HCMC doctors save severed hand of pregnant woman by attaching to leg, later reattaching

As of Sunday, nearly two weeks after the surgery, her condition is stable and, what is more, her twin fetuses are also developing well.

The fingers on her reattached hand have begun to show slight movement as she undergoes physical therapy.

On Nov. 17 the surgical team performed a series of microsurgeries, including removing the hand along with a 15-cm segment of the posterior tibial artery from the leg, preparing the stump of the arm and fixing the radius bone with plates and screws.

The surgeons connected one artery and three veins to restore circulation, and used the peroneus longus tendon and a branch of the superficial peroneal nerve to reconstruct the lost tendon and nerve structures.

For maximum safety, the hospital consulted, among others, specialists at the Hospital for Traumatology and Orthopedics HCMC and Tu Du Hospital, HCMC’s leading obstetrics and gynecology hospital.

Throughout the hours-long surgery, the heartbeats of both fetuses were continuously monitored.

The decision to graft the hand on to the leg was a temporary solution made in September when the patient was brought following a workplace accident.

Then 23 weeks pregnant, she had severe crush injuries to the lower third of her forearm, with her right hand completely severed and badly contaminated.

Doctors assessed that reattaching the hand immediately carried a high risk of sepsis and necrosis, which would threaten the lives of both mother and babies.

Besides, a seven- or eight-hour surgery requiring a large amount of anesthesia could easily trigger a miscarriage.

On the other hand, turning the injury into a permanent stump would leave the patient disabled for life. So the doctors chose to graft the hand on to her right lower leg so that blood supply would keep the tissue alive until the pregnancy was more advanced.

The temporary graft surgery took only two to three hours, and also allowed removal of damaged tissue.

Dr. Tang Chi Thuong, director of the Ho Chi Minh City Department of Health, said the surgery marks a significant technical milestone in microsurgery and reconstructive procedures for provincial-level hospitals.

Binh Duong General Hospital has in the past grafted a completely severed lower leg on to the patient’s other leg to keep it alive before reattachment, and the patient later regained the ability to walk.

Elsewhere, such temporary grafting of a severed limb on to a leg has done performed only in China, by some accounts.