An Egyptian famer whose finger was amputated in a freak accident in Abu Dhabi said surgeons saved the use of his left hand after reattaching the severed digit just hours after the incident.
Mohamed Mansour Mohamed, a 30-year-old who works at a farm in the UAE capital, was trying to close a bathroom window at a friend’s house when a glass pane fell on his hand, resulting in his left index finger being severed.
Unable to bear the pain, Mohamed, who has been living and working in the UAE for the last two-and-a-half years, fainted on the spot. Mohamed’s friend who found him lying unconscious picked up the finger and rushed his friend to a private hospital nearby. 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,” he said. “When I realized the extent of my injuries, I thought I had permanently lost that finger.”
He continued, “Little did I expect that I stood a chance to regain the finger.”
After assessing his injuries, the doctors offered Mohamed a ray of hope by telling 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 to total amputation are commonly seen in the emergency department.
Usually, they require specialized treatment by a hand surgeon who does reconstructive surgery and microsurgery.
In Mohamed’s case, he needed a replantation surgery which is a rare surgery performed only by a select few hand surgeons in the UAE with microsurgery expertise.
As the severed finger was preserved properly, a medical team conducted the initial bench dissection of the severed finger under the operating microscope, where all the structures, including dorsal veins, arteries and nerves were tagged with microsutures.
After conducting dissection in the proximal finger, the doctor performed the bone fixation using a single axial k-wire (a stiff, straight wire used to repair the fracture), followed by repair of the tendons. Doctors then repaired the arteries and veins under the microscope using microstructures.
Once a good blood flow was established, the skin was sealed with a few sutures.
In this case, as the team had to reattach the severed finger and attend to the deep injuries on the other three fingers, as well as harvest vein grafts for the anastomosis (connecting the blood vessels), the surgery was completed in six hours.
However, according to Dr. Leon Alexander, a specialist in plastic surgery at Burjeel Medical City who led the operation, a replanted body part never regains 100 percent of its original use.
“Most doctors consider regaining 60 percent to 80 percent of use an excellent result,” he said. “However, most replanted digits get approximately only 50 percent of total motion.”
Mohamed is now looking at a long recovery process that can take between three and six months and sometimes up to a year so that his body can relearn the mind-muscle-finger connection.
The medical team was able to reattach Mohamed’s finger because the ischemia (reduced blood and oxygen supply) time was short, the amputated finger was not severely crushed, and the finger was well preserved.
According to Alexander, preservation of the amputated part is the most crucial step in such cases.
“The amputated part must be wrapped in moist saline-soaked gauze and transferred to a plastic bag,” he said. “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.”
Preventing crush injuries
According to doctors, most amputation injuries are avoidable and happen because of lack of attention or lack of protective gear.
Doors and power tools are responsible for most finger amputations.
They say that such incidents can be avoided if residents install door guards to prevent fingers from getting jammed in the doors, while workers who use power tools and heavy machinery must follow all safety instructions and precaution and wear proper protective gear like hand protection (gloves), work attire, heavy work boots and helmets with protective eye goggles.
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