Rare surgery helps 6-year-old Mo. girl run over by lawn tractor
The surgery involved removing her shin and attaching her reversed foot to the knee socket
By Donald Bradley
The Kansas City Star
KANSAS CITY, Mo. — Leave it to Izzy to remember Grandpa's belt.
There the kindergartner was Wednesday, lying in a hospital bed, listening to Grandma tell about how Izzy got run over by a John Deere lawn tractor. And how Grandpa jumped off the mower and held her in his arms and ripped off his belt to use as a tourniquet on her leg.
"When I got close, he waved me to stay back," the grandmother, Sandra Williams, said in the pediatric intensive care unit at University of Kansas Hospital.
Izzy, 6, head on her pillow, cuddled dolls Gracie and Isabella and stuffed dog Meatloaf and seemed to not be paying much attention to the story until Grandma mentioned that Grandpa has been a basket case since that day.
That's when Izzy threw an arm up from her covers. The story stopped cold, and all eyes in the room went to her.
"They need to give Grandpa back his belt!" she proclaimed.
Wednesday was Day 14 for Izzy Smith (real name Isabella) at KU Hospital, where she's had seven surgeries since arriving by helicopter ambulance with massive injuries to the bone and muscle of her left leg.
In a rare procedure called rotationplasty that lasted eight hours, doctors removed sections of the thigh and shin, rotated her foot and attached the shin to her thigh so that her heel is where her kneecap had been. The procedure gives her the best fit for a prosthetic lower leg, her ankle serving as a knee joint.
Her foot? Backward.
Her smile? Right where it's always been and beautiful as ever. Family members say her strength got them through this ordeal.
"I was supposed to be strong for her, but it was the other way around," said Stephanie Williams, Izzy's mother. "I've gone through every emotion, and the one thing I've learned is that crying doesn't help. I'm trying to be like her."
Before the radical procedure, she explained to Izzy what the doctors were going to do to her leg and foot. The hospital provided a doll for Stephanie to use as a prop.
When Stephanie was finished, she looked down at her daughter and asked if she understood.
"Yeah, it means my foot is going to be in a different place," Izzy answered. "Will I be able to run?"
Izzy and her 1-year-old brother, Brady, had been at their grandparents' house in Richmond in Ray County because Stephanie had gone to Jamaica with her fiance. It was May 1. The kids were in the house with their grandmother while their grandfather John Williams, a farmer, mowed across the creek.
Izzy decided she wanted to look for flowers. She knew she was never to go anywhere near where someone was mowing but somehow got beyond the creek. Sandra thinks her husband was backing up near a tree when the accident happened.
John later told his wife that he held it together out there because Izzy was so strong. Maybe a whimper but no crying. She told him she knew she wasn't supposed to be out there. He tightened his belt around her leg and called 911.
Sandra came out of the house and saw her husband on the ground. She thought something had happened to him. Then she saw Izzy's hand. John told her not to come any closer. Sirens approached. Police cars and two ambulances arrived.
"They thought they might need one for John too," Sandra said.
Izzy didn't particularly want to ride in the ambulance, but she didn't go far. Only to the highway, where a helicopter would soon land. Her father, Jordan Smith, was waiting at the hospital when she arrived.
Later that night, family members got word to Stephanie that she needed to get home as quickly as possible. She had only arrived in Jamaica the day before for a weeklong stay. A suspicious customs agent asked why she was leaving so early.
"I just broke down," Stephanie said Wednesday.
Orthopedic surgeon Kim Templeton saw Izzy the day after the accident and knew immediately the severity of the injuries to her thigh bone and muscles limited the options.
"We didn't have a lot to work with," Templeton said Wednesday.
One way to go was amputation at the hip. The other was rotationplasty, a procedure done only a handful times each year in the United States.
"The advantage is that you get to keep and use as much of the real leg as possible," Templeton said. "It takes less energy to get used to and allows someone to be more active and functional."
It's a procedure that is usually used on young cancer patients to remove tumors without removing the whole leg. It's also one that typically has a month or more of preparation.
"With Izzy we had two days," said Kathy Davis, a palliative care worker at the hospital.
Templeton removed portions of Izzy's shin and thigh. She turned the foot 180 degrees so that the toes pointed backward and attached the shin part to the severed thigh, sewing all the muscles together and making sure the nerves and blood vessels were intact.
Izzy will be fitted for a prosthetic lower leg when healing progresses, probably in about eight weeks.
"But with as much damage as she had, it's hard to predict," Templeton said.
One thing Izzy does have going for her, Templeton said: "It's easier for a child to learn to use an ankle as a knee joint."
Izzy's fourth-floor hospital room is decorated with cards and artwork. Classmates in Richmond signed a pillowcase for her. Nurses and other hospital staffers drop in to check on her, some even on their day off.
One nurse wrote: "Remember you are a strong, brave and wonderful girl."
One day Izzy worried about how other kids would treat her back home. Would they tease her or laugh at her?
But for the most part, Grandma Sandra said, Izzy has been strong -- and funny.
A day not long ago, the hospital arranged for another girl who had the same rotationplasty done to visit with Izzy. About 25 people crowded into the hospital room to watch. Izzy was taken aback by the spectators' statue-like stares.
Afterward, she told her family: "I wish they would have blinked."
How to help
Stephanie Williams has set up a PayPal account to help with Izzy's medical expenses, including therapy and prosthetics. The family will also have to redesign their home to make it easier for Izzy to get around. To donate, go to PayPal.com. Izzy's account is IzzysSquad415@gmail.com.
(c)2014 The Kansas City Star (Kansas City, Mo.)
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