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the surgery at
close to the hospital, so she arrived soon
after—along with the ve missing ngers.
“The woman had lost a tremendous
amount of blood—well over half of that
normally in her body,” Dr. Hartzell says.
While the patient was stabilized, Dr.
Hartzell and physician assistants Amy
Jorgensen and Jordan Janssen immediately
set to work under microscopes marking the
nerves, vessels and tendons of the severed
ngers.
“At this point, you know you’re going to
be sewing under a microscope for hours and
hours,” Dr. Hartzell says.
Dr. Hartzell and the team performed a
successful ve- nger and partial hand re-
plantation surgery that took approximately
17 hours to complete—reattaching bones,
tendons, nerves and blood vessels.
The bones and tendons are easy to re-
attach, he says, but the nerves and vessels
take the most time and concentration.
Some of those parts of the hand are as thin
as 1 millimeter.
Veins were harvested from the patient’s
left hand, and skin grafts were taken from
the patient’s right arm during this dif cult
and rare case.
Dr. Hartzell, who was previously in-
volved in the second face transplant in the
world as well as the rst hand transplant in
the western United States, says the surgery
was unique in its dif culty, as compared to
a full hand transplant or reattachment of a
single nger.
“Technically, this is probably the most
dif cult case I’ve worked on,” Dr. Hartzell
says.
The patient should eventually be able to
open and close her hand and hold things
like eating utensils following extensive
physical therapy and possible future
surgeries.
She will likely never have the ne mo-
tor skills she once had, but sensation will
return “remarkably well,” Dr. Hartzell
says. “[The patient] is a remarkable young
woman who handled it all with grace and
courage.”
Dr. Hartzell praised the efforts of
everyone involved. Even though
he has done a lot of replanta-
tions and partial hand opera-
tions at Faith Regional, the
end result of this case was
particularly gratifying.
“It’s always exciting to see
a hand turn pink [after sur-
gery],” Dr. Hartzell says.
9
What is
a hand
surgeon?
On the surface, the
answer to that ques-
tion seems simple: A
hand surgeon is a doctor
who operates on hands.
However, there’s more to
the profession than that.
First, a hand surgeon
may be an orthopedic,
plastic or general surgeon.
These physicians under-
take additional specialized
training to become hand
surgeons.
Second, most of these
surgeons are also special-
ists in performing proce-
dures on the delicate and
complex structures that
make up the hand, wrist
and forearm.
And third, hand sur-
geons can also provide
nonsurgical treatments
for a variety of problems.
These include:
•
Carpal tunnel
syndrome.
•
Tennis elbow.
•
Wrist pain from arthritis
and other causes.
•
Sports injuries of the
hand and wrist.
•
Fractures in the hand,
wrist and forearm.
•
Nerve and tendon
injuries.
A hand surgeon may
treat these conditions
with medications, splints,
therapy or injections.
However, if surgery be-
comes necessary, these
professionals can provide
just the right touch.
Sources: American Academy of
Orthopaedic Surgeons; American
Society for the Surgery of the Hand
