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Innovative Technique Saves Farmer's Hand

A new technique at SIU Medicine helped save a man’s hand after a farming accident in rural Jacksonville this fall.


Tim Daugherty, MD, a plastic and reconstructive surgeon with the Department of Surgery, performed an "ectopic banking" procedure for the patient, Benjamin Heinemann, when silage machinery severed half his hand.


The accident occurred on his sister's property. As soon as it happened, the amputated fingers were put on ice and he was driven to Jacksonville Memorial Hospital.

Hospital staff then contacted Springfield Memorial Hospital to arrange a transfer.


Dr. Daugherty was on call for his first weekend of hand trauma emergencies at SIU Medicine plastic surgery. He had just returned to Springfield after completing an extensive hand fellowship in Baltimore, Maryland at the Curtis National Hand Center.


“I had them send me some photographs and I immediately started planning the surgery," said Daugherty. The fingers were damaged but in one piece. Daugherty prepared to use ectopic banking, a revolutionary technique that temporarily reconnects an amputated body part to the patient for later replantation.


As Heinemann was prepared for surgery, Daugherty focused on the amputated portion of the hand. During this initial operation, the doctor and his team used microsurgery to repair structures in the hand, tagging tendons and nerves for later identification. Daugherty then attached the amputated portion of Heinemann's left hand to his right forearm.


This was the first time the ectopic banking procedure had been performed in the Midwest.


Over the next 6 weeks, Heinemann recovered at Springfield Memorial Hospital while his medical team closely monitored the banked portion of his left hand. This allowed for blood vessels to grow into the fingers to aid in replantation.

Six weeks after the accident, Daugherty determined the left hand was ready to reattach. During the 12-hour surgery, Daugherty and a team of surgeons and residents from the Institute for Plastic Surgery lifted the fingers from the right forearm and reattached them to Heinemann’s left hand using microsurgical anastomosis, a technique requiring optical magnification through an operating microscope or loupes.

Because SIU Medicine is a relatively small academic medical center, Heinemann and others have been surprised that such a revolutionary and complex surgery is available in central Illinois. For Springfield native and SIU School of Medicine alumni Daugherty, it's a well-known fact -- and one that led him to return to the Land of Lincoln following his Baltimore fellowship.

The replantation surgery was successful, with positive results so far. Heinemann has been released from inpatient care and given time for his bones and tissue to heal. He will undergo months of hand therapy at the Institute for Plastic Surgery. There will be future surgeries to reconstruct nerves and reinsert tendons. The hope is that he will regain function and dexterity as well as sensation, Daugherty said.



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