March 8, 2019

UAMS Saves Woman’s Nearly Severed Arm with Prosthetic Elbow

Shahryar Ahmadi, M.D., an orthopedic surgeon at UAMS, examines Lisa Shelton

Shahryar Ahmadi, M.D., an orthopedic surgeon at UAMS, examines Lisa Shelton’s elbow that he reconstructed almost after it was nearly severed by an 18-wheeler in 2012.

Lisa Shelton wreck Morrilton

Pictured is Lisa Shelton’s truck after it was hit by an 18-wheeler close to Morrilton. The photo is courtesy of the Petit Jean Country Headlight in Conway County.

Only a few nerves kept Lisa Shelton’s left arm attached to her body when she arrived at the University of Arkansas for Medical Sciences (UAMS) after it was almost severed by a truck door.

In December 2012, Shelton, of Jerusalem, was on her way to meet her sister for lunch in Morrilton when her car rounded a curb and was hit by an 18-wheeler. The truck’s door smashed her left arm, taking out tissue, bone and muscle from her elbow, causing a forearm fracture and leaving her arm a mass of mangled tissue. She also suffered a deep cut on her knee.

“I don’t remember the accident itself,” Shelton said.
“I think it was a good thing that I don’t remember. What I do remember is waking up after the accident about a week later and my arm was wrapped and I was wondering where I was.”

After she was extracted from her badly disfigured car by emergency crews using the Jaws of Life, Shelton was taken to a Little Rock hospital and quickly transferred to UAMS, which was better equipped to handle her severe injuries. At UAMS, Shahryar Ahmadi, M.D., an orthopedic surgeon, took Shelton immediately to the operating room to determine whether her arm could be saved.

“When she first came in, the skin, muscle and bone around her elbow were completely gone and she had dirt and grass in the wound,” Ahmadi said. “The main concern at the time was infection. Extensive soft tissue damage and contamination usually significantly increases the risk of infection.”

Even with that risk along with the possibility of amputation, Ahmadi said his intention was to save her arm.

“We always try to save the limb if possible,” he said. “Luckily the bundle of nerves and vessels located in the elbow was intact. That was a good thing.”

Shelton has since undergone more than 10 surgeries over the course of a few months to save her arm and restore most of its function. Her first few surgeries occurred within a couple of weeks. Most of those surgeries focused on fixing Shelton’s forearm fracture and knee injury; cleaning her elbow of nonviable tissue; and applying skin grafted from Shelton’s legs.

She was fitted with an external fixation device that she wore for six weeks consisting of pins and rods attached to the bone from the outside of the arm that kept the elbow from moving to allow tissue to heal.

During Shelton’s last and most extensive surgery in July 2013, Ahmadi implanted a prosthetic elbow and reconstructed a missi ng tendon from donor tissue that allows Shelton to have most of her range of motion. The prosthesis is a much better option than fusing the bones together, which does not provide movement in the elbow.

“The last reconstruction surgery was very long and very complicated,” Ahmadi said. “We had to go through all the scar tissue, nerves and vessels in our way so we didn’t cause any more damage.”

Almost eight months after her last surgery, Shelton is allowed to lift up to 5 pounds and do light chores around the house. Even though life is not the same as before the accident, she is thankful that she has her life and her arm.

“I thought my arm would be amputated, but I have a really good doctor,” she said. “He saved my arm, he saved my life and he saved me a lot of pain down the road. I just couldn’t imagine my life if I had not been brought to UAMS.”

As for the future, it’s a bright one for Shelton and her husband, Wayne.

“Every day gets a little better,” she said. “Time is my best friend, and so is Dr. Ahmadi. I hope to be able to do a little more at a time and do some traveling on our motorcycle.”

WARNING: The following photos of Shelton’s arm before surgery are graphic in nature and may not be suitable for children. Click here to see the pictures.