Hand microsurgery boom at Clinica Pederzoli: complex reattachments
Tour de force centered on microsurgery for the team of the hand surgery center at Clinica Pederzoli. Over the course of a week, doctors Alberto Donadelli, Nicola Collini, and Cristof Fulco, coordinated by head Ruggero Testoni, performed three procedures: reattaching two fingers first, then a hand, and finally a thumb.
The intensive week of work began last Thursday when a young retiree from Valpolicella, with a do-it-yourself hobby, showed up at Clinica Pederzoli with two fingers missing from his right hand: the ring and little fingers. “It was a circular saw that caused the clean cut,” explains Dr. Donadelli. “In such cases, the task is easier compared to a crush-type amputation, although the operation still qualifies as microsurgery. Everything went well, and the patient was discharged.”
Microsurgical procedures
More complex was the procedure performed last Saturday, when an Vigasio-based waste transport worker arrived at the hospital. As he was descending from his truck, a steel bar fell onto the back of his hand, causing nearly complete amputation of the limb. “In this case, we had to perform a highly complex bone fixation of the fingers,” explains Donadelli. “Additionally, we reconstructed tendons and carried out microvascular nerve and blood vessel reconstruction essential for hand viability. Again, the operation was perfectly successful—it was the first stage, aimed at saving the hand’s function, with further surgeries planned to improve function and remove potential adhesions. The full team worked for over four hours.”
Microsurgery involves the use of a microscope, meaning the surgeon operates with a binocular device that magnifies the view and allows for stitching very small blood vessels—using threads thinner than a hair and not visible to the naked eye—as well as tiny needles.
Thumb surgery
The third operation was performed the day before yesterday, when an operator from Trento arrived by helicopter after a steel pipe cleanly severed his right thumb. “The thumb is a special finger,” explains Donadelli, “the most important of the hand because it allows opposition of the fingers and thus enables grasping objects. For this reason, reattaching the finger in the best possible way is crucial to maximize functionality. It’s still early to assess the outcome since, in the initial days, the patient cannot move the hand and is on anticoagulant therapy, but technically, the operation was successful.”
To maximize the chances of a successful procedure, it is vital to properly preserve the amputated part of the hand. If done correctly, it can survive for up to eight hours; otherwise, efforts by surgeons risk being rendered futile. “The best method,” confirms Donadelli, “is to place the finger in an empty, sealed bag, which should then be stored in a container, ideally isolated and filled with ice. This method is the most appropriate and not simply placing the part in direct contact with ice, which causes cold burns. It’s also not advisable,” as has happened before, “to immerse it in alcohol solutions, which damage the blood vessels.”