We all understand that road accidents can have devastating results. If one is lucky, the injuries are restricted to just a few bruises here and there, but in many cases, the injuries are far more serious. One such injury is an avulsion.
In medical terms, an avulsion is a severe cut or tear in the skin which. It’s rather deep, to such an extent that the inner elements like the muscles, bone, ligaments etc. are exposed, almost giving it the appearance of being crushed. Naturally, an avulsion of any type generates a wave of terror in us even if we see it in another person or even if it is a picture or a video.
If a similar avulsion is in a heel pad, i.e. near the ankle and heel, it’s called a heel pad avulsion. In such cases, a heel pad avulsion surgery is performed to treat it. This sort of an injury is usually a result of a traumatic road or domestic accident where the heel area is affected. It potentially poses a challenge to our future regular locomotion if not treated properly. In case the torn area has lost blood supply, it’s called a total avulsion and needs to be reconstructed. If the area is still attached sufficiently so as to retain sensation, the torn area is reattached to the body. In any case, it is a complicated procedure for the doctors. The heel pad supports the weight of the body and hence, has evolved in a very complex fashion.
One such challenging case was treated by our doctors at Sai Sanjeevani.
Rairaj S (name changed), aged 42 years, got his left foot trapped in between a two-wheeler leaving heel pad injured. The avulsion was partial and he suffered from damaged soft tissues and minimal fracture in his heel bone.
Since the avulsion was partial, a reconstruction was possible. The doctors first had to clean up the area of foreign materials and damaged tissue. This process is called debridement. It is essential for an infection-free recovery. The torn portion was stitched using k-wire. K-wires or Kirschner wires are sharp and smooth pins of stainless steel made specifically for medical use. They are used to hold ligaments, bones and tissues in proper places. The patient, in this case, needed two k-wires to hold the avulsion to the heel bone. The same wire was used to repair the fracture in his heel bone.
The patient was released in two weeks. Physiotherapy was advised for the next eight weeks so that he could take weight on the heel very gradually.
A heel avulsion surgery can be very challenging for a surgeon since each accident and each patient is different from the previous one. It can be performed even without the most technically updated medical tools. But the outcome can be more promising if the surgery is performed within the ‘golden period’ i.e. six hours.
About the doctor:
Dr. Anjaiah is an Orthopedist in Kothapet, Hyderabad and has an experience of 22 years in this field. Dr. Anjaiah practices at Sai Sanjeevini Hospitals in Kothapet, Hyderabad. He completed MBBS from Osmania Medical College, Hyderabad in 1991 and MS – Orthopaedics from Osmania Medical College, Hyderabad in 1994.
About the hospital:
Sai Sanjeevini Multi Speciality Hospitals, a unit of Singapanga Healthcare Pvt. Ltd has been providing health services to the people in need for the last 14 years. This health care organisation combines practical, proven research, cutting edge procedures and state-of-the-art treatment to produce excellent medical and lifestyle outcome for our patients. Our hospital and medical staff provide innovative medical care in a friendly, compassionate, community environment conducive to patient recuperation in a family atmosphere.