Sheikh Shakhbout Medical City (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, has successfully reconstructed a patient’s hand following an accident involving a vehicle engine, which led to amputation of all of the digits of his dominant right hand.
The accident occurred when a vehicle engine was accidentally turned on while the patient was repairing it, leading to traumatic amputation of his thumb and all four fingers.
The patient was admitted to SSMC where he was taken to the operating theatre immediately and underwent microvascular replantation of his fingers during an all-night operation, further bolstering the hospital’s reputation as a surgical center of excellence. Microvascular surgery is a very complex surgical technique which is used to re-connect very small blood vessels and nerves in the fingers and restore the circulation to the amputated digits before they die from lack of blood supply.
Dr. Roderick Dunn, chair of the Division of Plastic and Reconstructive Surgery at SSMC, explained: “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. Dunn added, “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. The patient later 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 is able to 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 life 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 clearly a success, and the reattached fingers were all healthy. X-rays showed the bones were healing, and his hand is moving properly
Dr. Ateq Al Messabi, deputy chief medical office and consultant general surgeon at SSMC, said: “This is another example of outstanding multidisciplinary teamwork. It reflects our ability to act quickly when presented with a serious trauma to ensure the best possible outcome.
“Our model of care at SSMC puts the patient’s needs at the center 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.”
