Limb preservation team uses microsurgery techniques to save patient's leg after devastating work accident 

By: Crystal Huff

A work-related injury caused Beth Rahn to lose one of her legs. She was on the brink of losing her remaining leg when the Washington University Orthopedics limb preservation team helped save it.  

Beth is a co-manager at a farming supply manufacturer in Arcola, Illinois. One day at work, Beth was pinned to the ground by a forklift that was backing up. The machine ran over her legs, crushing them.  

Beth was taken by ambulance to a hospital in Champaign, Illinois and subsequently transferred to a hospital in Springfield, Illinois. “I was told early on that I would lose my left leg,” says Beth. In addition to the severe injuries to Beth’s left leg, her right leg also sustained potential limb-threatening injuries. Beth spent five weeks in the hospital in Springfield, Illinois.

After her left leg was amputated, doctors worked on saving her right leg. Beth says, “I had a skin graft and an external-fixation device to stabilize the leg.”  An external-fixation is a surgical treatment where rods are screwed into bone and exit the body and are attached to a stabilizing structure on the outside the body.

Beth says, “Shortly after, my leg started showing signs of an infection.” After several issues with fighting off infections, Beth’s workers’ compensation catastrophic case manager at Paradigm, Kim Roberts, insisted Beth transfer her treatment to Washington University Orthopedics at Barnes-Jewish Hospital.

Kim says, “Once I got involved, I knew she needed a team of specialists to save her remaining leg. Dr. McAndrew, Dr. Brogan and Dr. Boyer are excellent to work with and really care about their patients.  Washington University Orthopedics workers’ compensation office staff, Misty Ramirez and Laura Meyer, are life savers. They expedite everything and make sure my injured workers are seen promptly.”   

Beth was treated by orthopedic trauma specialist Christopher McAndrew, MD, MSc, and microvascular surgeons David Brogan, MD, MSc, and Martin Boyer, MD, FRCSC. Together, they manage a limb-preservation clinic, bringing together experts across specialties to solve complex limb reconstruction problems.  

“In order to give Beth a chance at walking again, we knew she would need a combined effort to restore the alignment of the ankle and provide stable soft tissue coverage. As a group, we planned a series of surgeries to remove damaged tissue and fix her bone. We covered a skin defect on her ankle with a transfer of vascularized skin using microsurgical techniques,” explained Dr. Brogan. “In Beth’s case, we recognized the impact that saving her remaining leg could have on her overall recovery and quality of life.”

Dr. McAndrew added, “Her right ankle was managed in an external fixator, but the alignment could not be maintained with this device. Restoring the alignment and holding it with internal fixation is risky, but it’s made easy when you have surgical partners who can solve complex wound issues. Her right leg needed an aggressive approach to be saved.”

Beth stayed at Barnes-Jewish Hospital for 16 days and had several surgeries on her right leg. She says it was definitely a team effort. “I felt like I was finally getting the very best care and they were all just great. They had a really great bedside manner.”  

Beth was finally able to return home two months after her work accident. Four months later, she was ready to begin physical therapy. With her new prosthetic leg, she feels that life has finally started to return to normal. 

Beth says, “I came through this so well with lots of prayers. I couldn’t have done with it without my husband, family and my wonderful doctors.” 

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