Female patient L.T. D, 53 years old in Hanoi, works as a construction worker at a construction site. According to relatives, the accident happened at about 5:30 pm on May 12 when she was cleaning the concrete mixer at the end of working hours. While operating, her left glove was suddenly tightly wrapped by the curoa cord, pulling her whole hand into the machine.
The accident caused the third finger (middle finger) of her left hand to be almost completely severed, exposing the bone tip and severe soft tissue damage. Immediately after that, she was taken by colleagues to the emergency room at the National Hospital for Tropical Diseases.
According to Dr. Duong Manh Chien, Head of the Department of Plastic Surgery and Interdisciplinary Surgery, when admitted to the hospital, the patient was still conscious but the injury to the finger was very complex. The third finger was almost completely severed across the horizontal circumference of the proximal intervertebral joint, blood vessel damage on both sides, only a small patch of skin about 0.5 cm remained.
The image of the fingertip slumped, pale white, and no blood leaking when pinched is a typical sign of complete stopping blood supply to the finger. X-ray results show images of near intervertebral dislocation accompanied by severe soft tissue edema," Dr. Duong Manh Chien said.
Doctors determined that this was a particularly dangerous situation because the finger was not completely severed but still had a small part of skin attached, so it could not be refrigerated as in the case of complete severance. At that time, the finger falls into a state of "hot blood shortage", with a very high risk of necrosis if the blood vessels are not reopened within 6-12 hours.
Determining this to be an emergency case, the surgical team immediately took the patient to the operating room. During the surgery, doctors recorded very severe injuries: fractured third finger on the left hand, near joint dislocation, complete severance of blood vessels, nerves on both fingers and the entire tendon system.
This is a difficult case because the damaged area is large, complex with many components. It is not a sharp cut but a torn wound, causing blood vessels and nerves to be bruised and severed into many sections," Dr. Duong Manh Chien shared.
Under the surgical microscope, doctors proceeded to fix the bone, stitch up the micro-vases to restore the blood supply, and at the same time reconnect the nerves and tendons. After nearly 4 hours of stressful surgery throughout the night, the first positive signs appeared when the finger gradually turned pink again, warmed up and blood circulated normally.
After two days post-operative, the patient's health stabilized. The connected finger showed signs of good recovery, no cyanosis or blood clots appeared. According to the treatment protocol, the patient will have a fixed nail removed after about a month and begin to exercise to restore function. However, because the nerve is completely severed, the sensory recovery process can last at least 6 months with active physical therapy.
