November 29, 2005
UCSD Hand Surgeons Charged with Saving Colleague’s Hand
When Rick Bodor, M.D. first got the call on January 19, 2002, about UCSD’s Chief of Vascular Surgery being in the Emergency Room with a multiple finger replantation, he was already busy in another Operating Room reattaching a patient’s finger.
“I thought that my colleague, Dr. Steve Sparks, was merely consulting me on another patient who had injured a hand and lost some digits, little did I know that the Emergency Room was calling me to see him as the patient,” recalls Bodor, a plastic surgeon in the UCSD Plastics and Hand Surgery departments.
Sparks’ dramatic story elicited the interest of the Discovery Health Channel who came to
UCSD to film this re-enactment of the injury, surgeries and recovery for their nationally acclaimed show, Impact: Stories of Survival. The episode will air on April 30 at 6 p.m. and 9 p.m.
A short time earlier, Sparks had been repairing a fence in his backyard. He had finished just ten minutes before company was to arrive for a dinner party at his home. Sparks had reached over the top of the table saw to turn it off when the saw caught the edge of his glove and pulled his hand into the saw.
Thinking quickly, he managed to keep the bleeding controlled by squeezing his hand together. Shortly after, the first guests arrived for the dinner party. Rather than wait for an ambulance, Sparks grabbed a cell phone, jumped in the friend’s car and asked him to drive to UCSD Medical Center in Hillcrest.
In route Sparks called the ER and the OR and told them he would need the hand set-up. Sparks remembers that he already knew some of the fingers weren’t going to be reconstructable.
Bodor called in Matthew Meunier, M.D., a colleague and hand surgeon with the UCSD Orthopaedics department. Meunier and Bodor expedited Sparks into the OR and began working collaboratively on the damage.
Bodor’s microsurgical and plastics focus, and Meunier’s orthopedic and hand focus, allowed each to team up with additional specialty skills to salvage the hand. Bodor focused on the microsurgical vessel and nerve components while Meunier concentrated on the bone, tendon, joint and other areas of the mangled fingers. Together Bodor and Meunier sewed 8-12 micro-sized stitches around each of the multiple tiny one-millimeter vessels and nerves, measuring no larger than the tip of a pencil lead.
“Combining the skills and different perspectives of both orthopaedics and plastics in the OR on a case like this was helpful. As we proceeded, we held team discussions on what we needed to amputate and what we could save,” Bodor says.
Meunier recalls that “The index finger was the worst and not salvageable so we completed the amputation. The long, middle finger we could repair. The ring finger was injured severely but it was further out on the finger so we completed that amputation too. The small finger was beat up but we were able to salvage it.”
The operation was long and tedious. The surgeons spent most of the night in the operating room.
Bodor says that the first 5-6 days are the most crucial on whether reattached fingers are going to make it. The smallest movements, such as making a fist, not elevating the hand or becoming dehydrated, can cause a tiny vessel to clot. Blood thinners are also used but can’t completely prevent clotting. That’s where Sparks stoic and positive attitude played a huge role.
“He was the greatest picture of a patient you’ve ever seen in this situation,” Bodor says. “He didn’t flinch at any aspect. He did whatever was necessary to ensure a good outcome.”
Following the reattachment and amputation surgery, Sparks underwent intensive hand therapy for seven months to restore his range of motion. After he stabilized, Meunier performed several smaller surgeries to remove excess bone and free up some tendons. By fall of 2002, Sparks wanted to return to his own operating duties but was having trouble holding instruments and tying knots.
“I found out once I was injured that you don’t use your index finger to hold instruments, you use your middle finger,” Sparks says. “All you do with your index finger is guide it. Without my index finger I needed another finger for guiding. My ring finger was a little too short to guide an instrument. I needed a little more length. That’s when Dr. Meunier said we could try a distraction lengthener, an innovative way to stretch out the bone. He surgically attached it in September of 2002 and removed it three months later. Twice every day I would turn the screws. It worked. I gained a whole centimeter in length.”
Now he had to relearn how to tie suture knots with his injured hand, so Sparks sat at home repetitiously tying knots around pens and pencils for hours, just like he did in his surgery residency.
These days Sparks is back in the OR and operating with his injured hand. Tying knots and handling instruments is once again so natural that Sparks says when he’s performing renal access or removing varicose veins he doesn’t think about the injury much anymore. In fact, if you ask him if January 19 will forever stand out in his mind, he shrugs and says, “it isn’t that big a thing.” A devastating injury of this type would ground and permanently demoralize a lot of people, but for Steve Sparks it was simply a challenge to overcome.
Sparks’ dramatic story elicited the interest of the Discovery Health Channel who came to UCSD to film a re-enactment of the injury, surgeries and recovery for their nationally acclaimed show, Impact: Stories of Survivial. The episode will air on April 30 at 6 p.m. and 9 p.m.
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