Bilateral hand amputation

Case contributed by Jeffrey Cheng
Diagnosis certain

Presentation

Self-afflicted injury made by slicing both hands across buzzsaw following history of mental health issues.

Patient Data

Age: 70
Gender: Male
x-ray

Bilateral hand amputation from the distal carpal row.
Amputation of the left first proximal phalanx.
Amputation of the right second middle phalanx.

Normal radiocarpal joints, bilaterally.

Case Discussion

The patient was taken to emergency theater on the same day for reimplantation of both hands with good results. Although most of the intrinsic hand function was lost, some grip strength was reconstituted due to tendon reconstruction.

Three years after the initial injury and reconstruction the patient has significant flexion capabilities bilaterally. He is able to flex his MCPJ to 45°, his PIPJ to 90° on both hands and is able to grasp small objects. His mood has significantly improved secondary to appropriate psychiatric involvement.

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