Microsurgery to Reattach Finger Joint for Man Who Had a Work Accident

(PLVN) - Information from the Central Hospital for Tropical Diseases, the unit has just received and treated a case of a male worker who was slashed by the blade of a vertical cutting machine at a mechanical workshop, severing the distal phalanx of his left index finger.

The patient is NVD, 22 years old. He said that while operating a vertical cutting machine at a mechanical workshop, because he was wearing protective gloves that were too loose, his hand got caught in the rotating shaft, causing the blade to cut off the distal joint of his left index finger.

The complex injury severed the bone, blood vessels, and nerves, leaving only a thin layer of tissue holding the finger to the hand. Clinical examination revealed that the severed finger had lost circulation, was flat, had lost elasticity, and was pale—clear signs of gangrene. Further tests confirmed that the finger was soft, did not bounce back when pressed, and did not bleed when pricked with a needle. Without urgent intervention, the limb would not be salvageable.

According to Dr. Duong Manh Chien, a plastic and cosmetic surgery specialist, amputation at the distal phalanx of the index finger is one of the biggest challenges in microsurgery. Unlike the area near the hand, where blood vessels are larger, at the distal phalanx the arteries and veins are very small, difficult to find and easily blocked after reattachment. Even in large, highly specialized hospitals, the success rate at this location is still limited. However, for young patients and injuries to the index finger - a finger that plays an important role in daily life and work - doctors decided to perform emergency microsurgery with the goal of reconnecting blood vessels, nerves and fixing bones to preserve limb function.

The surgery requires absolute concentration and precision. Doctors use microscopes that magnify dozens of times to observe arteries that are smaller than fat cells. Specialized sutures, thinner than a strand of hair, are used to connect blood vessels. Dr. Chien shared: “Microsurgery is the art of stillness. The mind must be as calm as a flat lake surface for the hands to be steady.”

After several hours of surgery, the blood vessels were reconnected, the bone was fixed with a pin, and the nerves were partially restored. Due to the small size of the blood vessels and the high risk of spasm, the circulation in the fingertips after surgery was unstable. The patient was closely monitored, with continuous circulatory support measures.

After 14 days, the patient's index finger began to recover positively. Photo: Thanh Thanh

After 14 days, the patient’s index finger began to recover actively. The tip of the finger was pink again, elastic and had clear vital signs. Doctors assessed the results as positive, although the patient needed to continue physical therapy to fully recover function.

From this case, doctors emphasize the importance of complying with occupational safety when operating machinery. Workers need to use protective gear properly: gloves must fit well, without excess fabric; long hair, loose clothing or straps must also be securely fixed. When working with cutting machines, stamping machines or machines with rotating shafts, it is necessary to concentrate and strictly follow safety procedures.

If an accident results in a severed limb, it must be handled properly: wrap the severed part in clean, damp gauze, place it in a sealed plastic bag, then place this bag in a second bag containing a mixture of ice and water, avoiding direct contact of the limb with the ice. Take the victim and the limb to the hospital as soon as possible, ideally within 6 hours (or up to 24 hours if properly refrigerated).

The index finger and thumb are the two most important fingers on the hand, playing an essential role in daily life and work. Injuries to these fingers, even small ones, can have long-term effects if not treated promptly. The above case is not only a warning about the risks in the working environment but also shows the important role of modern medicine, especially microsurgery, in preserving limbs and improving the quality of life for patients. Awareness of accident prevention and proactive handling when incidents occur are the keys to protecting each person's health and ability to work.

Ngoc Nga

Source: https://baophapluat.vn/vi-phau-noi-lien-dot-ngon-tay-cho-nguoi-dan-ong-bi-tai-nan-lao-dong-post548110.html