February 15, 2022

A Devastating Injury

It was March, and Ketrina Moore was wrapping up a weekend of celebrating her birthday. While crossing a street, Ketrina and her husband, Andre, were struck by a car in a hit-and-run. Andre escaped with minimal injury, but Ketrina had to be rushed to Barnes-Jewish Hospital. She needed emergency surgery for a devastating leg injury.

When Ketrina woke up in the hospital after surgery, she was distraught. “There was a possibility I could lose my leg. I wasn’t sure I was going to walk again.”   

The Race to Save a Leg

While at Barnes-Jewish Hospital, Ketrina was treated by several specialists, including Christopher McAndrew, MD, MSc, an orthopedic trauma surgeon and part of the limb preservation team at Washington University Orthopedics. 

Ketrina says, “Dr. McAndrew is an awesome orthopedic surgeon. He is truly a passionate person. He eased my worries; he really talks to his patients and gives them the information in a straightforward manner.”  

Dr. McAndrew explains, “Ketrina had a limb-threatening injury to her left leg, just below her knee. She had an open tibial plateau fracture with bone loss, and quickly developed compartment syndrome: a painful and dangerous condition where built-up pressure from bleeding and swelling cuts off blood flow to muscles and nerves."

Dr. McAndrew shares, “My limb preservation partner, microsurgery specialist, David Brogan, MD, MSc, was on call when Ketrina arrived at the hospital. He debrided her wounds (removed damaged tissue and debris), temporarily straightened and stabilized her leg with an external fixator and performed fasciotomies (cutting of connective tissue to relieve pressure) to save muscle function in her leg.

Resolved to Get Better

Over the course of the next 10 days, Ketrina had five surgeries to clean her wounds, remove dead tissue, and ultimately put the pieces of her knee back together. Her fasciotomy wound wasn’t able to be closed, so she was also treated with a skin graft to the lateral side of her leg. 

“Honestly, I wasn’t sure we were going to be able to save her leg, much less do so in a way that was going to get her the function she wanted,” recalls McAndrew. “We talked about the possibility of an above-knee amputation a few times."

Dr. Brogan comments, “Ketrina’s resolve in the face of such significant injury has been inspiring. At the time of her injury, we followed our basic principles of achieving stability for the bone, getting the wound clean and preventing further damage by performing fasciotomies. Despite the severe injury to her leg, the coordinated team effort ultimately resulted in a good outcome for her.” 

The Slow Recovery Begins 

When she left the hospital after staying for more than two weeks, the slow recovery process started. Her wounds healed gradually over several months, but there was special concern for her left leg fractures. She had radiating pain in her leg from damaged nerves and she lost strength. For three months, Ketrina’s living room was converted into a hospital room. 

“I had a hospital bed in the middle of my living room. I had to have round-the-clock care and was not able to get up for any reason. Three months after my injury, in June, I was finally able to move out of the living room and into my bedroom."

Because of the fragile internal support to her left tibia (shin bone), she stayed in the external fixator for a few weeks after being discharged from the hospital. Physical therapy followed, and she was ready to attempt full weight bearing by August. A family cruise had been planned for that October, and Ketrina was able to attend with the assistance of a wheelchair. 

Dr. McAndrew notes, “Two things have always amazed me about Ketrina: her positive outlook in spite of this injury, and the love and support from Andre and her family. We talked a lot about their plans and need to stay involved with the family. Ketrina’s left leg fractures weren’t healing (called nonunion), as we suspected they wouldn’t. The alignment was stable, and our evaluation of her bloodwork suggested that there wasn’t an infection. We made plans to deal with her unhealed fractures, but we were lucky to be able to delay the surgery to let her get on the cruise. Once she got back, we had surgery scheduled to repair the nonunion of her tibia.”

Back to the Operating Room 

That November, Ketrina went back to the operating room. The plan was to use a bone graft from her femur to allow her tibia to heal. When the orthopedic surgeons opened her fracture site, however, it looked infected. Wanting to be cautious and not waste her bone graft, Dr. McAndrew and his team debrided her tibia once again, and a cement spacer with antibiotics was placed in the space where her tibia hadn’t healed. She was on antibiotics for six weeks and back to no weight on her leg. 

In January, Ketrina went in for her final surgery. The cement was removed and bone graft from her femur was placed in the space where her tibia hadn’t healed. New plates and screws were placed to hold her leg in alignment, and the process of waiting and watching started again. 

A full year after her accident, her X-rays finally showed signs of healing, and she started bearing weight. She restarted physical therapy to help her regain strength and to learn to walk again. 

Grit and Determination (and Love) 

Dr. McAndrew remarks, “Her recovery was faster than I ever expected and she was determined to get back to life. She really is an example of someone with grit and determination (along with a lot of love and support), and I was happy to be able to help her along the way. She inspires me.”

Dr. Mc Andrew recently saw her at the three-year anniversary of her injury. He recalls, “Her latest accomplishment was to get into some high-heel shoes for a formal event with Andre. They’re heading to the beach for vacation, and I couldn’t be happier for them.” 

Ketrina says, “My flexibility is a little limited and I have drop foot, but I have about 90% range of motion back. I love skating and dancing and I am positive that one day that I will be back on the floor.”