JNMC surgeons fix amputated wrist in complex surgery

Severed wrist of 25-year-old Aligarh resident was replanted by a team of plastic surgeons of the Jawaharlal Nehru Medical College (JNMC), Aligarh Muslim University (AMU), making it to the list of the rare cases of limb replantations of near total amputations across the country. The patient, Chandrashekhar, has been discharged after recuperating at JNMC.

Chandrashekhar was drilling underground when his hand accidentally went under the sharp borewell drilling machine. His relatives rushed him to JNMC—somehow managing to hold his wrist hanging by the thin skin.

“The patient had lost a lot of blood before reaching the trauma centre. We immediately wheeled him into the emergency operation theatre. He was first resuscitated with transfusion of units of blood and fluids before the restoration of blood supply and repair of tendons, nerves and bones of the severed wrist in a six-hour long, marathon surgery”, said Prof Arshad Hafeez Khan (Chairman, Department of Plastic Surgery).

Dr Sheikh Sarfraz Ali, who carried the procedure with colleagues, Dr Gautam Chaudhury and Dr Indrajith K Sudhy said: “The complexity of the surgery lies in getting the blood supply back to the amputated part. We surgically fixed tendons and nerves and reattached major veins”.

He added: The whole skeletal framework, arteries and nerves of the patient were repaired in a specific sequence to regain the anatomy and function of the hand. He had to be given more units of blood during the surgery.

“In such cases, proper preservation of the limb and rushing the patient to the hospital at the earliest are keys to successful replantation,” said senior Plastic and Reconstructive Surgeon, Prof Mohd Yaseen.

Speaking on the postoperative care of replantation patients, Hand and Microvascular Surgeon, Prof Imran Ahmad pointed out: “Sensation in the affected part takes much longer to regain and tendon injuries require more recovery time than fractures. Success of these surgeries depend highly on follow up physiotherapy and a well designed postoperative dynamic rehabilitation program “.

“Limb replantation is a tricky and difficult operation, but with the advancement of micro-surgery, it is becoming possible to replant totally amputated body parts by restoring blood supply and repairing tendons, nerves and bones. At the Department of Plastic Surgery, JNMC, we are routinely doing complicated microsurgical procedures with increasing success rates”, said Microvascular Surgeon, Dr Mohd Fahud Khurram.

Dr Shahna Ali and her team provided the patient with the anesthesia.