After rare femur surgery, Bihar girl to walk again

A 12-year-old girl from Bihar will be able to walk again after doctors here reconstructed her femur shaft by using a fibula graft taken from her mother, a private hospital said.

When 12-year-old Kashish from Begusarai met with an accident and underwent a surgery on her right thigh to get her broken femur, the longest and strongest bone in a human body, repaired, little did she or her family imagine that she would acquire a blood-borne infection and become immobile.

However, doctors at Aakash Healthcare in Dwarka performed a two-stage surgery to cure osteomyelitis, a rare but serious infection of the bone, and reconstructed her femur shaft by using her mother's calf bone.

The doctors said five weeks after the post-accident surgery, the girl was diagnosed with chronic osteomyelitis acquired during the surgery of the right femur.

Due to the condition, she complained of pain and swelling of right thigh along with fever. Her parents contacted their relative in Delhi who sought the opinion of doctors at Aakash Healthcare and the girl was admitted into the hospital on August 16.

She was found to have deformity and pain on thigh and crepitation (a crackling sound upon movement), the hospital added.

In the first stage of surgery, the dead part of the femur bone was removed and an antibiotic spacer was placed at that site. After a gap of six weeks, the spacer was removed and her femoral shaft was reconstructed using a fibula graft taken from her mother in the second stage of surgery.

Dr Aashish Chaudhry, the director of orthopaedics, joint replacement and spine Surgery at Aakash Healthcare in Dwarka, led the complex surgery.

''She was brought just in time as osteomyelitis is a rare but serious infection that affects about two out of every 10,000 people. If left untreated, it can become chronic and cause sepsis, necrosis (loss of blood supply) to the affected bone and bone tissue death by disrupting the flow of blood to the affected area which could be life threatening,'' he said.

Talking about the challenges involved, Chaudhary said the biggest issue was to control the 15 cm infection of a body part which is the longest human bone. The girl's condition required an open reduction and internal fixation (ORIF) of the femur as it is a definitive procedure that facilitates early mobilisation and reduces risk of further infection – other conservative treatment would have required intensive medical care and prolonged bed rest, the doctor said.

If the doctors had opted for other procedures, her movement would have remained restricted for a longer duration which is not conducive for a child of her age.

''Besides, such treatments, including debridement (the medical removal of dead, damaged, or infected tissue to improve the healing potential of the remaining healthy tissue) and saucerisation (surgical removal of tissue from a wound to form a saucer-like depression), would have had high chances of recurring chronic osteomyelitis with resultant multiple surgeries and disability. She was discharged after four days. She can resume her normal outdoor activities in one to one-and-a-half years,'' he said.

The doctor said for the next one year, the girl will have to ensure that the operated area is not pressurised and will have to use a walker for some time and then a stick to walk. After the doctors will be convinced that the site has fully healed, she will be allowed to walk on her own.

The doctors said the girl's mother Khushboo was the best donor as she was the closest relative with minimal chances of ''histogenetic incompatibility leading to complications'', thereby, reducing the chances of the child's body rejecting the implant.

The woman, who donated 15 cm from her calf bone, is relieved that her daughter will be able to go back to school and can become just the child that she was.

''We were very anxious when her injury site continued to swell even after the operation. We are happy that Kashish can grow up having a normal life,'' the mother said.

(This story has not been edited by Devdiscourse staff and is auto-generated from a syndicated feed.)