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Your Healthy Family: Surgeons work together to save teen's arm

Posted at 5:37 PM, Sep 22, 2022
and last updated 2023-02-20 12:54:38-05

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When Konnor Burge arrived at UCHealth Memorial Hospital Central in Colorado Springs via an emergency medical helicopter in December of 2020, his arm was severely injured, and doctors weren't sure they could save it.

Prior coverage: Your Healthy Family: Brighton teen suffers major injuries in 2020 car accident

“I really thought Konnor might end up with an amputation,” recalls Dr. Jonathan Barnwell, an orthopedic trauma surgeon. “It’s a conversation we had.”

Konnor’s mom, Stormy Burge, also remembers it was touch-and-go at first. “Every surgery, every day, they reminded me it's still a possibility he's going to lose his arm.”

Konnor had suffered multiple injuries from an accident on Poncha Pass near Salida. Putting his broken arm and leg back together would be a feat of orthopedic and reconstructive skill.

Dr. Barnwell explains: “He had several devastating injuries. His upper arm was broken at the shaft, we call it comminuted, which means it’s in several pieces. His nerves were exposed in his arm. In his femur bone, he had what's called an intra-articular distal femur fracture, meaning that his knee joint had come apart in several pieces. Both of those injuries required stabilization and putting those small pieces back together, putting metal plates and screws across there to hold it together until his body healed up.”

Konnor doesn’t remember much about the day of the accident. The teen was in the passenger seat, traveling home to Brighton after visiting his grandparents in New Mexico. His brother was also injured, and his father, who was driving, died.

Both Konnor and his younger brother were flown to Memorial Central, a Level I Trauma Center in Colorado Springs. Konnor endured 14 surgeries during his 21 days in the hospital.

To fully restore an arm that’s missing skin and muscle takes so much more than just putting the bone back together, explains Dr. Barnwell. “You need blood flow, you need muscle, you need nerves, you need bones - you need all those things coming together. Our job is to get the mechanics of the architecture restored, get the bones back in place, and then he comes in and gets things covered up for us because if we can't cover up the bone like that, that's an amputation.

“He” is Dr. Fred Deleyiannis, a plastic and reconstructive surgeon with UCHealth who tells me he had his work cut out for him rebuilding Konnor’s arm. “This was pretty challenging in the sense that it was a lot. Many wounds will require soft tissue coverage, but few need a nerve transfer at the same time. But, when you're missing the ability to flex or extend, say, a body part, if you can figure out a way to actually make the muscle contract and function like a muscle, that would make something move.”

Konnor sums up what Dr. Deleyiannis did like this: “Dr. Deleyiannis is the doctor that reconstructed my arm. He did a muscle graft from my leg to put it in place of my bicep muscle and he reconnected my radial nerve and repaired everything in my arm.”

Dr. Deleyiannis explains that there was a lot that went into weaving together muscle, nerves and skin to allow Konnor to keep a functional arm. “Konnor’s arm was missing tissue basically down to the bone. The humerus, which is the main bone of the arm, was exposed. When you have a bone exposed like that with a fracture, and nerves also exposed, you need to cover them with soft tissue. Our job was to replace what was missing, but also to try to provide what is called a functional muscle transfer. With the biceps partially missing, which is the main flexor of the elbow, we had to put muscle in there that would not only cover the bone, the hardware, and the nerves but also try to give innovation to a muscle so that the muscle could contract, and gave him good elbow flexion, so he had good upper extremity function. Our job was to do a free flap, a transfer of muscle from the thigh into the gap that was missing the muscle (in the arm), and then we hooked up a nerve of the free flap into a native nerve of the arm to allow it to contract so that you have good elbow flexion.”

Dr. Barnwell appreciates how the team came together. “I give Dr. Deleyiannis a lot of credit for his ingenuity, figuring out how to get the muscles over there. Dr. Deleyiannis had some good tricks up his sleeve. We're very fortunate to have Dr. Deleyiannis on our team.”

In our next story, we will see how Konnor is doing these days, the work he’s had to put in with physical therapy to return to what he calls a “new normal” with his right arm. Also, what the reunion meant to Konnor and his caregivers.

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