The following article was published in The Toronto Star on Jun. 13, 2003.

GAVIN TAYLOR
STAFF REPORTER

A patient arrives at a hospital with a finger or and violently hacked off, the severed appendage in an ice box. It's a scene that surgeons in the University of Toronto hand program see more than 50 times a year.

On Wednesday night, the victim of a machete attack was brought to Toronto Western Hospital, where surgeons from the program started operating to reattach her severed hands. Dr. Herb von Schroeder, one of three hand surgeons at the hospital, says the procedure succeeds in over 80 per cent of cases, a surprisingly high rate for a gruelling operation that typically takes six to eight hours.

Hospitals regularly reattach ears, feet and other body parts. But hands are a special case because of the delicate anatomy.

"It takes dozens of joints and muscles just to make a fist," Schroeder says.

When a hand is cut off, surgeons must refit the dense network of bones, nerves, tendons and blood vessels that make these motions possible.

The doctor begins by fitting the skeleton back together, attaching finger bones with fine stainless steel wire and aligning larger bones with metal plates. Work then proceeds on the back of the hand, as the doctor stitches together tendons and uses a microscope to repair veins that are the size of thick hairs.

Using only fine-tipped scissors, needles, and forceps, the surgeon stitches sutures barely visible to the naked eye, rebuilding blood vessels and more than a dozen veins. The same procedure is repeated on the palm.

The patient's arm is wrapped in bandages for two weeks after the operation. It might take an entire hand four months to grow its nerves again, at a pace of one millimetre a day.

"It's not like an electrical cable that you just hook up and it starts to work," Schroeder says.

By the time patients remove their bandages, they are able to wiggle their fingers and feel some sensation.

But it usually takes a year of physiotherapy before they regain most of the functions of their hands.

"It's rewarding when you see how grateful the patients are," Schroeder says.

The original article can be viewed here.