A teen's bike accident presents doctors with a rattled brain, a shattered leg

By John Kelly
Washington Post Staff Writer
Monday, January 3, 2011; 6:38 PM

Tyler Junkin-Mills's parents thought their teenage son was shirking. On the day in June that the family moved from Ashton to Olney, the 16-year-old rode off on his bike. He'd said he was going to the bagel bakery where he worked to check his schedule, but they suspected he was trying to avoid unpacking the boxes scattered around their new home.

The bicycle helmets hadn't been unpacked.

When Tyler had been gone so long that annoyance turned to worry, his dad, Chip, drove off to find out what was keeping him. Two blocks from their house, at Route 108, Chip saw police officers cleaning up after an accident. Tyler's twisted bike lay by the side of the road.

Chip dashed up to the bike. An officer greeted him. "Is this your son's?" he asked.

By that time, Tyler was at Children's National Medical Center, or close to it. A helicopter had whisked him there after he'd been struck by a Chevrolet while pedaling home. Tyler remembers none of this, but the good Samaritans who rushed to help him said he was agitated, fighting their efforts to stabilize him. His right leg was mangled. A passing doctor from Walter Reed stopped and straightened the leg, fearful that Tyler might lose the limb if they couldn't keep blood flowing to it.

Tyler had no identification, couldn't remember his last name and gave his age as 13, not 16. (He may have been thinking of his little brother, Nicky.)

"That turned out to be a great thing," said his mother, Brooke Junkin-Mills. She wonders whether Tyler might have been taken to a different hospital if paramedics had thought he was older.

At Children's, doctors assessed Tyler's injuries: a compound fracture of the femur, a broken tibia, an ankle that had been "degloved" of flesh as the pedal sliced through it. (Mothers, Brooke says, don't let your children bike in Crocs.)

Most worrisome was the injury to Tyler's head. Had his brain been harmed?

"If that is a problem, everything else can wait," said Matthew Oetgen, the orthopedic surgeon tasked with putting Tyler's leg back together. There is a saying in the emergency room: "Life before leg."

Tyler's head injury improved overnight. Oetgen spent the next day piecing together the Humpty Dumpty-like pieces of his leg. The femur wound was open, a route for infection. Oetgen addressed that first, drilling through the broken pieces and inserting a long rod down the middle, locking it with screws at the top and bottom. The tibia was next, then the foot.

In X-rays, it was clear that Tyler was still growing. The ends of his bones had growth plates, places where new bone was being added. Cover those with screws and metalwork, and the bone might stop growing - or it might grow too much, as the body overcompensates for trauma.

"Kids notice when the legs are different lengths," Oetgen said. "You have to get that right."

Tyler has the good fortune (or bad luck) to have a mother who is a physical therapist. She made him walk every day. He worked with weights to strengthen muscle and bone. His goal was to walk into class at Sandy Spring Friends School without crutches.

He was successful. This month, Tyler will start ski club. "I don't know if I'm going to be going as fast as I could before, but I'm going to try," he said.

Children's Hospital

Our campaign for Children's Hospital is still growing, too. We are getting ever closer our goal of raising $400,000 by Friday - we stand at $249,688.57. Won't you help? Send a check or money order (payable to Children's Hospital) to Washington Post Campaign, P.O. Box 17390, Baltimore, Md. 21297-1390. To donate online with a credit card, go to www.washingtonpost.com/childrenshospital or call 301-565-8501.

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