Although my job as a Foot and Ankle Surgeon does necessitate the removal of toes, feet or limbs on occasion, nothing is more harrowing then when I have to remove a limb on a young, healthy, unsuspecting person. I am sure that the surgeons who had to give Sian Green the unfortunate news that she would be returning to England minus one leg felt terrible do so.
On Tuesday August 20th, Sian Green, 24 of Leicester England was on the first day of her “dream” holiday to New York City. She was either standing or sitting at 49th st and 6th ave – home to Rockefeller center near Radio City music hall – when a yellow cab jumped a curb and ran into the unsuspecting Green. Thanks to some quick work from some bystanders and Dr. Oz, the patient’s life was not in jeopardy.
However, despite the heroic efforts of trauma surgeons at Bellevue Hospital, Ms Green lost her left leg just below the knees. Her Right leg was severely injured but with physical therapy and time is expected to regain most if not full function.
As a foot and ankle specialist, most cases that require amputation of some level of the leg is usually caused by disease. Chronic diseases like diabetes and peripheral vascular disease as well as acute cases of infection are usually the cause of most amputations of limbs in the United States. In these cases, the removal of parts of the foot and leg occur to save the patient’s life while still allowing them to function. Amputation is generally the last resort when treating patients; it’s not something any doctor likes to do but something unfortunately is required of us.
Most amputations that are caused by disease are preventable. The five step LEAP program was developed at the HRSA National Hansen's Disease Program in 1992 as a simple yet effective way to help those at risk for lower extremity amputations to avoid them from happening.
1 – Annual foot screening: All diabetics, even the most well-controlled, are at risk for lower extremity amputation. This is because diabetes is more than just a number; it is a chronic disease that affects almost every body system including the ability to touch/feel as well as the immune system and the ability to heel. Even the smallest scratch or callus on one’s foot can become big problems without adequate care.
2- Patient education: By educating oneself about the warning signs and problems associated with chronic disease, one becomes responsible for their own health.
3 – Daily self inspection: This is especially important in those who have poor sensation in their lower extremities. Pain is the body’s warning sign that something is wrong. Without being able to feel, even the smallest scratch or ulcer has the potential to get infected and cause bigger problems.
4- Footwear Selection: Shoes are more than just a fashion statement; instead, think of them as an aid to maintaining foot health. A comfortable, proper fitting shoe can make up for a lot of our inherent foot problems. By offering protection from the elements, cushioning and support, shoes can help keep our feet healthy and functioning for our entire lives.
5- Management of Simple Foot Problems: By being proactive and reporting any and all foot problems to your healthcare provider or podiatrist, we can effectively treat small problems before they become bigger ones.
Although many lower extremity amputations are preventable, traumatic amputations like those suffered by Ms. Green do happen on occasion. We here at Family Foot & Ankle Specialists, wish Ms. Green a speedy recovery and our sincerest hope is that she lives a full and happy life.