UAE: Doctors reconstruct patient’s amputated hand in 12-hour surgery

A multidisciplinary team of doctors has performed an all-night-long complex surgery to reconstruct a patient’s hand following the amputation of all of his fingers and thumb on the right hand in a freak accident.

The patient's thumb and all four fingers got amputated after a vehicle engine was accidentally turned on while he was repairing it. He was admitted to Sheikh Shakhbout Medical City (SSMC) where in a 12-hour all-night operation, a multidisciplinary team reconstructed his hand by performing microvascular replantation of the fingers and then reconstruction of the thumb using a microvascular second toe transfer.

Microvascular surgery is a very complex surgical technique used to reconnect very small blood vessels and nerves in the fingers and restore circulation to the amputated digits before they die from a lack of blood supply.

“On arrival at SSMC, the patient was taken straight to the operating theatre and underwent microvascular replantation of the index, middle, ring, and little fingers in a 12-hour operation throughout the night. Unfortunately, the thumb was too damaged to replant,” Dr Roderick Dunn, chair of the division of plastic and reconstructive surgery at SSMC, said.

“This was an extreme injury – the digits were avulsed from the hand rather than being amputated by a clean cut, making surgical replantation much more difficult. Following the lengthy procedure, the index, middle, and ring fingers survived.”

After successful microvascular replantation of three of the patient’s fingers, further options for thumb reconstruction were discussed between Dr Dunn, the team, and the patient. Later, the patient underwent a microvascular toe transfer, using the second toe from the left foot to make a new thumb in his injured right hand. This procedure was performed successfully three weeks after the initial injury and enabled the patient to have a functional hand with three fingers and a thumb.

Currently, the patient, who is undergoing regular hand therapy rehabilitation and can use his hand for some day-to-day activities, will eventually be able to return to work.

Dr Dunn asserted that without this surgery, the patient would have been condemned to live as a hand amputee, unable to work or look after his family.

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