Surgeons rebuild teenager's hand

As a result of an horrific car accident teenager Kim Murray has endured more than most girls of her age and is now on the road to recovery thanks to surgeons at the Norfolk and Norwich University Hospital.

16-year-old Kim, of Felixstowe, was involved in a car accident that left her hand very badly injured. Now she is getting used to a “new” hand that has been built by plastic surgeons using bone from her pelvis to make new fingers, tendons from her wrists and ankles, and skin from her groin.

Kim was a passenger in a friend's car driving on to the Orwell Bridge, Ipswich, when the car rolled over on Saturday June 10 just after 1pm. It was a hot summer's day and the sunroof was open. Instinctively Kim raised her arms to protect herself but her right hand went out the sunroof and was badly damaged as the car skidded down the road.

Unconscious, Kim was unaware of the arrival of the ambulance and her mind has blacked out much of what happened in the immediate aftermath of the accident. She was taken to the A&E department at Ipswich Hospital where she was stabilised before her transfer to the Norfolk and Norwich University Hospital (NNUH).

At NNUH the plastic surgery team were set up to carry out an operation that evening to clean up the extensive injuries to her arm and minimise the chances of infection. A second operation followed to build new tissue into Kim's damaged hand. This involved a free flap of skin, fat and blood vessels taken from the groin.

This was then transposed to the hand, and the artery and vein were sutured under the microscope to blood vessels at the wrist to keep the flap alive.  The flap was then positioned and sewn on to the hand.

Kim, a student at Deben High School, Felixstowe, recalled: “I can't really remember the accident and with all the morphine and stuff I had been given I couldn’t really think about any of it afterwards. It was only after the first operation that I could begin to get my head round it.”

The eight-hour operation, carried out by consultant plastic surgeons Miss Elaine Sassoon and Mr Jon Clibbon and team, involved a number grafts with bone taken from her pelvis, tendons from her wrists and ankles plus skin from her groin in order to rebuild her hand.

Plastic surgeon Miss Elaine Sassoon said: “It was really quite an horrific injury and Kim had lost a lot of skin from her fingers to her wrist and, unusually, also quite a lot of bone from her hand in the road accident. She had effectively lost three fingers. We could not use a simple skin graft to the hand because the injury was so bad, so living skin via a free flap was used.
We effectively reconstructed the three fingers as well, using tendon and bone grafts. The aim is to restore the cosmetic appearance as well as function.”

During the long operation Miss Sassoon harvested the bone from Kim's pelvis and it was then shaped by Mr Jon Clibbon for grafting into her fingers and skin was taken from the groin in order to provide a free flap graft for the hand.

Kim will now need a year's worth of rehabilitation work with physiotherapists and is likely to undergo two further operations to improve her new hand cosmetically.

Kim's Dad, Stuart, said: “All the staff at the hospital have been fabulous, from the surgeons and nurses right through to the ward and canteen staff. It's been a traumatic experience but she's been very well looked after.”

Friday 18th of August 2006 09:00:41 AM