kaunas told her about her true condition, they only said that an open leg fracture was diagnosed. “Medically, in such situations, we say there is no hope, the faster and better way for the patient is to make a radical decision right away, but knowing Meda’s age, we simply could not accept it. We did everything we could to the maximum,” said prof. J. Stučinskas.
The professor spoke with Meda only a few weeks later, when his colleague, orthopedic traumatologist Arnoldas Sipavičius, performed a complex operation to join broken bones. He openly identified possible scenarios, impending risks and complications to the patient.
“I told her that there were several options: to leave the leg straight and immobile, to amputate or to replace the damaged surface of the knee joint with a prosthesis. She listened to all the information without any major elements of tragedy and confidently said that she wanted to have at least a little flexibility in her leg”, recalled Meda’s determined attitude. J. Stučinskas.
Meda underwent nine operations during the entire treatment period, she spent about 39 hours in the operating room.
“The operation usually takes place outside the operating room, but before the operation. You have to anticipate several steps forward, have several options if something turns in a different direction. Before the operation, we do the preparatory work: we measure, apply the templates on the X-rays, see how the situation will look. We cut out the corrected axes in the photo itself and look at various implant systems. “Mead was the only one suitable out of all the possible options,” said Prof. J. Stučinskas.
Without blood circulation, nothing would exist
Vascular surgeon Viktoras Šliaužys of Kaunas Clinics, who restored blood circulation to patient Meda, says that acute ischemia occurs during injuries (impaired blood flow to some part of the body or organ) and doctors have 6-8 hours to restore blood circulation. “During injuries, arterial blood flow is completely cut off, so this is the main reason why in such cases there is a risk of amputation,” explained the doctor.
According to the vascular surgeon, Meda’s injury was not a scissor, not a cross, but a crushing injury, which in the vascular sense is like overstretching, tearing off an artery.
“The artery becomes stratified along its entire length and there is no more blood flow. It can only be restored after performing a bypass surgery, said V. Šliaužys. – Meda had a good superficial vein, which we used for a bypass. At that time, we restored the blood flow, but a year later, the patient suffered damage to the performed shunt. The situation was complicated, two consecutive operations were required. The decision was made to take a superficial vein from the other leg and place it in the injured leg.”
The doctor is open – the success rate was very low, there were no guarantees that the operations would be successful. “Sometimes amputation is an easier solution for both the patient and the doctors, but we fully understand that it changes a person’s life fundamentally. This was the main reason why we tried to hang on even to those few percent of success”, said V. Šliaužys.
Optimism works wonders
Doctors of plastic and reconstructive surgery who performed tissue transplantation in Medai, dr. Domantas Rainys and Adas Čepas say that complications of one kind or another arose at each stage of tissue transplantation.
“Meda’s case was not standard. This required special focus, flexibility and creativity. Joint teamwork made it possible to combine various abilities and provide the best possible assistance to the patient,” say the doctors.
During the transplant, Meda was transplanted with her own tissues. “We took the latissimus dorsi muscle from the back along with the skin and subcutaneous tissues, from which we formed a chimeric (artificial) patch. Two tissue bundles were formed on one vascular bundle, which were transplanted to cover defects in the lower leg, encircling the entire knee joint in a circular fashion,” the surgeons say.
Over the years, about a hundred people contributed to Meda’s treatment – doctors, nurses and assistants, operating room operators and assistants, rehabilitation specialists, and physiotherapists.
“I really want to cry, but at the same time I’m very happy. You are all heroes. Not everyone can do such things and take such responsibility, for that one must have a vocation. I’m walking on my own legs and I’m very happy about that,” the girl thanked the doctors.
Meda does not hide that during the entire period of treatment there were all kinds of thoughts, but the attention and care of those around her allowed to drive away gloomy thoughts.
“I tried not to let bad thoughts into me. I thought that I was lucky – after all, I survived and I still have a leg”, said the patient optimistically.
2024-07-10 05:32:20