The wife said: “Grow legs.” How does the first patient in Ukraine with prostheses implanted in the bone feel

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57-year-old Ihor Krupnov is an entrepreneur who volunteered to defend our country. He had military experience in Afghanistan. At the beginning of the full-scale invasion, Ihor went to the Military Commissariat: he was immediately sent to the southern front. He and his comrades liberated the Kherson region. There he was wounded and lost both limbs. The doctors of the “Unbreakable” National Rehabilitation Center performed a unique osseointegration operation for the soldier, that is, they inserted a metal implant into the bone, to which the prosthesis is now attached. “UP.Zhyttia” visited the Rehabilitation Center and talked with doctors, patient Igor and his wife Valeria. Prosthesis implanted in the bone Osteointegration is the newest technique for our country. It is owned by specialists of only 4 countries in the world: Australia, USA, Germany and now – Ukraine. It consists in the fact that a part of the prosthesis is implanted directly into the patient’s bone. And after healing and recovery, an artificial foot is fitted. This gives a person greater mobility and functionality, reduces inconvenience in everyday life and use. In addition, thanks to this prosthesis, a person can feel the surface under the artificial feet. Igor’s daily training. Photo: Roman Baluk The first operation in Ukraine was performed by a top specialist from Australia, Munied Al Muderis. He installed Igor’s implants, and also conducted training for Ukrainian doctors so that they could perform such operations on their own. It happened at the beginning of April – five months after the injury. Six weeks later, he finally got on his feet and took his first steps. “There is no such number of people with prostheses in any other country in the world, except for Ukraine. People who lost their limbs in the war deserve to receive the best prostheses,” says the head of the First Medical Association of Lviv Oleg Samchuk. He adds that the technology is not very widespread in the world, because it is innovative. However, after Igor’s successful implantation, the hospital has already formed a list of patients who want to receive such a prosthesis. As the traumatologist Vasyl Rokita explained, the most important thing is that the bone is ready for implantation. Most patients present after blast injuries, and the inflammatory process can cause implant rejection. “Ihor insisted that the operation be performed on two legs at the same time. We succeeded. The biggest difficulty is the cleanliness of the wound where the prosthesis is integrated. It is equally important to understand the patient and care for the implant in the future,” says the doctor. The first day after the operation Concomitant chronic diseases can also be contraindications for the implant, but the condition of the bone is of primary importance. “The ideal patient for osteoimplantation is one who wore a classic prosthesis before, but has some dissatisfaction with this adaptive device and wants exactly that one,” adds Vasyl Rokyta. Among the advantages of the osteoimplant: mobility, functionality, surface feel. “The implant, which is implanted in the bone, then enables the patient to have tactile sensations of surfaces – soft, hard, elastic, etc. For example, Mr. Igor feels the difference between concrete and linoleum,” explains the traumatologist. At the same time, patients are not recommended to practice excessive running and jumping, as the risk of bone fracture is very high. Read also: Prosthesis is not a panacea. What you need to know about artificial arms and legs Igor’s military experience Previously, the man served in Afghanistan. Before the full-scale invasion, he ran a swimming pool construction business for over 20 years. “The war caught us in Lviv – we got into a car to go to Kyiv on my business matters. We stayed in the city. For several days, Ihor tried to get a job in the Teroboron, but he was not accepted because of his residence permit in Dnipro. Then he started “storming” military commissars. He was sent to the southern front,” Valeriya says. Ihor was the captain of the Armed Forces in the Kherson direction. “We held the defense for almost 7 months, and in November we got the desired result: the enemy withdrew, and we occupied the liberated territories. In the south of the liberated Kherson region, I was injured: a pickup truck ran over 2 anti-tank mines. At that moment, my service ended,” the man says. Igor’s stubbornness transformed into resilience Valeria adds that from the first day Igor went to the front, she constantly collected money for ammunition, first-aid kits, thermal imaging cameras, and drones. “When the volunteers and my friends got tired, it became quite difficult to collect large sums, I decided to help some volunteer center. That morning in November, I held a strategic session for the participants of the Center for Volunteering and Protection – the largest association in Lviv. And in a few hours I Igor’s commander called and informed about his injuries. The man was taken to a hospital in Mykolaiv, he lost a lot of blood. There were not enough facilities in that hospital, and there were almost no guarantees that Igor would survive,” the woman recalls. She turned to the volunteer association, which she provided advice to, and they put her in touch with Nezlamnyi. Saving a life in Lviv It took several days to prepare the documents for transferring the patient to Lviv, but the time had to be counted in hours. “I actually managed to jump on the last train to save the man. The odds of him dying on the way were 1:1, which is 50%. But the odds of him dying in that hospital were also sky high. It was very a terrible night. He was brought in an ambulance, two resuscitators were on duty on the way. When he was brought to Lviv, he already had a Hippocratic mask – this is a stiffening of the facial muscles. Consider that a person is almost in the grave. He was immediately taken to the intensive care unit and his leg was amputated.” – says Igor’s wife. Doctors in Lviv saved Igor’s life. They fought for the life of the 57-year-old captain for a long time: about a month and a half of surgery and recovery. “I went to the hospital 2-3 times a day. The leg was amputated several times. In total, there were 10 operations, the last one was about implantation. When he was going for the tenth operation, I saw that he could not take it anymore. He is very stubborn in life , this trait was transformed into resilience. I think it was thanks to these characteristics that he survived,” Valeriya says. After a series of operations, an ordinary mechanical prosthesis was made for Ihor. “During rehabilitation, his mood fluctuated a lot. And sometimes he said that he wanted to go home. But I firmly refused, saying that I would not accept him home like this. Because when Igor went to the front, he promised me that he would return alive and well. And he came without legs, so grow legs, then come home. It was a strange and harsh reaction, but he pulled himself together and started training. I didn’t lie to him. I honestly didn’t want him to go home in a wheelchair as a cripple that everyone felt sorry for.” – says the wife of the wounded soldier categorically, but with a smile. Read also: “Carry my legs back.” How a 24-year-old military man with a triple amputee learns to live Prosthetic implant “When I was first offered this type of prosthetics, I was still in such a state that I could not analyze the situation. I entrusted it to my wife and a friend. They learned about the topic and learned, that this type of prosthetics gives the most natural sensations and has the greatest functionality. On ordinary prostheses, the sensitivity is about 40%, and on osteoimplants – 70%. I feel the difference between the surfaces I walk on,” says Igor. Valeriya notes that this decision was not easy. “Innovative things are when you don’t have the opportunity to ask what happened to others. This is the first time in Ukraine, and for us it was a leap into the abyss. In my opinion, it is a great responsibility. From the moment of the injury, many choices had to be made every day. But this had the greatest impact on the future. Doctor Hnat Gerych and Vasyl Rokyta helped us make this decision,” she says. The woman adds that treatment is a partnership between doctors and the patient, where all important decisions are made together. Rehabilitation already with prosthetic implants “My decision was also influenced by trust in doctors. I had a complex injury, and there was a question about amputation above the knee, but a doctor from Australia promised to keep it,” the man recalls. The couple notes that the turning point in the treatment was the second day after the osteoimplantation operation. According to the protocols, the patient should have already put on the miniprostheses that were implanted in his bones. “I thought it was impossible or at least painful, but the doctors convinced me to try. I stood up and felt no pain. Blood was still flowing from the wounds, my legs were terrible, but it was comfortable to stand. The whole period after the injury was very painful, which I had to endure it. There was also pain after the last implantation surgery, but the rehabilitation process took place with it,” Igor says. Valeria shared that it was very difficult to pass the period of primary prosthetics, when the leg was a separate part. Igor and Valeria “I looked at my husband and thought that he was a different person. But when he was implanted, I began to perceive that my Igor had returned. It was a strange feeling, as if the future was in front of me again. Until that moment, every day was like a battle . Igor said that he finished his war, but it was transformed: it became our war and our front. It lasted more than 6 months, because the doctors and I fought for Igor’s life, his quality and freedom,” Valeriya says. The first steps The center said that on the day Igor was supposed to take his first steps on osteoimplants, he met his wife in the ward with the words: “My legs have grown.” Igor got implants for the first time “The main thing in such situations is the lust for life. Sometimes life goes with an amputated limb. This was what I was most afraid of. Since Igor’s leg was cut off several times, it was as if life was leaving our union. It was scary, for example, when I come to my husband in the hospital, and he is not eating, because his leg has to be amputated again tomorrow. When he got the implants, I felt free, and not a person attached to an invalid. This was a turning point in our marriage,” she recalls Igor’s wife. According to the protocols, the patient can take the first steps 6 weeks after the operation. All this time, I had to stand on the implants every day for 40 minutes a day. Igor says it was not difficult. “When the prostheses were put on, I saw that they were so small and comfortable. I thought: I will get up and go. But my knees were not ready for this. They were pierced by a sharp pain. It has not gone away to this day, but it is decreasing every day. I am slowly separating. Until I still walk with crutches, this week we will switch to sticks, and then I will be without them,” he adds optimistically. Ihor is already walking on crutches, which will soon be replaced with sticks. Traumatologist Vasyl Rokyta notes that Ihor was fitted with a normal functional foot, but if the patient wishes, a running or swimming foot can be attached. It is important that with this type of prosthesis you can drive a car with normal control: manual control is not needed here. This is explained by the fact that the prosthetic implant transmits different surfaces and has a certain sensitivity. It is enough to drive a car. “I first drove around the hospital for a few laps, then I realized that it is very easy. There are no strict restrictions on the number of steps or the load either – you have to be guided by your feelings, you just have to not overload yourself,” Igor says. Igor drives a car with prostheses As of today, he already feels a rush of strength and energy, his mood has improved. Ihor notes that he is on the way to recovery. “I’m not running yet, but I’m already walking normally. I want to try myself in running on these gadgets. For example, to beat a marathon,” says the fighter in rehabilitation with a smile. He adds that after recovery he will return to civilian life, plans to restore his business and help his wife in business. And then he dreamily says that he still needs to fix up an apartment in Odessa. “After the victory – it’s a must. Because it’s our dream – to live near the sea. Although Igor loves the mountains more… He’s the one trying to support me. Maybe we’ll even sell an apartment in Odessa and buy one in Crimea, where there are both sea and mountains” , – adds Valeriya. Victoria Andreeva, UP.Zhyttia Read also: Happiness is to have a hand again. Military about injuries, amputation and electric prosthesis

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