Coimbatore, Jun 6 UNI | 2 months ago

A 41-year-old worker from Uttar Pradesh got a new lease of life after a rare surgery was performed on him in a city hospital recently.

Through the surgery in a city-based hospital, the right hand of the worker was joined to the left wrist to give him at least one useful hand.

Explaining about the rare surgery, Ganga Hospital, Head of the Department of Plastic and Hand and Microsurgery, Dr S Raja Sabapathy, told reporters here today that this was done because the right forearm was severely crushed making reattachment of the hand impossible. The left hand was so badly crushed that reconstruction of the same side was also not possible. In this situation, a rare surgery in the form of "Cross Hand Transfer at the wrist level" was done creating a record in the world.

Mr Matru Yadav hailing from Azamgarh in Uttar Pradesh was working as a contract labourer at the Aravangadu Cordite Factory. On June 2, 2014, in an accidental blast, his right hand was blown away and fell at a distance. The right forearm was destroyed.

On the left side, the whole palm was lost and only fingers without blood supply were found hanging. He was immediately given first aid and shifted to Ganga Hospital, Coimbatore, for further management.

Mr Yadav was in shock on arrival. He was resuscitated and made fit for surgery. The totally amputated right hand was properly stored by the doctors at the Aravangadu Hospital. Dr S Raja Sabapathy said they were shocked to find that on the right side the most of the forearm was missing almost close to the elbow. This made reattachment of the hand on the right side impossible. Whereas the left side, the palm was totally lost and the fingers were also damaged. So the possibility of him losing both hands was imminent.

The microsurgical team quickly decided to replant the right hand on to the left side. It does involve some complex rearrangement of tendons and nerves because now the thumb of the original right hand goes to side of the little finger. Complex planning and execution was necessary to reroute the nerves and tendons so that when the nerves recover he still feels the thumb as the thumb and the complex movements of the thumb are still possible.

Dr Sabapathy said each case needed some planning and thinking because this surgery was rarely been done in the world.

The surgery took eight hours. Three teams of micro surgeons worked simultaneously one to prepare the amputated hand, one for each upper limb.

It was days after the operation now and the patient was doing well.

Dr Sabapathy said it would take six to nine months of physiotherapy to make his hand function well.

Dr Sabapathy said "if such reconstructions has to happen so many things has to be correct. First the doctors at the site must secure and bring the amputated part in a proper manner. The best way to bring is to place the part inside the plastic bag and place ice around it. Second the patient has to be brought to the microsurgical centre which has the facility to do it." He said the end result would be better than the best available prosthesis though cosmetically the position of the hand would look a little different.

The surgical team consisted of Dr Raja Sabapathy, Dr Hari Venkatramani, Dr SanjaiRamkumar, Dr Ravindra Bharathi, Dr Manoh, Dr Raja Shanmuga Krishnan and the anaesthesiology team consisted of Dr Venkateswaran, Dr Boopathy and Dr Arun.

(Posted on 06-06-2014)