Ivan Regains Strength in Rehabilitation
With the help of physical and occupational therapists, Ivan is learning to walk again.
The 17-year-old has undergone more than 10 surgeries and hundreds of hours of therapy. He and his mother found it too difficult to speak about their experience until now.
Ivan and his family moved to a large city in Ukraine six months before a war began. The 6’1” physically-fit teenager hoped to become a professional arm wrestler and weight lifter. That changed when he barely survived a March 2022 airstrike. Ivan’s legs and left arm were trapped for hours before he was freed. He had severe injuries including broken bones. Associated Press journalists captured the incident and included it in their Academy Award-winning documentary 20 Days in Mariupol.
The film’s director and narrator said he did not know if Ivan survived, but they have since been in touch. Maiia, Ivan’s mother, said the film’s director texted the family, "He is extremely happy we all survived. He said he would be thinking about us at the Oscars." During his moving acceptance speech, the director said this was a movie they never wanted to make, lamenting a conflict that has caused so much damage. Maiia said, through translation from Ukrainian, "We didn’t want to be in that movie either.”
Ivan underwent an operation in the occupied part of Ukraine, in the city of Mariupol, and was hospitalized until the hospital ran out of medicine. Ivan and his parents drove 200 miles, passed many checkpoints and reached the safer city of Dnipro, where he underwent “a large number of operations.”
Rehabilitation nurses added to his recovery during inpatient rehabilitation, and our social work and care management team helped with Ivan's transition from the hospital to the community.
A children’s charity, led by a physician at Shriners Children’s Boston, offered care in the United States. Ivan was flown by air ambulance to Doctors Hospital in Augusta, Georgia, where he had additional orthopedic treatment for fractures and bone infections, as well as skin grafts. After completing this acute phase of treatment, he came to Shriners Children's Chicago for intensive rehabilitation, which involves three or more hours of therapy each day. “He was a really strong healthy guy before; he was a power lifter, so that helped his recovery,” said Gaby Martinez, M.D., a physician who specializes in rehabilitation.
When Ivan, 17, first arrived, he could only stand for a few minutes. “He came to us just starting to walk with a walker and bracing on his legs, significantly deconditioned,” said Elena Zumbuleva, PT, D.P.T., his physical therapist who connected closely with Ivan and Maiia because both know Russian. His care team at Shriners Children’s Chicago also included physiatrist Sue Mukherjee, M.D., occupational therapist Brian Hovorka, MS, OTR/L and physical therapists Alexandra Bailey, PT, D.P.T., and Michelle Urban, PT, MHS, WCC. The care team said that treating wounds of war is not typical in their practice.
Ivan spent seven weeks receiving multiple hours of physical and occupational therapy each day, in addition to wound care from the rehabilitation team and treatments to reduce scars. Dr. Martinez said Ivan improved with Shriners Children’s multidisciplinary approach to rehabilitation.
Unfortunately, during his time in rehab, his surgeon, Kelsey Davidson, M.D., saw that the fracture in Ivan’s left upper leg was not healing. “When the fracture didn’t heal, we took out the femoral nail in his bone that was stabilizing the fracture,” said Dr. Davidson. “We put a new one in, which is a technique used to stimulate the fracture to heal.”
After the surgery, clear signs of infection were apparent in his surgical wounds. Dr. Davidson said, “We got his cultures back and it was the same bacteria he had in his bone in Georgia. It was likely sitting there. So for three months, we were just trying to get that infection under control.”
He has also undergone multiple surgeries since, as well as specialized wound care. “After one of his surgeries, the incision opened up, which is not uncommon when there is underlying infection,” said Dr. Martinez. “Dr. Davidson managed this with a wound vac, and then I transitioned him to just dressing changes. With wet-to-dry dressing changes, the wound closed up in less than three weeks.”
A year later, Ivan continues to use a custom ankle foot orthosis on his right leg. Shriners Children's offers in-house prosthetics and orthotics services at most locations. As another attempt to restore his left leg bone, Dr. Davidson and plastic surgeon Chad Purnell, M.D., performed a rare 10-hour surgery with a fibular free flap, moving a bone from his lower leg to the fracture area. "It will be 6-12 months before we know if the surgery worked to give Ivan back the ability to walk without a walker or a wheelchair," Dr. Davidson said. "Ivan and his mom have been so strong and so positive throughout the entire experience, even despite all the setbacks. It's incredible."
The family only recently decided to speak publicly about their experience. “It is all easier to talk about now. It was extremely hurtful to talk about a year ago,” said Maiia. “We would like people to know about the war in Ukraine. Not about us in particular, but about the war, so that the war would cease as fast as possible. We need the world’s help.”
The family looks forward to returning to Ukraine when Ivan is medically ready. During his treatment in America, he completed school online with his class. He is now studying online at a university in Ukraine to earn a degree in physical therapy. The teenager who came across the globe to receive care and therapy now wants to use his experience to help others.