Page 8 - HOH 25 JULY,2015

Doctors in China save man’s
severed hand by grafting it to his leg

ARUBA TRAVELLER - Saturday, July 25 2015 A man in China may regain use of his hand after it was cut

off in an industrial accident. Even more amazing is how the
doctors saved the man’s hand: They grafted it onto his leg.
The man, who has been identified as Mr. Zhou, lost his entire
left hand weeks ago by a spinning blade machine in the fac-
tory he was working. A surgical team, led by Dr. Tang Juyu,
carried out the procedure at the Xiangya Hospital in Changsha
in central China.
Tang and the team decided they could not simply put the
hand right back where it came from. “There were great risks
to reattach the hand back directly to the arm, as tissues of the
severed [area] were greatly damaged,” Tang said.
Instead they grafted the hand to Zhou’s lower right calf, and
connected it to blood vessels in the region to keep the tissue
alive. The operation was a “race against time” to get the blood
supply back to the severed hand, Tang said.
After about a month, the blood vessels and tendons in Zhou’s
arm healed and the doctors reattached the appendage to its
original limb. Zhou has been reported to be able to move his
fingers a little bit, and he will continue rehab to try to recover
full use of the hand again.
It is hard to say at this point what Zhou’s prognosis is, said
Tang, who has performed this type of hand-to-leg graft for
two other patients, as well as one case in which the team
temporarily attached the hand to a patient’s belly.
“This is a very nice, novel approach when you can’t reattach
the hand to the arm right away,” said Dr. Ting, assistant profes-
sor of plastic surgery at the Icahn School of Medicine in New
York. “It’s like the leg is just babysitting the amputated hand
until the arm is ready for it,” Ting said.
While not aware of any instance of this type of procedure being
done in the United States, Ting said it’s still probable because
“almost everything has been done once or twice.”
There have been reported cases in the United States in which
other regions of the body “babysat” severed fingers and ears.
In a case such as Zhou’s, a severed hand could, in theory, be
attached to any part of the body where there are accessible
blood vessels that it could be connected to, Ting said. “[But]
cosmetically you would not want to put it on the head or
neck, he added.
There are big risks to grafting a hand in a case such as Zhou’s,
said Tang. For example, the tissue of the hand could die or
rebuilding it could fail, he added.
Even if the grafting succeeded in keeping the hand’s tissue
alive, there is a possibility that it could lose some function.
“It needs to keep moving or the joints and tendons will be
very stiff and you can’t use it,” Ting said. However, it could
be possible to do some rehab with the hand even while it is
attached to the leg, such as having a physical therapist move
the fingers, he said.
Although it could be useful to develop this grafting procedure
in the United States, the need for it would be rare. “This is not
a common injury,” Ting said, and even less so in the U.S. as
much industrial manufacturing has moved overseas.

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