Date: Thu, 17 Jan 2002 22:26:45 +0530

Subject: S/P Hemipelvectomy - Interlocking Nail Removal

Dear friends,

Dear list members,

Kindly find attached the pictures of a young doctor.(Some of you may remember this case as a living hero published by Readers Digest sometime ago).

This young individual(a seond year medical student at that time) was brought to us four years ago with subtotal amputation of right hemipelvis and fracture left femur. He was treated with emergency right hemipelvectomy, emergency permanent sigmoid colostomy,ileal conduit for urinary diversion and external fixation for left femur. After he was stable and off ventillator interlocking left femur was done.

He was initially ambulated on a pair of crutches and later on a prosthesis specially made at Armed Force's Artificial Limb Centre, Pune. This prosthesis weighed 11.5Kg. Later when this developed problems another prosthesis weighing 9 Kg was made by a centre in Kerala (Lords). At present he has one prosthesis made by Endolite which weighs 4 Kg. However this is not quite satisfactory.

My questions to the list are:

1) Should we attempt removing the Interlocking nail now (Sun nail, marketed by Mathy's Medical India for Synthes) ?
2) Can someone make a light weight prosthesis which can accommodate the colostomy and ileostomy and are there any good Samaritans who will be willing to support this?

Dr.T.I. George, Consultant Orthopaedic Surgeon,
Polytrauma, Microvascular Surgery And Hand Surgery Unit,
Metropolitan Hospital, Trichur, S.India.

Date: Thu, 17 Jan 2002 09:49:39 -0800

From: Chip Routt

If the nail is asymptomatic, leave him alone...he's had enough operations.

I'll send your note along to our limb viability/amputation experts, Drs. Doug Smith and Will Ertl, for their comments.

Chip

M.L. Chip Routt, Jr.,M.D.
Professor-Orthopedic Surgery
Harborview Medical Center
Seattle, WA