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.
Emergency Hand Surgery for Complex Thumb Trauma
The patient was immediately shifted to the emergency operating room, where Dr. Anupam Khandelwal and his team initiated surgical treatment. The wound was thoroughly irrigated using normal saline, hydrogen peroxide, and povidone-iodine solution to reduce contamination and infection risk.
After meticulous debridement, the damaged MCP joint was reduced and stabilized with a K-wire under C-arm guidance. The torn ligaments and other vital soft tissue structures were then carefully repaired to restore stability to the thumb.
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.
Thumb Tendon Repair Surgery
The second stage of surgery involved repair of the thumb’s extensor tendons. At the MCP joint level, two important tendons control thumb extension:
- Extensor Pollicis Longus (EPL)
- Extensor Pollicis Brevis (EPB)
Both tendon ends were identified, explored, and repaired using Prolene 3-0 sutures. This crucial step helped maximize the chances of restoring normal thumb movement, grip strength, and hand function.
Skin Reconstruction and Thumb Salvage
The injury had also created a large traumatic skin flap. Such flaps are at high risk of ischemia because their blood supply is often compromised following severe trauma.
Following ligament and tendon repair, the skin was meticulously reconstructed and closed. Thanks to timely intervention and expert hand trauma treatment in Indore, the patient’s thumb was successfully salvaged, preventing permanent disability and loss of hand function.
Importance of Early Treatment for Hand Injuries
Injuries caused by cutter and grinder machines can damage bones, tendons, ligaments, nerves, blood vessels, and joints. Prompt evaluation by a qualified hand injury surgeon in Indore can significantly improve outcomes and help preserve function.
Workers operating power tools and sharp machinery should always wear protective equipment and follow workplace safety protocols to reduce the risk of serious hand injuries.
Expert Hand Surgery in Indore
Dr. Anupam Khandelwal Joint Clinics (AKJC) provides advanced treatment for:
- Thumb injury treatment in Indore
- Hand trauma surgery
- Tendon repair surgery
- Grinder machine hand injuries
- Finger and thumb reconstruction
- Emergency hand surgery
With timely diagnosis, advanced surgical techniques, and specialized rehabilitation, many complex hand injuries can be successfully treated while preserving function and quality of life.