A patient ( Carpenter by Profession ) came to emergency room with cut injury of Left Thumb as he was operating an angle grinder machine at work. He was operating this machine since 15 years. His focus shifted elsewhere for a few seconds when the machine slipped from his hands and ran over his Left Thumb cutting It through 70% of Circumference at the level of METACARPAL-PAHALNGEAL(MCP) JOINT. Dr. Anupam Khandelwal during examination noted that the Bones i.e. METACARPAL & PROXIMAL PHALANX were exposed and MCP JOINT CAPSULE, VOLAR PLATE , MEDIAL & LATERAL COLLATERAL LIGAMENTS were disrupted. The PALMER LIGAMENT , DIGITAL ARTERY AND DIGITAL NERVE were intact. His Wound was Bleeding profusely and he had a lot of PAIN.
Dr. Anupam Khandelwal & his team operated him in EMERGENCY OPEATION ROOM. Dr. Anupam Khandelwal washed with 3 litre of normal saline , Hydrogen Peroxide and Povidine Iodine solution mixture. Then debrided the wound and reduced the joint with a K-wire under C-arm guidance. Then Dr. Anupam Khandelwal team repaired the Joint Ligaments and other Vital Structures.
Then the second Phase of Surgery – TENDON REPAIR was done. At the level of MCP Joint – two extensor tendons of thumb are present : Extensor Pollicis Longus(EPL) & Extensor Pollicis Brevis (EPB). The ends of both the tendons were explored and identified. Then repaired by PROLINE 3’0 Suture.
Then SKIN was repaired . The traumatic accident lead to generation of a long transverse rectangular SKIN FLAP. These Skin flaps are prone to ISCHEMIA as their blood supply is compromised due to cut off from rest of the skin from three sides.
By this surgery the THUMB of the patient could be SALVAGED and SAVED. It is advised to workers/operators of SHARP INTRUMENT / MACHINES to wear appropriate SAFETY GEAR and take all necessary precautions to protect their HANDS and other body parts from such injuries as these can cause loss of Life / Body part.
DR. ANUPAM KHANDELWAL JOINT CLINICS(AKJC) have a well trained team to deal with TENDON INJURIES , CUTTER / GRINDER & other HAND injuries.