Doctors at Binh Duong General Hospital have successfully reattached the right hand of a 20-year-old pregnant woman who suffered a traumatic amputation in a workplace accident. For two months prior to the reattachment, the hand had been temporarily grafted onto the patient’s leg to preserve blood flow and tissue viability.

The patient, L.N.P., was admitted in September after the lower third of her right forearm was crushed and the hand completely severed. At the time, she was 23 weeks pregnant with twins. In a high-risk decision, doctors grafted the severed hand onto her right lower leg - a rare microsurgical technique requiring extreme precision to sustain living tissue during the waiting period before reattachment.

On November 17, the patient returned to the hospital in stable condition. Ultrasound scans confirmed that both fetuses, now at 34 weeks, had strong heartbeats and normal amniotic fluid levels. The patient expressed a strong desire to have her hand reattached, both to regain function and to care for her children after birth.

Recognizing the extraordinary nature of the case, the hospital convened a multi-disciplinary consultation involving anesthesiology, orthopedics, obstetrics, intensive care, hematology, and nutrition departments. They also sought expert advice from major referral hospitals such as Cho Ray Orthopedic Hospital and Tu Du Obstetrics Hospital in Ho Chi Minh City. Throughout the surgery, fetal heart rates were monitored continuously to ensure maternal and fetal safety.

The surgery lasted several hours and required a series of complex, high-stakes procedures:

The team first detached the hand from the leg graft, including a 15cm segment of the posterior tibial artery to facilitate revascularization.

They prepared the forearm stump and used plates and screws to fix the radius bone.

One artery and three veins were connected to restore circulation to the hand.

Tendons and nerves were reconstructed using grafts taken from the peroneus longus tendon and superficial peroneal nerve.

With meticulous precision and complete concentration, the surgical team completed the procedure successfully.

Post-surgery, the reattached hand was warm and pink, with excellent blood flow and oxygen saturation (SpO₂) of 98–100% at the fingertips. The patient was alert, able to eat, and already showing slight finger movement with the guidance of physical therapy. Both fetuses remained stable with regular heartbeats and no signs of distress.

The case is being hailed as a remarkable success - not only in preserving a vital limb but also in safeguarding the patient’s ability to care for her children. It stands as a testament to the advanced microsurgical capabilities and the coordinated teamwork across specialties at Binh Duong General Hospital.

Phuong Thuy