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

Microvascular surgery is a very complex surgical technique used to reconnect very small blood vessels and nerves


Ashwani Kumar

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KT File
KT File

Published: Tue 11 Jul 2023, 11:00 AM

Last updated: Tue 11 Jul 2023, 11:23 PM

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.

When the patient came in for his follow-up visit a month after the second surgery, the toe-to-thumb transfer was a success, and the reattached fingers were all healthy. X-rays showed the bones were healing, and his hand is moving properly.

“This is another example of outstanding multidisciplinary teamwork. It reflects our ability to act quickly when presented with serious trauma to ensure the best possible outcome,” noted Dr Ateq Al Messabi, deputy chief medical office and consultant general surgeon at SSMC – one of the UAE’s largest hospitals for serious and complex care and a joint-venture partnership between Abu Dhabi Health Services Company (SEHA) and Mayo Clinic.

“Our model of care at SSMC puts the patient’s needs at the centre and draws on the expertise of our world-class professionals to offer integrated, cutting-edge care that is exactly what the patient needs at every step of their treatment journey,” Dr Al Messabi added.


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