The Rejoined Leg

Stories of the surgical reattachment of an arm, hand or foot after accidental amputation have reached medical journals from places as far apart as Boston and Canton. But rare indeed is the restorative surgery that can claim the success now reported from California. An Oakland motorcyclist whose leg was sliced through three inches above the ankle had his severed foot put back in place, and last week, more than three years after the operation, he was well on the way to walking normally.

Hanging by a Ribbon. Carl L. Larsen, just out of the Navy, was trying out his powerful new motorcycle that summer day in 1962 when he lost control and rammed a driveway culvert. His severed right foot hung by a ribbon of skin and other tissues; its two major arteries had been cut. By the time he was carried to Oakland's Highland Hospital, his bloodless leg was a deathly white, mottled with blue. Amputation seemed unavoidable. But Larsen was a young giant (then 22) in top physical condition, and a team of surgeons headed by Dr. Walter L. Byers decided that there was some hope.

The most important artery, the posterior tibial, was destroyed for a length of several inches and was beyond repair. The smaller anterior tibial artery had lost only 1 1/2 inches. By taking out splintered bone and shortening the leg slightly, the surgeons were able to pull the two ends of the artery together. Then they drilled through the bone above and below the fracture and inserted four stainless-steel pins; they held the projecting ends of the pins together with steel bars and surgical screws. With everything firmly in place, Dr. Byers and his assistant finished the delicate task of repairing the tiny artery, only 1/12 in. in diameter.

Sutures for Tendons. Larsen spent weeks in a cast and a year on crutches. He needed more bone grafts before he could walk with a leg brace and go to work, standing all day at a bench, repairing ignition armatures. With no tendon attachments, he could not bend his ankle, and although he got along for two more years with a gimpy gait, Dr. Byers was not satisfied. Last December he got Larsen back into the hospital, where orthopedists freed three major tendons from masses of scar tissue both above and below the old break, and joined them with steel sutures.

Last week, out of a cast again but still wearing a brace, Larsen could move his foot and walk with only a moderate hitch in his stride. He insists that he will soon be playing tennis again. As to why there had been no prompt report of the surgical feat, Dr. Byers says: "In 1962, I didn't know that it hadn't been done before, and the job wasn't complete until the patient could move his toes."

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