Doctors in the city saved the leg of a 92-year-old lady suffering from gangrene. Mohinder Kaur suffered a fall at home, injuring her left leg and was rushed to a nearby hospital. An x-ray revealed a complex fracture dislocation of her ankle that required urgent surgery.
However, Kaur has multiple comorbidities including diabetes, hypertension and coronary artery disease, and was on blood thinners at the time, making immediate surgery difficult and risky.
Further evaluation revealed a significant degree of atherosclerosis of her peripheral vessels suggesting a significant reduction of blood flow to her ankle and foot. She was promptly admitted to Wockhardt Hospital at Mumbai Central where a team of doctors, under the supervision of Dr Mudit Khanna, was formed to investigate this complex issue.
Cardiologist, Dr Ravi Gupta addressed the cardiac issues as well as the blood supply to the limb which was compromised. He performed a peripheral angioplasty to improve the blood supply to her leg. However, the gangrene and skin necrosis made fixing the fracture very difficult.
According to consultant plastic surgeon Dr Shraddha Deshpande, the team performed a 3-stage surgery to save Kaur's leg. The first stage involved removal of the dead necrotic tissue and covering the fracture site with negative suction dressing. A flap surgery was then performed in two stages to ensure optimum blood supply and healing of the compromised limb. The gangrenous great toe was also addressed at the same time.
“Owing to the compromised blood supply, diabetes and cardiac issues as well as the age, it was a risk to be performing a flap surgery on such a patient. After the surgery, the wound took some time to heal. But eventually, it was completely healed, and she could walk comfortably on her feet,” Dr Deshpande said.
Kaur's relative Aneet Puneja said the family had lost all hope of her leg being saved as it seemed impossible at the time. “At this age, we did not want her to undergo an amputation and surgery was also a risk. However, with the expertise of the team of doctors at Wockhardt her leg has been saved,” Puneja said.
