Over the past 2 years we have seen an increase in Shark bites on the coasts of Queensland and Northern New South Wales. We present 3 such patients with similar injuries to their thighs. We conducted an extensive literature review in search of patterns of injury.
One of our patients presented a significant treatment dilemma. He had completely divided his common peroneal and tibial nerves at the popliteal fossa with minor bony injuries. He had a minor rent in his popliteal vein with an intact artery. Classified as a Gustillo & Andersen type IIIc injury there was much determination towards amputation as the best treatment option.
After much consideration and multidisciplinary consultation fasicular neurorrhaphies were performed microsugrically. The idea was to hope for some recovery and at least improve the outcome of a later below rather than through or above knee amputation.
Motor recovery had commenced at 3 months and over the ensuing 6 months his foot drop and high stepping gait almost completely resolved. At 400 days his sensory level was down to his ankle at 40cm from repair. At last visit (18 months) he has dorsal and sole plantar surface protective sensation and no neuropathic skin sequelae or traumatic ulcers. He initially developed neuropathic pain that steadily improved over this time. He has returned to the surf on a boogie board which is what the injury occurred on.
We see the above result as an unusual and promising one worthy of sharing in view of dilemmas devastating injuries like these can place on treating teams.