British tourist’s crash injury may be too severe to reattach limb: medical expert

New York Daily News—August 21, 2013

Dr. David Wellman, an orthopedic trauma surgeon, weighs in the taxi accident involving Sian Green, describing the factors involved with reattaching a severed limb.

Despite the high failure rate of reattachment, surgeons will do everything possible in the early stages even if there is a small probability of success,’ writes Dr. David Wellman, an orthopedic trauma surgeon.

There are several important factors at play when surgeons are performing a replant — or reattachment — of a severed limb.

The key elements are the time it takes to get to the hospital ER and OR from the time of the injury; how large the zone — or area — of injury; and the ability to get blood flow returned to the severed part.

With a crushed leg and severed foot, the initial goal is always to save the limb if possible. Unfortunately, there is a high probability a person will need a below knee amputation with this type of injury despite the best of efforts.

Despite the high failure rate of reattachment, surgeons will do everything possible in the early stages even if there is a small probability of success.

In a situation like Sian Green’s, the impact from the taxi and damage to the severed limb was likely too severe to allow for direct repair of the vital structures to allow the return of blood flow to the injured foot.

Crush injuries are more difficult to salvage than an injury that occurs from a sharp blade, such as those that happen in an industrial accident. Crushed limbs have a zone — or area — of injury that is much larger, and even the intact portion of the limb will likely have significant damage.

Read the full story at nydailynews.com.