9 year old boy presented to Mallareddy hospital with history of injury to right upper limb axilla

9 year old boy presented to Mallareddy hospital with history of injury to right upper limb axilla

9year old boy presented to Mallareddy hospital with history of injury to right upper limb axilla secondary to fall of wall on the right upper limb while he was playing .Patient consulted 2-3 hospitals before who suggested right upper limb amputation . Patient presented 12 hrs after injury , It was challenging surgery . On examination there is no radial pulse, cold periphery, no movements of fingers.CT scan showed complete transaction of axillary artery and vein, complete mid shaft fracture of humerus. Patient was resuscitated in ICU and after hemodynamically stable , he was taken into OT.


Dr Sanjeev Rao senior vascular surgeon has done the surgery .


Intraop finding there was open wound with tissue and muscle loss with multiple sand and mud particles inside .There was complete transection of axillary, artery and axillary vein,Nerve contusion injury. We thought of bypass initially but carefully mobilized the artery and vein so that we could do end to end anastomosis so that it helps the growth of artery. We successfully anastmosed the artery and vein with 7.0 prolene . Orthopedic team(Dr venumadhav) placed elastic nails and plastic surgeon (Dr Raghuram) closed the wound with ssg .


Postoperatively radial and ulnar pulses are palpable, right hand felt warm, movements of fingers present. Patient is discharged in stable condition .
The kid thanked the doctors and hospital for saving his limb and he also want to become surgeon and do great surgeries with the hand