Bengaluru hospital restores hand functioning of youth injured in factory

Bengaluru: A 26-year-old man got restored his hand movement and functioning after two successful surgeries at BGS Gleneagles Global Hospital, Kengeri. Rudresh, a youth from Bidadi was admitted to the hospital on October 23, 2021, with severe and devastating injuries to his left hand, caused due to a terrible accident at a manufacturing unit.

The gas explosion at the site cost him a traumatic amputation of his index and thumb fingers. Looking at his critical condition, he was immediately rushed to the emergency ward for his first round of surgery which took more than 5 hours.

People working in this sector sustain hand, leg, palm, finger injuries which may result in permanent deformity or even death due to lack of medical intervention during the "Golden Hour".

As part of the Hand Trauma Management protocol, the 26-year-old patient was rushed to the nearby hospital where the doctors managed to reduce the excessive blood flow. However, due to the lack of infrastructure, the patient was recommended to get admitted at BGS Gleneagles Global Hospital.

Accordingly, he was admitted to the hospital in a critical condition, with a traumatic amputation of half of his hand including middle index and thumb fingers. Rudresh was bleeding profusely, so the ER team stabilized him and did imaging for clear understanding of his injury. The patient's 1st, 2nd and 3rd metacarpal (bones of the hand) were fractured.

The thenar muscles and skin were also completely damaged.

Consultant - Aesthetic and Reconstructive Surgery, BGS Gleneagles Global Hospital, Dr Naveen Kumar H R said, "Thumb, index and middle fingers belong to radial side of hand which constitutes 80% of hand function. Among them thumb contributes 40%, Index and middle finger contribute 20% each. Injury to his thumb radial side of the hand was devastating and became non-functional immediately after the accident.

The challenge for us was to reconstruct thumb in its anatomical position, to create first web space and to provide at least one opposing finger to revive the patient's grasping power.

We have successfully reconstructed patient's thumb and first web space using radial artery forearm flap & abdominal flap.

As his Index finger was not available for replantation, the injured middle finger was fixed & soft tissue repair was done so that this will be used as index finger in future."

Without any further delay the first stage surgery was performed. The doctors did debridement (treating the wound) of wounds. Subsequently, the doctors used K wires to fix the middle and thumb fingers.

The left osteoplastic thumb was reconstructed using radial artery forearm flap for soft tissue reconstruction.

The second stage of the surgery was performed on October 29, where the patient underwent abdominal flap surgery to reconstruct the first web space. Rest of the raw area of the hand was covered using skin graft. Post-surgery the patient was moved to the ICU ward and was provided adequate medication and robust care.

The surgery was successfully performed by an expert team including Dr Naveen Kumar H R, Plastic, Reconstruction and Hand Surgeon, Dr Ramya Deepthi, ER team lead by Dr Narasimachar, head of emergency and trauma medicine and Anesthesia team lead by Dr A M Kuttappa, head of anaesthesia and critical care, the nursing team headed by Joice Inbarani, physiotherapy team headed by Babu J and all supporting staff.

The Cluster COO, Gleneagles Global Hospitals, Bengaluru, Biju Nair says, "When it comes to industrial accidents, it is critical for a patient to immediately rush to a well-equipped multi-specialty center where multiple departments can come together to treat any type of injury.

It is the efforts of multiple departments that today the patient has regained his hand functions. I am grateful to the team of doctors, nurses and other supporting staff members at BGS Gleneagles Global Hospital for rescuing yet another patient from an unfortunate accident."