“There have been days when I didn’t feel like I would make it through,” says Jarrell Bryant, a former
patient at Memorial Hermann-Texas Medical Center who was admitted through the hospital’s Red Duke Trauma Institute. “I went through the ‘why me’s,’ but I got past it. My wife and I have an eight-year-old daughter I have to set an example for. If someone tells her she can’t do something, I want her to be able to say that her dad lost a leg and kept on going. Then no one will be able to keep her from accomplishing her goals.”
In late September 2016, Bryant and his motorcycle buddies were heading home in the wee hours of the morning.
“Five of us were riding together, and we slowed down as we approached a sharp curve,” he says. “The guy riding next to me caught his back wheel on the curb. He bounced off the curb and T-boned me at the back of my motorcycle.”
The impact sent Bryant into the air, and on his way down he slammed his left leg into a street sign, breaking it and separating his pelvis from his sacrum. After initial treatment at a community hospital, he was transferred to the Memorial Hermann Red Duke Trauma Institute.
The first doctor he remembers seeing was Andrew Choo, M.D., who is dual fellowship trained in orthopedic traumatology and shoulder and elbow surgery. “Dr. Choo and I talked. My wife and I had already come to terms with the fact that, given the damage to my leg, I might lose it,” Bryant says. “Instead, he was optimistic and said ‘Let’s see what we can do.’”
While Dr. Choo was cleaning Bryant’s leg and removing necrotic tissue in the OR, his partner Milton “Chip” Routt, M.D., a professor in the Department of Orthopedic Surgery at McGovern Medical School at UTHealth, stabilized Bryant’s pelvis with a malleable trans-symphyseal plate and screws in the front and strong, large-diameter screws in the back.
“We routinely repair this type of injury,” says Dr. Routt, whose areas of expertise include traumatic pelvic ring disruptions and acetabular fractures. He is internationally recognized for pioneering safe percutaneous pelvic fixation techniques, improving surgical care for complex acetabular fractures and advancing surgical safety.
“Jarrell had open, contaminated fractures of his tibia and fibula,” says Dr. Choo, a clinical assistant professor in the Department of Orthopedic Surgery. “We worked hard to save the leg but found a lot of contamination in the wound, as well as missing muscle, muscle damage and nerve damage. We had a long talk with him about options, including limb salvage. Did he want a full-court press to save his leg versus amputation? He said he wanted to get back to work as soon as possible and felt that a prosthesis would allow him to do that.”
Dr. Choo’s goal was to save as much of Bryant’s leg as possible and perform a below-the-knee amputation for a better functional outcome. “With a well-fitted prosthesis, these patients can do almost anything, from running to rock climbing,” he says. “Dr. Melissinos was able to rotate the muscle and cover the wound with a skin graft from the upper left thigh to allow for the below-the-knee amputation.”
Emmanuel Melissinos, M.D., a reconstructive plastic surgeon who specializes in trauma, has practiced at Memorial Hermann-Texas Medical Center for more than 25 years and is respected by his colleagues as an exceptionally talented surgeon. During the 16 days Bryant was hospitalized, he also saw physiatrist and amputee specialist Danielle Melton, M.D., director of the Limb-loss and Orthotics and Prosthetics Program at TIRR Memorial Hermann.
“Dr. Melton is fantastic,” Bryant says. “My wife and I met with a prosthetist on our first post-hospital visit to her office. We started the initial fitting in mid-December 2016, a process that took less than a month, and went over exercises to build my core strength to make walking easier. I got my new leg on Jan. 10 and started physical therapy the following week in Dr. Melton’s clinic.”
The orthopedic trauma team involves Dr. Melton early on when considering an amputation. “She lets patients know what to expect and helps prepare them psychologically for the next steps,” Dr. Choo says. “Jarrell had a fantastic attitude. Because of his military service, he knew people who had had an amputation. He was motivated, informed and well prepared.”
To learn more about Memorial Hermann’s Orthopedic Trauma Services at the Red Duke Trauma Institute, click here.