September 30, 2022 by KiKi Bochi
Role Reversal: Bethesda East Vascular Surgeon Undergoes Limb-Saving Surgeries
It’s not uncommon for doctors to fall ill or be injured and become patients — sometimes at the same hospital where they practice their specialized care. In the case of Jesus G. Jimenez, M.D., vascular surgeon at Bethesda Hospital East, part of Baptist Health, this scenario became an extreme reality after he sustained serious injuries to his feet, ankles and legs in a car accident while on vacation in South Carolina in September 2020.
As a vascular surgeon, Dr. Jimenez often treats patients with diabetes or peripheral vascular disease or other conditions that have the potential of leading to foot or leg amputations. After the accident shattered much of his left lower leg, physicians in Charleston told him he might face amputation himself.
Dr. Jimenez then immediately called his friend, colleague and a fellow surgeon he had mentored years ago, Julio C. Ortiz, DPM, FACFAS, director of the foot and ankle surgery residency at Bethesda Hospital.
“I sustained very serious lower extremity fractures and injuries,” recalls Dr. Jimenez. “In fact, my left leg was an open fracture, a compound fracture. There was nerve injury, circulation injury, and multiple, very intricate bones were involved. The orthopedic surgeon over in South Carolina told me that I would probably need an amputation of my left leg. And as a vascular surgeon, one of my jobs is helping people prevent amputations. So, that was a big deal for me.”
‘You Need to Get Down Here’
Dr. Ortiz called Dr. Jimenez right back.
“You need to get down here,” Dr. Ortiz recalls telling his colleague and friend over the phone. “I don’t trust anyone else with your care.” Dr. Ortiz was in a position to help his friend and mentor. Dr. Ortiz had rotated with Dr. Jimenez when completing a vascular surgery rotation during his resident training many years ago and has always admired his tenacity and work ethic.
He speaks about the irony of helping salvage his colleague’s leg.
“We’ve worked very closely on limb salvage as a vascular team,” said Dr. Ortiz. “My job is to save the limb as a foot and ankle specialist, but I can’t do it without a good, competent vascular surgeon and Dr. Jimenez has always gone above and beyond in an attempt to salvage limbs. There’s no one I’ve trusted more, and when I saw the nature of his injuries, I needed to make sure that he got the best care possible.”
Bethesda is ideally suited for the level of care that was needed to salvage Dr. Jimenez’s limb. The hospital has hyperbaric oxygen chambers, a wound care center, a dedicated operating room staff that is very experienced in limb salvage, a reconstructive foot and ankle surgical residency, and an on-site rehabilitation facility.
After arriving back at Bethesda East Hospital, Dr. Jimenez underwent a grueling nine-hour surgery by a team led by Dr. Ortiz. The surgery involved both of his feet, ankles and lower leg extremities. Dr. Jimenez would undergo several more follow-up surgeries — but after that first one, the possibility of amputation was no longer discussed.
“We were no longer in the area of considering the amputation,” recalls Dr. Ortiz. “His legs are saved. Unfortunately, we’re not only talking about the bones, but he also had some muscle and tendon damage, and also some nerve damage. At some point, we will likely need to either fuse his ankles or do an ankle joint replacement. My goal was to get him perfectly aligned. So, if we can do an ankle joint replacement, he’ll be able to walk pain free and have his full motion back.”
Dr. Jimenez is very grateful — despite still facing many challenges as he returned to work, unable to walk without assistance of crutches or a wheelchair. But he is optimistic as he continues his sessions of rehabilitation and follow-up surgeries.
The Extent of His Injuries: ‘One in a Million’
“Obviously, I’m biased because I’m employed there and I’ve been a doctor there for 20 years, but I think that they were wonderful,” said Dr. Jimenez. “And they really helped me so much. So, I spent five months in a wheelchair. And I finally got back to work six months later. And it’s been a little bit of progress at a time … as far as how much work that I’ve been able to do.”
How severe were Dr. Jimenez’ injuries? His right lower leg suffered complex fractures. The talus, the bone that sits between the heel bone (calcaneus) and the two bones of the lower leg (the tibia and fibula), was broken down the middle. Additionally, both the tibia and the fibula “were both fractured and it was fairly angled,” said Dr. Ortiz.
And then there was the more severe left leg injuries, some of which Dr. Ortiz characterized as “one in a million.”
“On the left side, both the tibia and fibula were fractured and severely fragmented,” he explained. “The heel bone, his calcaneus, in a very rare type of fracture, broke right down the center with a complete extrusion of the fat pad under the heel. Fortunately, the heel fracture was not very far out of place and could be treated without the need for screws or plates. The scariest part of the recovery were large wounds on both sides of the left heel that increased the risk of a bone infection. Had the bone become infected all the work to save the left leg could have been compromised.”
Dr. Ortiz said he realigned all of the fractures with a large plate and multiple screws. “We grabbed every piece of bone that was displaced and lined them as perfectly as possible to hold everything together. We used a very large plate that went almost all the way to the middle of the leg — and with multiple screws to hold together every fragment that had come out of place.”
Dr. Jimenez remains optimistic, despite the long recovery that still lies ahead.
“Eight operations, and it looks like I’m going to need two more, which will be done at the Bethesda,” he said. “And they’re complex surgeries. And I have total confidence that these complex surgeries can be done at Bethesda, and they’re going to be successful!”