amputation

A Day in the Life of a Trauma Surgeon: Get Your Foot Off of My Dash

We have all seen it before. You are cruising right down the road, and it immediately catches your attention. There is a female passenger in another vehicle with her feet up on the dash.  Imagine the horror if someone did this to your brand new vehicle!

The nightmare came true for both Bob and Carol. They were running errands around town and Carol put her foot up on the glistening dash of Bob’s new SUV. Holding back his true thoughts, Bob politely says, “Honey, please get your foot off of my new dash.” Carol replies, “I am just admiring my new pedicure like you’ve been admiring your new SUV.” As the conversation heats up, Bob becomes distracted while making a left hand turn at a four-way intersection and fails to yield to an oncoming vehicle. Distracted as well, Carol still has her foot on the dash at the time of impact.

Brake pedals are slammed to the floor and evasive maneuvers fail. Bob’s brand new SUV is struck in the right front corner sending it into a spin, before it rolls over onto its roof and slides to a stop. Fortunately, all the occupants of both vehicles were seat belted and most were able to walk away from the crash. Carol was not so lucky. As the passenger frontal bag deployed, it pushed Carol’s foot through the windshield and her toes were amputated as the vehicle slid on its roof, dragging her foot across the hot summer asphalt.

One can only imagine the pain and fear when Carol looked down and saw that her toes were gone. After stabilizing Carol for transport to the hospital, the good-intentioned paramedic recovered her missing toes. After transferring Carol’s care to me, he said, “here are her toes for you to put back on.” I smiled and thanked him, knowing well that was not going to happen. Not only were two toes completely missing but the three amputated toes along with her foot were too badly damaged to perform a reimplantation.

Carol received a complete trauma evaluation, and fortunately the only injury was to her foot. We took her to the operating room and cleaned things up, leaving Carol a functional forefoot amputation. After a couple of days of physical therapy she was back on her feet.

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