The month of August 2023 will be marked as a record-breaker for the Hand Surgery Unit at Rambam Health Care Campus (Rambam) in Haifa, Israel. Seven hand surgeries, primarily work accidents involving a circular saw or broken glass, were performed in less than a week – an unusual concentration of such cases – even at the global scale.
Photo: Dr. Alex Munteanu during a hand microsurgery procedure. Photography: Rambam HCC
Within six days, seven complex hand surgeries were performed to repair the tendons, nerves, and blood vessels of the patient’s hands. All but one of the injuries were work-related: four injuries were incurred while working with a circular saw and three involved deep cuts from broken glass.
According to Dr. Alex Munteanu, a resident in hand surgery and microsurgery at Rambam, one of the primary dangers in working with circular saws is losing control of the machine. “Victims from these injuries report that it is easy to lose control of this type of saw when changing the angle of the cut. The way the device is designed, as the angle changes, it pulls on the user’s hand and within seconds, their hand is cut instead of the work material. This is a particularly dangerous tool that requires great caution and skill to operate.”
In medical jargon, this kind of injury is called a “spaghetti wrist injury” due to the appearance of the injured hand “All the flexor tendons were damaged in the hand of the last patient who came to us, in addition to two arteries and two nerves,” Dr. Munteanu, explains. “It was a classic spaghetti wrist. Most of the patients that treated this past week came to us with similar injuries.”
Treatment in these cases is very complex and requires delicate and complex microsurgery (using a microscope for visualization). Due to the type of injury, the tendons, nerves, and veins are often cut in a jagged or ragged manner. The surgeon must locate smooth margins for fusing (reconnecting) the tendons, nerves, and veins. The entire procedure takes at least six to seven hours.
According to Dr. Munteanu, all seven men were treated successfully by the surgical team at Rambam. “The hands of all the patients are out of danger and functioning. Everyone can move their fingers and we will soon know if the sense of feeling was also preserved.”