On a bitterly cold day two years ago, then 15-year-old Kristi Ruth was helping dig postholes in a barn on the family farm.

The posthole digger met stubborn resistance from the frozen ground, so her father, Joe, eventually decided to give up and shut down for the day.

Kristi had been using her left hand to stabilize a support bar on the bouncy machine. As the implement shut down, her glove accidentally caught on a shear bolt, instantly wrapping her left arm around the spinning power take-off shaft, up to her shoulder.

Bones broke with every rapid turn; her flesh was ripped to shreds. Kristi's arm and coat were ensnared by the machine, which refused to let go.

She didn't know it at the time, but the remains of her coat were actually acting as a tourniquet against a life-threatening severed artery.

Kristi's younger brother, Josh, called 9-1-1 while her father and other brother, Jake, desperately worked to untangle her arm from the machine. Jake finally severed the coat's stubborn threads with a pocketknife.

Once freed, Kristi could barely stand yet she still managed to walk up the hill from the barn to the house. Even worse, she had lost all feeling in her left arm, which drooped lifelessly from her shoulder.

With help from her mother, Tammie, and others, including a neighbor who was a paramedic, Kristi arrived at Mercy Medical Center in Des Moines, where doctors assessed her injuries and indicated that without extensive surgery, they would have to amputate below the shoulder.

To save the arm, the doctors suggested she be flown to University of Iowa Children's Hospital for highly specialized surgery.

After a 45-minute flight by emergency helicopter, Kristi faced another seven hours of evaluation, consultation, and surgery. The first procedure was performed by vascular surgeon Timothy F. Kresowik, MD, who grafted a vein from her leg to replace the severed artery in her mangled arm.

Over the next 11 days, Kristi drifted in and out of consciousness and underwent further surgical procedures. Five different teams worked to save her life and repair her damaged muscles, tendons and nerves. Two procedures totaling 14 hours helped fix her now pinned and plated bones.

Most were led by orthopaedic specialist J. Lawrence Marsh, MD. All were complex and difficult, involving three totally different kinds of fractures.

Included was a follow-up tendon transfer surgery to restore finger mobility, and another to reduce wrist pain, performed by hand specialist Brian Adams, MD.

"All the doctors, the nurses, the therapists, and the psychologists were wonderful," Tammie says. "We want to thank them all. We know how lucky Kristi has been to even survive what happened. Dr. Marsh calls Kristi his ‘miracle child' when he sees her, and we understand why."

While she has limited mobility in her left arm and general weakness that prevents her from doing some things she would like, Kristi has accepted the fact her life has changed. She has adopted a spirited attitude while forging ahead with her senior year at Chariton High School, speaking passionately about farm safety at various public events and celebrating her 17th birthday.

"I still have an arm, even if it doesn't work like it should!" she says.

For more information about the UI's orthopaedic services at children and adults, patients and family members should call UI Health Access at 319-384-8442 or 800-777-8442 and ask for the Department of Orthopaedics and Rehabilitation.

For consultation or referral, physicians should call UI Consult at 319-384-8008 or 800-322-8442.

—Michael Sondergard