Jose Mari Jay, a 55-year-old man whose arm was severed just below the elbow after an accident, has regained the full use of his arm and hand due to the quick actions of first responders, and surgical and rehabilitation teams at Hamad Medical Corporation (HMC).
According to HMC, the complex surgery is thought to be the first of its kind performed in Qatar. Dr Mohamed Murshid Al Delaimi, Senior Consultant, Plastic and Hand Surgeon, said the surgery was a success because of the skill and experience of the involved first responders and medical teams, including the rehabilitation team at Rumailah Hospital.
‘The patient was admitted to the operating room within seven hours of the accident occurring. The delicate re-attachment surgery was completed in nine hours,’ said Dr Al Delaimi, who led the surgical team.
He said the procedure was complex because of the requirement to repair muscles, tendons, arteries, nerves, and veins. Much of the surgery was performed using specialised instruments under a microscope.
‘There are a number of steps in the replantation process. After the damaged tissue was removed and the bone stabilised, the surgical team connected the arteries, veins, nerves, and tissues of the amputated portion to the forearm using microscopic surgery. Through his efforts working with our rehabilitation team, the patient has been able to resume many of his normal daily activities,’ said Dr Al Delaimi.
Dr Al Delaimi added that the complex surgery was a team effort, noting that Dr Mutasim Al Mahi, Orthopedic Surgery Specialist and Dr Fadi Bouri, Orthopedic Surgery Resident, were instrumental in stabilising the forearm bones.
‘The goal of replantation surgery is to give the patient back as much use of the affected body part as possible. In order to allow the hand surgery team to focus on their work of reconnecting the blood vessels and to get blood flowing properly again, it was first necessary to create a strong foundation by repairing the damage to the bone,’ said Dr Al Mahi.
In addition to the skill of the medical and surgical teams involved, the success of a reattachment surgery depends on a number of factors, including the patient’s overall health and the damage to the affected body part. Getting the nerves to work again, restoring feeling, and stimulating new nerve growth is often the bigger challenge and can involve several months of rehabilitation.
‘Two months after the surgery, the surgical and orthopedic team re-evaluated the fracture, replacing the external fixation device with an internal fixation device using wires, plates, and screws. This allowed the patient to move his arm uninhibited. We also checked to ensure the bone was healing well and that there was good blood flow,’ added Dr Bouri.
Dr Iqbal Rasoul, Plastic and Hand Surgery Specialist, credits the level of coordination between the involved care teams and the condition of the severed limb, which had been preserved in ice, as major factors in the successful outcome of the surgery. He said the speed with which the Ambulance Service responded and the skills of the emergency, surgery, and rehabilitation teams provided Jay with the best possible chance of recovery.
Dr Mohammed Hassan Al Fahal, Orthopedic Consultant, Dr Moeen Al Kildi, Specialist Anesthetist, Dr Dhari Abdulateef Mohammed Almenshid, Resident Anesthetist, and Monica Liblan, Occupational Therapist, were also part of the care team involved in Jay’s surgery and rehabilitation.
Jay, who was transported to Hamad General Hospital by the Ambulance Service’s Life Flight Service within minutes of the accident,said his recovery exceeded his own expectations. He underwent several months of rehabilitation after his reattachment surgery but says within three months of the accident he felt no pain in his arm. He expressed his gratitude towards his care teams and HMC, thanking all those who helped him on his recovery journey, including his colleagues.
While accidental limb amputations are not common, it is important for all members of the public to have some understanding of first-aid treatment for this type of injury. Medical experts recommend applying firm pressure to the impacted area, ideally using sterile gauze. The amputated limb should be preserved by wrapping it in damp, sterile gauze or fabric and sealing it in a plastic bag, free from air. The plastic bag should be placed on a bed of ice or water. Placing the severed limb directly on ice should be avoided as this can cause more damage and reduce the possibility of successful reattachment.
