No Match for a Mower

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Loretta Coureas

JTJoynerThe mention of April 2, 2007, still brings tears to James and Shelby Joyner of Portsmouth. It should have been a normal spring day with J.T., the 4-year-old grandson they are raising.

“I was putting my riding lawnmower in reverse to put in the garage,” James recalls. His grandson had been playing in the front yard with his grandmother. “I looked back and thought it was clear.”

He didn’t see the boy, who was running to help his grandfather. In a flash, the mower knocked the boy down. The back wheel rolled over his leg, and the blade sliced through his sturdy Spiderman sneakers. As the whirling blade sunk into his foot and upper thigh, the mower’s safety mechanism stopped the engine.

In horror, James jumped from the mower, pulled J.T. from beneath it and somehow managed to tie a tourniquet around the boy’s thigh. He picked him up and ran to the house, yelling for J.T.’s grandmother to call 911.

“When you’re terrified, it’s hard to think,” Shelby Joyner said, recalling the moment. “How I grabbed the phone that fast and dialed 911 is beyond me.”

Help arrived in minutes from the Portsmouth Fire and Rescue Department. Paramedics who whisked the small boy and his grandmother to Norfolk marveled at how calmly J.T. told them to “just put a Band-Aid on it” so he could go home.

J.T. would not return home for nearly a month as surgeons at CHKD focused on saving and restoring his mangled foot.

Orthopedic surgeon Sheldon St. Clair quickly assembled a surgical team to begin the long process of saving J.T.’s right foot. First they had to meticulously clean out deeply embedded dirt, stabilize the bones and make sure tendons were intact. X-rays revealed that all the metatarsal bones in his foot were broken or cracked. Pins were used to secure the bones; spacers between his toes would keep his toes straight until the bones healed.

JTJoyner2“His foot was actually split in half from his toes up,” Dr. St. Clair said. “Our goal was to save his foot. It was a long and tedious surgery.”

A thick slice of skin and tissue had been torn from the top of J.T.’s foot, and a six-inch gouge on his thigh exposed muscle and bone. Pediatric plastic surgeon George Hoerr was called in to deal with the external wounds. But skin repairs would have to wait until the wounds were thoroughly cleaned, a painful multi-step process requiring “tissue vacuums” to irrigate and clean the damaged flesh. Dr. Hoerr’s team of wound specialists took J.T. to the OR over several days so anesthesia would block the pain for each of the cleanings.

Dr. Hoerr took J.T. back to the OR for the final step to graft skin over the open wound. He used a patch of skin from the boy’s tummy to cover the top of his foot. The graft healed well.

“We could tell J.T. was getting better when he kept asking the nurses and doctors when he could walk,” James Joyner said. After days of exploring the hospital in a wagon or wheelchair, the boy was anxious to return to normal. “I was so relieved they saved his foot so he could walk again,” his grandmother said.

A soft cast was eventually applied to stabilize his foot so J.T. could go home and continue healing. So the family headed home after 23 days in the hospital.

“Dr. St. Clair told J.T. he could walk when he got home, but not to run or jump for a while,” his grandfather said. “But the first thing he did was run to his neighbor’s house to play.” J.T. was determined to get on with his life – defying the odds like his idol, Spiderman.

“This was such a terrible accident,” his grandmother said. “But the wonderful people at CHKD knew exactly how to make it better. We are very grateful.

“We can’t erase the scars or the memories, but J.T. is getting along just fine now and has full use of his foot, thanks to CHKD.”

Drs. Hoerr and St. Clair practice with CHKD Health System’s Surgical Group in its plastic surgery and orthopedics and sports medicine practices, respectively.

This story was featured in the second quarter 2008 issue of KidStuff, a publication of Children's Hospital of The King's Daughters.

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