A 41-year-old patient presented to a hospital with amputation of nine fingers because of a workplace injury.
A 41-year-old male patient presented to a hospital in Muscat, Oman with 9 amputated fingers. The fingers got amputated because of a workplace injury, while he was operating a paper cutting machine. Eight of the patient’s fingers were amputated from the proximal phalanges. Whereas, the right thumb was amputated at the distal phalanx.
The total ischemia time when the patient was received at the hospital approximately 2 hours and 30 minutes after the amputation. Physical examination showed that the amputated parts were well-preserved and clean cut. The patient was hemodynamically stable and had a blood pressure of 90/60 mm Hg, which was most likely because of bleeding from the amputated parts. Likewise, further examination was done to rule out any associated injury.
All the amputated fingers were re-attached and a total of seven fingers survived. In addition, the patient’s hands regained reasonable functionality. Amputation of multiple fingers in both hands is a rare and serious injury, moreover, this is the first case of several fingers amputation to the best of the authors knowledge.
The fingers perfused immediately after replantation. However, a significant amount of blood was lost during the latter part of the operation. Possibly because of release of arterial clamps and heparin injection that was given to the patient. The wounds continued to ooze blood postoperatively and the patient was monitored at the intensive care unit for 48 hours after replantation.
The patient’s little and ring fingers of the right hand were terminalised at the medical college hospital in India, where he was being treated. Similarly, the left index finger developed congestion followed by skin loss over the middle phalanx volar aspect. Although, the exposed areas were covered with debridement and skin grafts.
The patient was followed up at the same institute in India. All his wounds had healed well with reasonable functionality of the hands. Additionally, he was able to manage daily tasks and began working 4 months after the replantation procedure. He was satisfied with the procedure outcome even three years after the surgery.
References
Patil, R. K., Malhotra, G., Srinivasan Venugopal, E. S., & Ramadan, A. (2019). Replantation of Nine Fingers in a Patient: A case report. Sultan Qaboos University Medical Journal, 19(3), e248.
