Shark attack extensively injuring both legs!!⚠️🦈
A previously healthy 32-year-old man, a body-boarder, was transported to hospital by primary retrieval helicopter, within 2 hours of a shark attack injuring both legs. The image above shows the initial intraoperative image of the patient's injuries. Left leg had an extensive laceration from anteromedial distal thigh extending laterally down to the fibula with an avulsed fracture of the fibula head, transected common peroneal and tibial nerves, exposed popliteal fossa and knee joint, damaged vastus lateralis muscle and bite marks on the femur. Right leg had a smaller open wound on the medial thigh. Tourniquets were applied bilaterally to decrease hemorrhage. En route to hospital he was intubated with an endotracheal tube due to severe agitation from acute blood loss. On arrival, the patient was transferred directly from helipad to theatre. Initial intraoperative exploration revealed an extensive laceration on the left leg and a smaller medial thigh wound on the right leg. All wounds were irrigated and debrided. Owing to the injury location, the left popliteal artery was visualised but found to be uninjured. Thrombectomy was required for a left popliteal vein thrombus. X-rays revealed teeth marks to the left femur and an avulsed fibular head. Finally, prophylactic antibiotics (cephazolin, metronidazole and gentamicin) were administered. The patient was admitted to intensive care unit. Case source - BMJ Case Rep. 2015; bcr2015212380.
Amazing how they can see an injury like this and still locate clots in specific veins. Hope the patient ended up okay
Very lucky to have kept the leg. Easily could have ended up a An AKA. Based on the nerve injury he would have lost all motor control of the foot and ankle. Picking up thrombus would be relatively easy with US.
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