Doctors re-attach woman's arm in unprecedented surgery 11 months after it was sliced off in a car accident

March 25, 2017  17:11

A mother-of-two has had her arm re-attached in a groundbreaking operation less than a year after it was sliced off in a car accident.

Kelsey Ward, from Schertz, Texas, was driving home from work in April 2016 when her SUV rolled off an exit ramp and turned over. 

A metal guardrail crashed through the passenger window and cut her arm off above her elbow.

Years ago, that kind of incident would have left Kelsey with a stump.

But in a surgery never performed before in Texas, doctors at San Antonio Military Medical Center (SAMMC) were able to successfully replant her severed arm.

It's a procedure that's been done fewer than 10 times in the US.

Doctors say Kelsey is recovering well, achieving small tasks like picking up a banana at the grocery store - and even the seemingly impossible, like doing push-ups.

Kelsey says she can't remember what happened the night she left work and drove home in April 2016.

She doesn't remember even getting in her car, so she's not sure was caused her SUV to roll off an exit ramp and flip over.

A metal guardrail pierced Kelsey's passenger window and lopped off her right arm just above her elbow.

She was left trapped inside and hanging upside down, with her seat belt still attached.

But San Antonio firefighters and paramedics arrived quickly and used tourniquets to stop the bleeding while they raced to free her.

'Then when we got her out of the car, that's when someone said, "Y'all need to look for the arm",' San Antonio firefighter Ryan Dunivan told News 4 SA.

'We were walking around and I happened to see just her fingertips on the other side of the vehicle under the roof of the car. Then we got spreaders under there just enough to pull the arm out.' 

The arm was put onto the ambulance with Kelsey and taken to Fort Sam Houston and the Level One Trauma Center at SAMMC.

Dr (Lt Col) Joe Alderete was told of the incoming case, but thought arm replanatation would be unlikely given the infections and other complications that can emerge as well as the many surgeries that would be needed.

'I was thinking there's absolutely no way. Most of the time these [accident victims] are crush injuries and not amenable to replantation,' he told News 4 SA.

However, the guardrail had almost cleanly sliced Kelsey's arm, making it easier to reattach the severed tissue, despite the several broken bones in her severed arm and the other injuries she had suffered in the crash, including a broken pelvis.

Dr Alderete's team included two vascular surgeons, a hand surgeon, a back-up hand surgeon and a plastic surgeon, along with many other SAMMC medical staffers.

'We were at one point - for the first ten hours of surgery - working on her at once. So just being able to bring the team together was incredible,' he said.

To replant and rebuild Kelsey's arm, over the last nine months a number of surgeries have been performed, including taking skin from one of her legs and deeper tissue from the other leg, which they used to help splice together major nerves.

And they improvised, patching her broken, severed arm back together.

However, should any threatening complications arise, Kelsey's arm will have to be taken off. 

'If we're dealt a hand where either infection takes over or the vascular reconstruction didn't completely revascularize her arm, then we could definitely make a late determination for amputation down the road,' Dr Alderete said.

And while the team was able to hook up Kelsey's ulnar nerve (the nerve that runs near a bone in the forearm) directly, they needed grafts for two other main nerves, the median and radial nerves, which until the last few years wasn't a realistic option.

Now eleven months later, Kelsey is a living case study in what's possible in rehabilitation, as she works with experts at the Center for the Intrepid at Fort Sam Houston.

Her therapist, Christopher Ebner, has been working with her nearly everyday since. 

He said in 15 years of practice, he's never seen someone as strong as Kelsey.

'It takes a ton of physical and emotional strength,' Ebner told KHOU.

Dr Alderete said that in Kelsey's case, they've learned a lot more about the replantation process

'We're able to use a mild electric prosthesis to help continue her function and teaching her brain what her upper extremity is supposed to do,' he said.

Kelsey has spent countless hours a week at her therapy sessions to re-strengthen her right arm.

She can now bend her elbow along with moving some of her hand and fingers - and she's even been able to do a push-up.

She says she's surprised by the speed of her recovery. 

'I actually have a lot of use with my arm, more than I thought I was going to get at the nine-month mark,' Kelsey told News 4 SA.

'We actually didn't think we were going to see any movement for a year at all. Not even elbow movement.'

Despite the joy in her achievements, Kelsey said her recovery has been far from easy. 

'It's worse than going through labor,' she said.

'It's the hardest, most difficult, most exhausting thing I've ever had to do. But I want my kids to know that there's nothing in this world that they're not capable of doing - and I'm living proof.'

Kelsey says she one day hopes to regain full use of her arm. A GoFundMe page has been set up to help cover medical expenses. So far, $745 has been raised out of $5,000 goal.

A few months after her accident, Kelsey's tattooed on her left forearm: 'My Story Isn't Over Yet'. 

'I wanted that because it was the most meaningful to me,' she said.

'I'm not gonna give up. And hopefully this is a medical breakthrough and it saves lives and helps people.'  

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