Viet Duc University Hospital successfully performed a surgery on emergency for reconstruction of the nearly amputated arm of an 18-year-old girl caused a traffic accident due to her sun protection clothing.

25/12/2023 09:26

Recently, doctors from 3 specialties: trauma, micro and plastic surgery, cardiovascular and thoracic surgery at Viet Duc University Hospital (VDUH) successfully performed surgery on emergency for reconstructing  the nearly amputated arm of an 18-year-old girl NKH (Vinh Phuc province) had a traffic accident due to a sun protection clothing.

Ms. NKH was admitted to the hospital with a nearly amputated left arm, blood loss, and pale. According to Ms. NKH and her family, on October 19, 2023, while being transported by her husband on a motorbike, her sun protection clothing got wrapped around the wheel and pulled her arm. The process happened so suddenly that the patient was unable to react in time, causing severe arm damage.

 A medical facility in Vinh Yen gave the patient first aid and immediately transferred to VDUH. At Viet Duc, experts diagnosed the patient with very serious injuries, including the broken left forearm and arm, dislocated elbow joint, severed injuries of vessels and nerves in the arm, crushed soft tendons and muscles in the arm, the extremities were so cold and loss of movement sensation.

Doctors on duty were together to consult and evaluate carefully the patient’s injury before surgery

Three surgical teams including Trauma Surgery, Vascular Surgery, and Micro- Plastic Surgery have continuously coordinated to evaluate on the complex injury to the patient’s left arm. The patient was indicated for surgery after resuscitation at the emergency room.

The teams of the Upper Extremities and Sport Trauma Department performed debridement of crushed soft tissue, nailing of the arm and forearm bones, correction of dislocations, and suturing of muscle tendons, Dr. Phan Ba Hai, MD, PhD – Deputy Chief of Upper Extremities and Sport Trauma Department shared.

Dr. Phan Ba Hai, MD, PhD – Deputy Chief of Upper Extremities and Sport Trauma Department checks the patient’s arm situation

The team of the Cardiovascular and Thoracic Surgery has quickly connected the arteries and vessels to supply the blood to the arm for Ms.NKH, according to Dr. Hoang Trong Hai, MD, MSc – Department of Cardiovascular and Thoracic Surgery.

 

The Micro and Plastic Surgery team has checked the patient’s brachial nerve ending, removed the crushed part and reconnected it with 4 nerves; tiny bundles of nerve fibers are meticulously reconnected through microsurgery, Dr. Bui Mai Anh shared.

Specialists in the Department of Maxillofacial Surgery – Plastic Surgery – Aesthetics, VDUH regularly check the recovery level of arm after emergency surgery for Ms.NKH

 

After surgery, the patient regained consciousness, her hemodynamic was stable, her operated arm was warm with the soft tissue defect. The doctors of VDUH did try the best to save Ms. H’s left arm.

After one week for following the infection and using antibiotics, Dr. Bui Mai Anh, MD, PhD – Department of Maxillofacial, Plastic and Aesthetic Surgery performed thigh skin grafting surgery for the left arm of the patient. ” When the completion of repair of the nerves and nerve arm has done, grafting the hand skin will be considered to ensure aesthetics and psychology for the patient”, Dr. Bui Mai Anh shares.

The doctors shared: fortunately, the patient received proper first aid from a other medical facility and was promptly transferred to VDUH, and the amputated arm was preserved correctly. If there was a delay, the patient could go into shock due to 3 reasons: blood loss, traumatic pain, and infection. Even if specialists do not operate promptly, the patient will quickly develop arm necrosis, require completed amputation, or, in the worst case, the patient will die.

Dr. Bui Mai Anh, MD, PhD successfully performed an arm skin graft for Ms.NKH

At the moment, the patient is fine, can be discharged from the hospital. However, she needs to be evaluating again the function of her arm. Once the wound is healed, the patient will be undergoing the rehabilitation to gradually regain the ability to move the arm, to keep her body balance and to reduce difficulties in her daily life.

NKH patient’s arm before and after grafting skin

Viet Duc University Hospital regularly receives the patients who have had  accidents and injuries caused by sun protection clothing or raincoats. For that issue,  everyone is recommended to choose the appropriate sun protection clothing or raincoats, be careful and pay attention when using shirts with long flaps in motorbikes, bicycles, electric motorbikes and electric bicycles ensuring absolute compliance with the traffic law. When the accident is happening, it is necessary to give the first aid to the patient as quickly as possible and, at the same time, take the patient to the nearest specialized medical facility for timely treatment.

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