An orthosis designed at San Antonio's Brooke Army Medical Center provides a spring-like motion
In March 2010, David, a U.S. Army special Forces deputy commander in Afghanistan, was injured when a 160-lb. bomb tore through his left leg. Over the next year, he underwent 23 surgeries, mostly to carve out small hunks of dying tissue; in one major procedure, doctors at Walter Reed removed 4 in. of his tibia because of an infection. He endured the painful stretching of the remaining bone, using a vise that, as it expands, pulls the ends of the bone apart. The daily sessions lasted six months, extending his tibia 1 mm a day to get to the point where the two pieces of bone were close enough to be fused together.
A year after his injury, David--who requested that TIME not print his last name because of the secret nature of his missions--could walk, but only very slowly and with intense pain. His doctors at Fort Lewis in Washington State sent him to Brooke Army Medical Center (BAMC) in San Antonio to see Lieut. Colonel Joe Hsu, an orthopedic surgeon and the director of a rapidly expanding program for limb salvage. "I was pretty much expecting him to tell me to cut my leg off," David says. "I had kind of come to terms with it. It's that simple. If I can't do the things I want to do, then take it off."
Instead, David was outfitted with a brace called the Intrepid Dynamic Exoskeletal Orthosis (IDEO). "It was night and day," he says. "After the first five minutes, I could walk at a normal pace." He quickly graduated to jumping on and off boxes and sprinting. A free-fall parachutist, David returned to his unit and plans to start high-altitude parachute jumping again. "Two years ago they'd have cut the leg off and sent us on our way," he says.
Because of the number of bomb-blast injuries in Iraq and Afghanistan, doctors in the U.S. have gotten very good at saving limbs. For every amputee from those wars, there are now an estimated five or six limb-salvage patients. But saving a severely damaged limb is a grueling process that requires as much physical therapy as an amputation, if not more. Although the overwhelming majority of limb-salvage patients learn--through extensive rehabilitation--to walk again, many suffer from chronic pain and loss of function. Yet it's worth the effort for several reasons. For one, doctors can always cut it off later, but once a leg is gone, there's no bringing it back. And while prostheses have improved dramatically in recent decades, every amputee who leaves the hospital leaves with a wheelchair. Prostheses break, amputees suffer infections, and many experience real pain in phantom limbs, which can be hard to treat.
The Patient's Choice