how does a cut finger get resewn back on with full functionality?
In: Biology
I work at a hospital pharmacy. After the microsurgery we prep and “dispense” ACTUAL leeches, because if we can put a leech on there it will suck the blood through and increases chances of keeping the limb by like 90% or something crazy (but don’t quote me on that number)
Unfortunately sharing leeches is like sharing needles, so when they come back down after use we give them a nice swim in alcohol and then a flush down the potty.
We keep them in the fridge with special salt water so they stay alive for a long time and “sleep” but those little buggers sure are good at squeezing through tiny openings! We keep them double bucketed. We give them a nice bath once a week in new salty water.
Hey this is something I have experience with. Last October I cut three fingers and my thumb on my right hand carving a pumpkin when the handle of the knife I was using broke. My pointer finger took the brunt of the damage. I cut the artery, nerve, two tendons, and went about halfway thru the joint in my pointer. I got one tendon in my middle finger too. They called it a zone 2 flexor tendon repair.
I had surgery to reattach everything 2 days later. Then months of rehab to regain motion. I have about 95% range of motion back now and almost full feeling (it feels like touching stuff with a latex glove on.) I am still dealing with some swelling so I have to keep compression bandages on but am pretty happy with the way it all turned out. I’ve got some pics I can post later if there is interest.
Hand surgeon here. A cut off finger that gets reattached doesn’t get full functionality back unless it is a fairly young child.
Surgically it is complex and a single finger will take hours to attach, then multiply that with however many fingers you’ve put through the table saw. First step is to stabilise the bone, this is usually done with two crossed, smooth steel wires that are drilled in to the bone. Once that bone is stable you tend to suture the tendon(s) back together. At the base of the finger you have two, after the first joint there is only one. At this point you get the operating microscope with 25x magnification in and suture one of the two arteries and the nerves of you can get them to match up. If there is a bit of artery missing you can borrow one of the veins on the inside of your wrist to plumb in as an extension. For the nerves you either sacrifice one or use a synthetic nerve tube to guide the growth back. Finally you flip the hand over and suture the tendon and two or three veins. With any luck it works.
The results aren’t great though. You will have a permanently stiff finger with poor if any sensation and it will be very cold sensitive. This is why in many countries you don’t reattach a single finger unless some specific cases like in children since they have much better results or if it involves a thumb. The US is different and I suspect much of it comes down to remuneration.
A finger cut off at the middle will do pretty well but the higher you go the worse the results will be. Once the major nerves to the muscles in the hand or even worse arm are severed outcomes are poor. The best you could hope for with a reattached hand would be 50% of the grip strength and enough sensation that you can feel if you stab yourself with a needle.
Wow, this thread is oddly specific. I happened to have my right index finger cut off at the tendon with a chainsaw when I was 3. Considering I was 3 at the time, I had no idea what was going on. Fascinating to read several years later what the doctors put me through.
For those interested, I have about 75% ability to “feel” with the tip of the finger. Like if I’m touching something soft or something hot, I only feel about 75% of what my other fingers feel. It is also very sensitive to touch in general, I don’t like to hold hands very long with my right hand.
According to Google (which is NEVER wrong), the severed digit should be kept in a bag of ice, but wrapped in something like a paper towel so it isn’t in direct contact with the ice.
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Plastic/hand surgeon here. Replants are generally repaired structure by structure, although in some situations digit by digit. Everything is washed and debrided. Then a couple incisions are made and the skin lifted back and the blood vessels, digital nerves, flexor/extensor tendons are exposed. This is done for the amputated finger and for the stump, and if possible 2 teams work simultaneously to save time.
Order of repair is usually: bone (k wires), flexor tendon, extensor tendon, artery, nerve, vein, skin.
Arteries, veins, and nerves are very small in the finger (1-2mm diameter), so usually use an operating microscope.
During healing, scarring causes the tendons to stick like glue, so most patients require another operation to free them up later. Replanting a single-digit amputation is traditionally considered relative contraindication, as the stiffness and poor sensation may actually decrease hand function rather than help it (except for thumb, which you’d try to salvage whenever possible).
If the bone is broken apart i think it can be temporarily cemented in place to heal back together, nerves and veins and stuff are stitched together using teeny weeny stitches. If a significant amount is removed and the tendons are cut, they have to be pulled back down from the shoulder(they ping all the way up your arm) and reattached. I cut off the tip of my thumb (around 15-20mm) and now I have no squishy padding it’s just skin ove bone, and the bones at an angle too so it realllly hurts if I just do much as flick it… generally they won’t reattach the tip if it’s a small amount, mostly because if it is a small amount it’s often too ruined to reattach or unsalvagable whereas a larger amount of finger is more necessary and more worth reattaching 🙂
My Right hand Index finger was cut off after the last joint (fortunately..), in a rather bloody CNC machining accident.
They sewed that thing back on again, was all blue for several weeks, then ok.
(Nail is all wrong, still is after 25 years)
But the weirdest thing was that I had lost all feeling in that finger, one night a couple of years after the accident, I woke up with a scream..
seemed like the nerves had re-connected.. and it felt like the “pain-info” had been laying dormant waiting.. I woke up certain my finger had been cut off again..
But now it works.
Not perfect, it’s a bit numb, but it works.
The most difficult part is reattaching the small arteries and veins using microsurgery with tiny sutures. Small nerves are also carefully reattached using small suture. Tendons are reattached with bigger sutures. Bones are typically fixed with metal pins
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