Entangled in a sunscreen jacket into a motorbike wheel, a 4-year-old girl in Tuyen Quang had her right arm completely severed. After nearly 6 hours of limb anemia, doctors at Central Military Hospital 108 performed a complex microsurgery, successfully replanting the arm for the patient.
Central Military Hospital 108 has just successfully performed a case of replanting a severed arm for patient N.B. N, 4 years old, Tuyen Quang after a serious traffic accident due to a sunscreen jacket being caught in a motorbike wheel.
According to family members, the accident happened at about 7 am on July 27, 2026. At that time, the baby was sitting behind the motorbike and wearing a sunscreen jacket. While moving, the jacket was caught in the wheels, causing the baby's right arm to be pulled and completely severed.
Immediately after the accident, the child was given first aid at a local medical facility. The severed limb was properly preserved in a cold environment before being transferred to Central Military Hospital 108. About 5 hours after the injury, the child was brought to the hospital in very serious condition.
Immediately upon admission, doctors from many specialties including Emergency, Anesthesia and Resuscitation, Pediatrics, Vascular Surgery and Upper extremity Trauma - Microsurgery consulted urgently and decided to perform emergency surgery to reconnect the arm.
According to MSc. Dr. Nguyen Van Truong, Department of Upper extremities Traumatology and Microsurgery, the team recorded that the entire right arm of the patient was pulled and severed horizontally at 1/3 of the upper arm position. There was also a brachial epithelial fracture and a crank crest fracture. The blood vessels and nerves were damaged by the mechanism of pulling, so they could not be connected directly.
Doctors performed dissection of crushed tissue, fixed the bone to the correct anatomical position, and used a visible venous segment taken from the calf to graft and restore the brachial artery and venous system. At the same time, the ulnar nerve segment was used as a graft to regenerate the medial nerve and dermal nerve.
After about 3 hours of stressful surgery, the team successfully restored circulatory circulation for the severed arm.
According to Dr. Truong, this is one of the particularly difficult surgeries because the lesion is caused by a striking mechanism, causing dissectional structures to be destroyed on a large scale. The patient is only 4 years old, so the size of blood vessels and nerves is very small, requiring microsurgery techniques with very high accuracy. In addition, the bleeding time of the limb lasting nearly 6 hours also significantly increases the risk of complications.
Another challenge is the risk of re-irrigation syndrome after restoring blood circulation. After a long period of anemia, metabolites accumulated in the limb can return to the body according to blood flow, causing metabolic disorders, blood clotting disorders, multiple organ failure, and even life-threatening.
To limit this risk, specialties have closely coordinated to minimize the time of anemia, quickly restore circulation and closely monitor systemic complications throughout the surgery process.
Currently, the patient is continuing treatment at the Department of Pediatrics. After surgery, the forearm and right hand are warm and pink, circulation is maintained well, showing that the arm has been effectively irrigated. Due to widespread soft tissue damage and the risk of edema after circulatory regeneration, the surgeons proactively sewed the incision sparsely to create conditions for fluid drainage, reduce tissue pressure and facilitate monitoring.
