Andhra Pradesh - Guntur   

Delicate surgery performed

GUNTUR: A city -based orthopaedician Surat Amarnath has given a second lease of working life to a factory worker, who lost his right thumb in an industrial accident.

The worker hailing from Ailavaram village in Bhattiprolu mandal of Guntur district lost his thumb, except for the bone at the centre, while working in a mill here in Guntur on March 21.

With the thumb functionally taking care of 60 per cent of the activity done with five fingers/palm, Kumar had lost all hopes of returning to work with same kind of skills. When he approached the orthopaedician at Guntur, the cut organ was of no use to sue it back or attach it, said Dr. Amarnath while presenting the patient before journalists to show how freely he was able to do some work on Saturday evening.

The usual practice of micro-vascular reconstruction was not possible in this case, so he chose to use the Chinese flap method, which helped the industrial worker regain the shape of his thumb, though it looked bulged now.

He even had two fractures in the hand. Explaining the procedure of grafting skin from the forearm to thumb and the second stage of surgery to be done for grafting sensory skin from the fingers so that he could have the sensation on the thumb, he said the procedure had become popular in China in 1980s.

The operation was done at the Amar Orthopaedic Hospital. He said that the Chinese method was a fascio-cutaneous flap raised on the volar aspect of the forearm based on the radial pedicle axis which can be used either pedicled or by microsurgical free transfer.

In hand and thumb reconstruction, it is used as an island flap vascularized by a reverse flow from the ulnar artery via the palmar arch. The possibility to raise a composite flap with vascularized bone or tendons make the Chinese flap very useful in hand reconstruction, he added though the practice was rare in India.

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