Nerve graft procedure restores Dothan teen's mobility
By JIM COOK
Nov. 18, 2017
DOTHAN, Ala. (AP) — Matthew Jayroe doesn't walk like someone who sustained serious nerve and tendon damage a few years ago. He runs.
Thanks to a nerve graft procedure, he's recovered from injuries that may have left him with chronic pain and limited mobility. A 16-year-old Northside Methodist Academy student, Jayroe enjoys playing basketball and he runs on the school's cross country team. This wouldn't be possible without the advocacy of his mother and the skill of a Maryland doctor who performed a complex procedure to repair damage caused in a kitchen accident at Jayroe's home.
In June 2014, Jayroe, then 13, was cooking supper with his mother, Teresa. Jayroe was moving a crystal butter dish when he dropped it.
"I tried to jump out of the way, but I happened to land on a big piece of glass," he said.
That big piece of glass did severe damage to Jayroe's foot. Teresa, a school nurse who works at Northside, applied pressure to the wound to slow the bleeding and transported her son to a local emergency room where he was treated. The glass had cut an artery and tendons.
After Matthew's foot was initially treated, Matthew and his family discovered that the injury to his foot resulted in a loss of nerve function from his heel through his first three toes. Teresa consulted with doctors throughout the area, but none felt confident they could repair the damage to his foot.
For Teresa, meekly accepting that her son's mobility would be limited wasn't an option. She began searching the Internet for a surgeon who could repair her son's foot. Her search led her to Dr. Lee Dellon.
Dellon, a professor of plastic surgery and neurosurgery at Johns Hopkins University and the founder of Dellon Institutes for Peripheral Nerve Surgery, is a pioneer in peripheral nerve surgery. Dellon said that while Matthew received good emergency care in Dothan, not many doctors can perform surgery to repair peripheral nerve damage to the foot - most doctors working in this field specialize in the hands.
In August of 2014, Matthew and his family traveled to Maryland for surgery. Matthew said he was apprehensive at the time.
"I didn't feel good about nerve surgery," he said. "I didn't want to have to go somewhere that's pretty far away."
Dellon used an Avance Nerve Graft to repair the nerve damage to Matthew's foot. The Avance Nerve Graft is made from nerve tissue harvested from cadavers that is treated to prevent patients' bodies from rejecting them. The graft is inserted where the severed nerves should run and the ends of the cut nerve are connected to the graft, giving them the right path to grow through to reconnect. Nerves will regrow at a rate of about an inch per month, and as the nerves regrow along the path of the graft, feeling is restored.
Matthew's surgery was not without complications. During the procedure, Dellon discovered that some tendons in Matthew's feet were cut and had to repair those as well. Matthew's surgery ended up taking six hours.
Dellon said Teresa played an important role in quickly finding a surgeon to treat Matthew.
"His mother did a great job," he said. "We wouldn't have had the success we had without her."
After Matthew's surgery, he spent several months performing physical therapy tasks such as walking in warm water to aid his recovery.
"For the first year he couldn't carry a backpack, because Dr. Dellon didn't want him putting too much pressure on his foot," Teresa said.
Recovery wasn't the only challenge the Jayroe family faced. There was also considerable back-and-forth with their insurer regarding coverage of his surgery. In the end, their insurer had to create a new code specifically for the procedure he underwent.
In time, Matthew recovered feeling and use of his foot. Earlier this year, he began running track and cross country for his school. Matthew and his family also got to participate in the Tournament of Roses Parade in Pasadena, California, in 2016. Matthew and 29 other recipients of donated tissue rode on the Donate Life Rose Parade Float during the event.
Dellon said he hopes Matthew's story will encourage other people living with peripheral nerve damage to explore options for treatment. According to AxoGen, Inc., the company that makes the Avance Nerve Graft, there are about 1.4 million peripheral nerve injuries in the U.S. each year. Dellon has a website - dellon.com - offering information about pain solutions and peripheral nerve injuries.
Teresa said she hopes more doctors in Alabama will learn about procedures like the Avance Nerve Graft, allowing them to offer better local access to care.