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January 18, 2012
Surgeons Having More Success Reattaching Fingers and Thumbs
'I have quite a bit of movement,' Loyola patient says
MAYWOOD, Ill. -- Tom Thompson nearly lost his left thumb and index finger in a power saw injury, but Loyola University Medical Center hand surgeon Dr. Randy Bindra was able to restore circulation and function to the mangled digits in a delicate 5½ hour surgery.
After undergoing three follow-up surgeries and highly specialized occupational therapy at the Loyola Center for Health at Burr Ridge, Thompson says his thumb and finger have regained 60 percent to 70 percent of their original function.
He can't bend the middle joint of his thumb, there's less feeling in his index finger and his grip strength is reduced. But he can do many everyday activities, such as tying his shoes, buttoning his shirt and picking things up between his thumb and index finger.
"Dr. Bindra and his team performed an outstanding job," he said. "I have quite a bit of movement. And my hand looks almost completely normal, like nothing happened."
Each year, thousands of Americans lose fingers and/or thumbs. Many, like Thompson, are do-it-yourselfers, Bindra said.
Thompson was cutting wood trim with a miter saw when the accident occurred. "I was in a hurry to finish, and my concentration level dropped for just a second," he said. His index finger and thumb were almost completely severed.
On average, Bindra sees three or four cases per month in which one or more digits have been completely cut off or almost completely severed. The typical patient is a do-it-yourselfer, rather than a professional carpenter who has undergone safety training, Bindra said.
Bindra reattaches bones with tiny plates, screws and pins. He sews nerves and blood vessels together with sutures that are finer than a human hair. In Thompson's case, Bindra also took a vein from a forearm to reconnect blood supply to the thumb.
Thompson underwent occupational therapy with certified hand therapists Kim Esposito and David Spear. The therapy included, for example, exercises to stretch and bend his finger and thumb joints and open the web space between his thumb and index finger.
Thompson also received extensive education on how to reduce post-surgical swelling, keep his wound clean and change his bandages.
Hand surgeons have long been able to reattach digits. But results are improving due to better techniques and more sophisticated surgical instruments and microscopes, Bindra said.
Bindra said a finger or thumb can be reattached within 12 to 24 hours of an accident. The digit should be wrapped in a clean cloth and put in a Ziploc bag, and the bag should be submerged in ice water.
Of course, it's best not to get injured in the first place. Before he retired, Thompson was involved with operating power tools for many years. "Always stay focused and pay attention -- and never hurry when operating power tools," he said.
Loyola University Health System (LUHS) is a member of Trinity Health. Based in the western suburbs of Chicago, LUHS is a quaternary care system with a 61-acre main medical center campus, the 36-acre Gottlieb Memorial Hospital campus and more than 30 primary and specialty care facilities in Cook, Will and DuPage counties. The medical center campus is conveniently located in Maywood, 13 miles west of the Chicago Loop and 8 miles east of Oak Brook, Ill. The heart of the medical center campus is a 559-licensed-bed hospital that houses a Level 1 Trauma Center, a Burn Center and the Ronald McDonald® Children's Hospital of Loyola University Medical Center. Also on campus are the Cardinal Bernardin Cancer Center, Loyola Outpatient Center, Center for Heart & Vascular Medicine and Loyola Oral Health Center as well as the LUC Stritch School of Medicine, the LUC Marcella Niehoff School of Nursing and the Loyola Center for Fitness. Loyola's Gottlieb campus in Melrose Park includes the 255-licensed-bed community hospital, the Professional Office Building housing 150 private practice clinics, the Adult Day Care, the Gottlieb Center for Fitness, Loyola Center for Metabolic Surgery and Bariatric Care and the Loyola Cancer Care & Research at the Marjorie G. Weinberg Cancer Center at Melrose Park.