The Uncommon Surgical Procedures - Reattachment of severed members



Because an individual's tissues present no histocompatibility problem with other parts of his own body, severed fingers and other members can be rejoined to the rest of the body if vital parts are not damaged beyond repair. Children sometimes suffer amputation of a part of a finger during play or in accidents at home. For example, a finger tip can be severed when caught in a closed door of an automobile. If the severed part of the finger is saved and the patient is given immediate medical care, the finger usually can be rejoined and sutured in place with a very good chance of survival of the graft.

Rejoining a Severed Limb

One of the most dramatic cases of a rejoined limb in American medical annals involved a 12-year-old whose right arm was severed at the shoulder when he was crushed between a train and a tunnel wall in 1962. Railroad workers called an ambulance, and the boy, his severed arm still encased in his sleeve, was rushed to a hospital. The boy was given plasma by physicians who packed the severed arm in ice and flushed out the blood vessels of the arm with anticoagulant drugs and antibiotics. During three hours of surgery, the major veins and artery of the arm were carefully stitched to the vessels at the shoulder. For the next five hours, surgeons joined the bones, located the main nerve trunks and connected them to the nerve ends in the shoulder, and repaired the muscles. The boy was released from the hospital three weeks after the accident but returned for additional operations to connect various nerve fibers. That operation was a success, but similar attempts to rejoin severed arms of middle-aged men have failed despite heroic attempts by surgeons to restore the limbs as functioning parts of the body.

A Chinese factory worker suffered accidental amputation of his right hand when it was caught in a metal-punching machine, and was rushed to a hospital in Shanghai. Chinese medical reports of the case indicate that a procedure similar to the one used on the American boy was followed. Blood vessels were rejoined first to permit the flow of blood to tissues. This was followed by surgery to connect the tendons and main nerve trunks. The bones of the forearm, where the amputation occurred, were joined and held in place with metal plates and screws. Physicians reported that the graft was successful, and the patient, a 27-year-old man, was able to move his fingers again within three weeks after the accident.

Medical records indicate that major reattachments of severed limbs are still rare, although rejoined finger tips, ears, and other parts not involving main arteries, veins, or nerve trunks are not as uncommon.



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