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MIRACULOUS RECOVERY FOR A 75-YEAR-OLD PATIENT WHO AVOIDED A LEG AMPUTATION AFTER A TRAFFIC ACCIDENT.

MIRACULOUS RECOVERY FOR A 75-YEAR-OLD PATIENT WHO AVOIDED A LEG AMPUTATION AFTER A TRAFFIC ACCIDENT.

17/03/2025

At the conclusion of June 2024, Mrs. M.T.M (75 years old, residing in Can Tho City) was involved in a traffic accident. She had her right leg trapped in the rear wheel of the motorbike while riding behind her niece. She was promptly transported to a local hospital, where she was diagnosed with a severe open tibial fracture, an important loss of the distal tibia bone, and a critical contusion of the ankle. She underwent a wound debridement, a ligation of the great saphenous vein, and a temporary external fixation. One week passed that did not see her condition improving. She was then recommended to have an amputation of her leg. Reluctant to accept this extreme solution, she sought additional medical opinions from hospitals in Australia, only to encounter the same recommendation.


On July 6, 2024, Mrs. M.T.M was transferred at the request of her family, to the Orthopedic Department at the American International Hospital (AIH) in the hope that her leg could be saved. She was admitted by Dr. Nguyen Viet Thinh, Deputy Head of General Surgery at AIH, who confirmed the diagnosis of a complex septic open fracture remarkable by the loss of the distal one-third of the right tibia, a fracture in the distal third of the right fibula, extensive soft tissue damage with skin loss totally exposing the right lower leg. Based on the severity of the trauma and the presence of infection, primary limb amputation was considered a life-saving option.

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However recognizing the profound psychological impact associated with the loss of a limb, Dr. Nguyen Viet Thinh consulted with Prof. Dr. René D. Esser, a former Head of Orthopaedic Department at the Medical Center of the Stanford University, School of Medicine who drafted a highly individualized treatment plan with the primary objective being to salvage the limb, although the initial prognosis was deemed very poor.


Upon admission to AIH, Mrs. M.T.M was put on antibiotic therapy and pain management in the waiting of surgery. Microbiological cultures were obtained for targeted antibiotic therapy preceded wound debridement. The initial external fixator, applied at the outside facility was removed and replaced with an Orthofix external fixator, more stable and offering the possibility of a complete treatment. Subsequent to surgery and customized antibiotic treatment, her wound exhibited positive progress, evidenced by satisfactory granulation tissue formation.


From August 2, 2024, to February 26, 2025, several sequential procedures were necessary that allowed for healing of the wound, tibial segmental bone transport, IM nailing after removal of the Orthofix External Fixator, arthrodesis of the ankle joint with the same IM nail and bone grafting. To the best of our knowledge such procedure has never been performed before in VietNam as well as overseas.

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Following 7 months of dedicated treatment, Professor R.D Esser and his team at AIH successfully treated the infection, restored the lost tibial length (8 cm) and preserved the patient's right leg with ankle arthrodesis using an IM tibial Nail, thereby averting amputation. During her follow-up appointment on March 10, 2025, the wound was clean and dry, and the patient was allowed partial weight bearing with regular follow-up visits until complete bone healing is achieved.

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Limb-lengthening surgery represents a highly complex procedure necessitating a team of proficient surgeons. In this instance, the Orthofix external fixator was employed, a pioneering bone reconstruction technique introduced by Prof. Dr. René D. Esser. He has been imparting knowledge and applying this method in Vietnam and globally for over 30 years, offering advanced treatment options for patients with severe trauma. This technique provides multiple advantages, including robust fixation, allowing early mobilization and rehabilitation while ensuring correct limb length. It further negates the requirement for synthetic bone substitutes by utilizing the patient's own bone, thereby reducing the number of surgeries needed and minimizing the risks of infection and soft tissue damage.


The Orthopedic Trauma Department at AIH encompasses a proficient team of international and Vietnamese physicians trained and experienced in leading medical institutions worldwide. In addition to their expertise, the orthopedic specialists at AIH are committed to understanding the unique needs of each patient, formulating personalized treatment plans, and supporting them in restoring a normal life as expediently as possible.


For treatment consultations at AIH, please message us at https://m.me/aih.com.vn or contact our hotline at 1900 3493.

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For checkup and consultation at AIH:
☎ Hotline: (028) 3910 9999
🌏 Website: www.aih.com.vn
📍Address: (Entrance from 199 Nguyen Hoang Street) No.6, Bac Nam 3 Street, An Phu Ward, Thu Duc City, Ho Chi Minh City.
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