Amputation to Reimplantation

MUHC Surgeons reattach amputated arm

Thanks to the expertise of McGill University Health Centre surgeons, Louis Côté will be returning to his home in Rivière-du-Loup with his severed arm saved. After 11 hours of delicate surgery, MUHC plastic and orthopedic surgeons reimplanted Côté's arm following a sawmill accident. Côté will leave the hospital soon and his surgeons anticipate that he will regain function of his arm and hand.

Time was extremely important for the success of this surgery. Thanks to the quick assessment and transport of Côté from a community hospital in Rivière -de-Loup to the MUHC, damage to his arm was minimized said Dr. Chen Lee, the MUHC Chief of Plastic and Reconstructive Surgery who operated on Côté. "We are extremely pleased with the success of this operation," he says. "As a lead tertiary-level trauma centre for the province of Quebec, we are well equipped and prepared to perform this kind of procedure and in Louis's case the entire system worked well to ensure that he got the care he needed as quickly as possible."

Following his arrival at the MUHC, Côté underwent immediate surgery. This procedure was completed in five steps:

• Bone preparation and attachment
• Microsurgical repair of the blood vessels
• Repair of 25 tendons to the hand and wrist
• Microscopic repair of three major nerves to the hand
• Skin closure

Following his discharge from the hospital, Côté will spend many hours in occupational and physical therapy. It is anticipated that he will have muscle control after two months and return of sensation after one year.

"Amputation can be a devastating injury," says Dr. Lee. "The ability to reimplant successfully increases the potential for a better quality of life, and removes the emotional trauma associated with the injury. Whereas microsurgical reimplantation was a notable feat just 20 years ago, it has become commonplace in specialized trauma centres such as ours." The MUHC is one of four Quebec institutions designated in 1992 to provide advanced trauma care for severely injured patients. The MUHC is contributing actively to the development of Quebec's trauma system and has embraced the trauma mission as a priority program.

There are approximately 150 to 180 reimplantation surgeries performed annually in Quebec. Most amputations occur in adults between 21 and 30 years of age.