Grafting, Reconstruction Save Life After Trauma

Jim Morris

September 18, 2019

When Jim Morris woke up in the ICU at The University of Kansas Health System, he didn’t know where he was or what had happened. His friends and family gave him the details of the work accident that took his life – twice – before doctors gave it back.

Trapped and crushed

Jim was working for a construction crew, framing a house at Council Grove City Lake in Kansas. About noon on December 13, 2017, he and another man were stacking bundles of lumber when a 3,000-pound bundle of 5/8-inch plywood fell on Jim.

“The band broke on the bundle, and the boards shuffled like cards over him,” Jim’s wife, Lisa Morris, says.

Life-flighted

After freeing Jim, paramedics saw he had a crushed left leg but no external injuries other than a cut on his head. They rushed him to a hospital in Council Grove, where he was to be life-flighted to the health system’s Level I Trauma Center in Kansas City. But Jim was bleeding internally. The chopper made an emergency landing at Stormont Vail Hospital in Topeka, where Jim received a blood and platelet transfusion.

Several hours later, after his family had been summoned, Jim had stabilized enough to get back in the helicopter. His heart stopped twice, and he was revived twice, during the 60-mile flight. There was a good chance the 56-year-old would lose his left leg, if he survived the injury at all.

Rapid assessment

When Jim arrived at the health system that evening, orthopedic surgeon Archie Heddings, MD, and members of the trauma team were waiting.

“We are uniquely set up to handle patients like Jim at any moment,” Dr. Heddings says. “Because we are a Level I Trauma Center, we have the resources to provide the highest possible standard of care for the most severely injured patients and those with complex, multisystem injuries.”

Dr. Heddings and the trauma team rapidly assessed Jim’s condition.

“His injuries were about as bad as could be sustained and still have limbs to salvage,” Dr. Heddings says.

Jim had a pelvic fracture, left femur fracture, left tibia fracture, right ankle fracture and extensive soft tissue damage. The trauma team rushed him to the operating room to clean and treat the injuries and apply external fixators – rods screwed to the bones – to immobilize Jim’s legs.

Limb-saving skin graft

Jim spent 6 days in ICU and then was transferred to the burn unit.

“He was on the burn unit because his injuries were so extensive, he required complex wound care,” says plastic surgeon Dhaval Bhavsar, MD, co-medical director at the health system’s nationally verified Gene and Barbara Burnett Burn Center.

Because the skin, fat and fascia (connective tissue) in Jim’s left thigh were dying from lack of blood flow, Dr. Bhavsar would need to perform an extensive skin graft before Dr. Heddings could repair Jim’s broken bones.

“That is what is special about the health system,” Dr. Bhavsar says. “Orthopedic surgeons like Dr. Heddings and plastic surgeons like me can work together to create a plan to stage reconstruction and healing for our patients.”

Dr. Bhavsar performed the skin graft on January 8, 2018. The healthy skin Jim received, applied with staples, was 1/100th to 1/80th of an inch thick – about the thickness of a hair.

After surgery, Dr. Bhavsar visited Jim every evening to chat. Jim would get emotional during those visits. He missed his children.

“When I would go home at night, he would tell me to hold my kids tight,” Dr. Bhavsar says.

Skeletal reconstruction

Dr. Heddings performed 10 surgeries on Jim’s legs and pelvis, inserting 38 screws and 9 plates to hold the bones in place.

“My job was to reconstruct the skeletal frame of Jim’s body to be very close to what it was prior to the injury so he would look normal and function as close to normal as possible,” Dr. Heddings says. “For injuries so severe, we pushed medical technology to its limit. We used the best current techniques.”

Jim was hospitalized for 70 days. Estimated recovery time was 5 years, but Jim’s actual recovery was much shorter. With the help of 8½ months of physical rehabilitation and home health care, Jim continued to heal at a rapid pace.

“Jim and Lisa are amazing people,” Dr. Heddings says. “They had a persistence and tenacity in working to overcome this injury.”

Months later, while waiting in Dr. Heddings’ office for a follow-up appointment, Jim noticed a man in a wheelchair who had the same skin graft scar above the knee that he had.

“But this gentleman’s leg ended at the knee,” Jim says. “During my next few visits, I must have seen 6 or 8 patients with that same scar and the same amputation. I feel truly fortunate to still have my leg.”

Back home, back to work

Jim was discharged on February 20, 2018. Today, at home in Emporia, Kansas, he walks with a slight limp, but has no pain.

Jim began work as a train conductor on March 5, 2019, 15 months after the accident. To take the job, he had to pass several physical tests, including walking on sloped gravel, walking without a cane and climbing into the train engine.

In a letter to Dr. Heddings and Dr. Bhavsar, Jim wrote, “The entire staff was amazing and accommodating to my every need during my stay and surgeries. I cannot express my extreme, sincere, heartfelt gratitude to the hospital and the staff.”

The accident and aftermath transformed Jim spiritually. Guided by a renewed faith that had seemed broken but then healed, Jim says he feels called to “live my life differently and right those who I had wronged.” He committed to mending broken relationships.

“Thank you is the best prayer anyone could say, and I say that one a lot,” Jim says.

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