UAE: Doctors reattach expat's severed finger in complex six-hour surgery

Resident had accidentally chopped off the digit while trying to close a bathroom ventilation window



by

Ashwani Kumar

Published: Wed 17 Aug 2022, 12:11 PM

Last updated: Wed 17 Aug 2022, 2:22 PM

A team of specialists from a private hospital in Abu Dhabi have successfully performed a six-hour-long finger replantation surgery on a 30-year-old Egyptian expat.

Doctors at Burjeel Medical City were able to reattach the patient's left index finger after a washroom window glass pane accidentally cut it off.

The dramatic turn of events took place when Mohamed Mansour Mohamed, who works at a farm in Abu Dhabi, was at his friend's home. As he tried to close a bathroom ventilation window, a glass pane fell on his hand and chopped off his left index finger. Unable to bear the pain, he fainted on the spot.

Mohamed's friend, who found him lying unconscious, picked up the completely severed finger and rushed him to the nearby hospital in an ambulance. Mohamed remembers waking up at the hospital, where he was informed about the accident.

"Fortunately, my friend's house is located near Burjeel Medical City, so I was transferred there within minutes. When I realised the extent of my injuries, I thought I had permanently lost that finger. Little did I expect that I stood a chance to regain the finger," said Mohamed, who has been living and working in the UAE for the last two-and-a-half years.

Doctors at the emergency department received Mohamed with a crush amputation injury of the left index finger. Moreover, there were deep injuries on the left middle and ring fingers, a partial nail plate avulsion (separation), and a nail bed injury to his left little finger.

Much to Mohamed's relief, doctors assured him that they would be able to reattach the severed finger to his hand. According to doctors, injuries to the hand ranging from superficial lacerations, or a cut, to total amputation are commonly seen in the emergency department. In Mohamed's case, he needed a replantation surgery, which is a complex microsurgical procedure.

Six-hour-long surgery

As the severed finger was preserved properly, a medical team headed by Dr Leon Alexander, a specialist in plastic surgery, opted for an emergency replantation of the left index finger. The surgery included a dissection of the severed finger and bone fixation using a single axial k-wire, followed by repair of the tendons, arteries and veins. The team had to also attend to the deep injuries on the other three fingers, as well as harvest vein grafts for anastomosis (connecting the blood vessels). The surgery was completed in six hours.

According to Dr Alexander, a replanted body part never regains 100 per cent of its original use.

"Most doctors consider regaining 60-80 per cent of use an excellent result. However, most replanted digits get approximately only 50 per cent of total motion. Despite this, a replanted digit is always better than a finger/hand prosthesis both in terms of appearance and function. Meanwhile, the cut nerves regenerate at a rate of 1mm/day, so the patient should get back sensation on the replanted digit gradually over six-12 months."

A long recovery ahead

In Mohamed's case, the medical team was able to reattach his finger because the ischemia – reduced blood and oxygen supply – time was less, the amputated finger was not severely crushed, and the finger was well preserved.

Mohamed is now looking at a long recovery process that can take between three to six months and sometimes up to a year as the body must relearn the mind-muscle-finger connection. There will be a follow-up after six to eight weeks, and Mohamed will then undergo an intensive active and passive range of motion programme with the hand occupational therapy team for three to six months.

Mohamed has still not come to terms with the trauma he experienced.

"I still cannot believe what has happened so far. Even though I am away from my family, I still felt like I was among my family members. I thank the medical and nursing team that took great care of me. They provided me with medical and psychological support, and they never gave up on me," he said, adding that he is currently focused on recovering and getting back to work soon.

What do you do when you sever your finger?

According to Dr Alexander, preservation of the amputated part is the most crucial step in such cases.

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"The amputated part must be wrapped in moist saline-soaked gauze and transferred to a plastic bag. The plastic bag must be wrapped and enclosed in another plastic bag filled with saline/water and then stored in an ice box or bag containing ice cubes. The amputated part must not come in direct contact with the ice as it will damage the digital vessels and nerves," Dr Alexander added.


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