Magic of making patients whole again

SUE FERGUSON

IT WAS A SMALL epiphany. While washing her face one morning, Eva Robles-Hanna stopped short. "Oh my god!" she says, recounting her reaction as she drew the water upwards in her two cupped hands. "What is this?" This was the palm of her right hand -- something she hadn't really seen for 14 years, since rheumatoid arthritis had prevented her from rotating her forearm. The same condition had displaced the 45-year-old former office worker's fingers, causing them to slope awkwardly toward her thumb, and wracking her swollen hand with pain. Cutting food was such torture that, when friends weren't around to help, she'd simply go hungry. But a six-hour operation at Toronto Western Hospital's hand clinic in February changed all that. It is, says Robles-Hanna, "a miracle."

Surgeon and program director Dr. Brent Graham claims no magical power. "We're just very skilled at what we do," he says. That's because the program's four surgeons and 11 physiotherapists focus exclusively on the human forearm and hand, a rare degree of specialization. And with up to 5,000 patients a year -- who suffer everything from carpal tunnel syndrome to paralysis to severed digits -- they get lots of practice.

A jungle of bones, nerves and tendons, the hand demands procedures that bridge orthopaedic, plastic and neurological skills. Graham regularly treats professional athletes, performing artists and other surgeons by sewing up nerves and resetting bones. Last year, he reattached the two arms of a Toronto woman who had been attacked by a neighbour with a machete.

Up to 40 per cent of the program's patients arrive with work-related injuries, like a finger or thumb lost to saws or other machinery. Spring, when the construction industry gears up, ushers in "replant season." In a three-week period this May, Graham performed six of these. One case involved a man whose thumb had been crushed by a 500-tonne press. "In a lot of places," he says, that thumb "would just be thrown in the garbage. Not here." When a thumb can't be saved, however, "we may bring up a toe" and use that in the thumb's place -- an ingenious, if not miraculous, solution.

From Macleans.ca:
http://www.macleans.ca/topstories/health/article.jsp?content=20040621_82887_82887