The Center for Podiatric Care and Sports Medicine

Rare Foot Surgery Saves Girl Involved in Escalator Accident

Posted by on Thursday, January 23rd, 2014


Doctors on the scene said it was “like a tank had run over her foot.” An unusual elevator accident left Juliana Valdez, a brave 10-year-old, with exposed nerves, muscles and tendons on the top of her foot. The initial observation was that the foot would require amputation, but surgeon Sanjeev Kaul had a different opinion. He wanted to try a foot surgery that would give Valdez a second chance at playing like a kid again.

“My gut told me there was a chance,” said Dr. Kaul. Three months later, the girl was recovering at home with a heavily bandaged foot that had been rebuilt using muscle and skin from another part of her body. She gets around with crutches, a walker and a wheelchair to avoid bearing weight on it, but she is expected to make a full recovery. Valdez says she’d like to get back to not only walking, but playing soccer, again.

foot surgery
The foot is a complex maze of muscles, tendons, ligaments, bones and nerves.
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The Procedure

The first step was to stabilize the girl’s condition and keep any possible infections at bay. The girl’s kidneys began to fail a week after the accident, due to the massive shock of trauma and infection. She was given antibiotics and recovered, but still had a long way to go. During the next month, 20 surgeries removed dead tissue and cleaned escalator grease off the bones. Surgical holes in her eardrums allowed her to be placed in a hyperbaric oxygen chamber to promote faster  healing. Finally, Juliana was ready for the procedure that would ultimately save her foot.

The operation took 10 hours and consisted of eight separate procedures.  The team of surgeons performed what is known in the industry as a “free flap reconstruction,” which borrows a block of tissues from another part of the body and moves it to the reconstruction site. They used muscle from the girl’s back and skin from her thighs. The surgeon used a microscope to connect blood vessels smaller than a matchstick to the tissue using stitches finer than a human hair. Following microsurgery, the new flap should be able to live in its new location.

The Recovery

It could take two years before Juliana can walk without support and get back to leading the normal life of a kid. The titanium rods will be removed from her foot in a couple of months. Though she lost two baby toes in the incident, Juliana attends therapy at a pediatric rehabilitation center and looks forward to getting back to sports one day. “She’s completely defying the odds,” Dr. Kaul said. “I think I would not shut out any possibility for her, bar none. She’s a strong girl, and I see miracles all the time.” Juliana also said she would like to work as an orthopedic physician one day because of her positive experience with the wonderful surgeons who believed in her.

escalator accident
Escalator riders have certain responsibilities, but Macy’s may also be held liable for the accident if their escalators were not properly maintained.
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The Aftermath

The family filed a federal lawsuit against Macy’s and escalator maintenance provider ThyssenKrupp. The company acknowledged that three of the four escalators have undergone upgrades; the elevator involved in the accident remains shut down. State records show that the escalator had been issued a temporary certification two weeks prior to the accident — allowing it to operate, despite a lapsed inspection.

According to the local New Jersey newspaper, Macy’s settled two other lawsuits involving local escalator amputations since 2009. Nationally, the U.S. Consumer Product Safety Commission reports that 22,674 people are injured by escalators and lifts each year. Here at The Center for Podiatric Care and Sports Medicine, we have a team of skilled trauma surgeons who are able to perform the latest procedures necessary to save lives and injured limbs.


If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.