Nerve Grafting Technique Saves Limbs Of Marine

11:25 AM, Mar 11, 2013   |    comments
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BETHESDA, Md. (WUSA9) -- With new ways to regenerate severed nerves, thousands of victims of trauma may be able to avoid amputation.

Imagine having a hand or a leg that is completely unusable and there is only one option: amputation. Severe nerve damage can lead to this, but luckily, one soldier avoided amputation, thanks to innovative technology that can restore feeling and function to a limb.

A bullet ripped through Navy Corpsman Ed Bonfiglio's left leg while he was on patrol in 2009, with a Marine Unit in Afghanistan. It caused very little damage to surrounding tissue and bone, but cleanly severed Bonfiglio's sciatic nerve.

Lieutenant Commander Patrick Basile, M.D. of Walter Reed National Military Medical Center says, "It was a good five centimeter gap of sciatic nerve, which at that level of the upper thigh is about the size a quarter."

"With the loss of the nerve, I lost all movement of the bottom of my leg," said Ed Bonfiglio, now a veteran.

At Walter Reed Army National Medical Center, surgeons gave Bonfiglio a choice: amputation below the knee or their attempting of a new nerve grafting technique called "allograft." A specially treated donor nerve from a cadaver is sewn into the gap in the severed nerve and provides a bridge where nerve fibers grow across it and reconnect. Lt. Cdr. Basile explains that traditionally, another nerve from a patient's body is harvested to bridge such an injury.

Dr. Basile says, "There are pluses and minuses to that, the minuses being, obviously that leaves a numb patch somewhere else in the body."

Since, Bonfilgio needed a larger nerve that his own body didn't have, Dr. Basile performed the allograft procedure in August 2009.

Dr. Basile says, "It worked fantastically."

While this doesn't work with nerves of the spinal cord, peripheral nerves can regrow at about a millimeter a day. Bonfilgio underwent hundreds of hours of physical therapy.  Finally, movement, sensation, and control slowly returned.

Dr. Basile says, "We saw motion about 6 months into his recovery, and after a year we were getting good ankle motion. Then, he showed lots of progress. He started walking, and between two and three years, he unbelievably started running."

Bonfilgio says, "From a wheelchair to crutches to this, its amazing. I never thought I would get this far. I thought I was always going to be on crutches or a cane for the rest of my life."

Bonfilgio, now 27, is a college student in North Carolina and wears a brace to stabilize the leg.



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