Medical Aid to Africa︱I Connected the Broken Thumb for the Chinese Compatriot in Africa……

Physician Zhao Xinhua, A member of the 28^th group China Medical Aid Team to Mali and Director Assistant of Orthopedics Department (III) of Zhejiang Hospital dictates his experiences of successfully connecting the broken thumb for fellow patient in Africa——

 “Doctor, save me, my finger is broken!”…At around ten o’clock in the morning on May 18^th, 2022, a sudden cry for help broke the peace of the Mali Hospital in a foreign country.

     The cry for help was from a Chinese compatriot, Mr.Yan. His right hand was cut by a chainsaw and his right thumb was almost broken, only a little connected to his index finger.

    “Send to hospital quickly!”, this was the first reaction from his colleagues, Because they were in a foreign country, they didn’t know the local hospital situation, and the local medical technical conditions in Mali were limited, so they didn’t know where to send him. If sent to a local hospital, it’s very likely that his thumb of the right hand would lose according to the technical conditions and medical level of the local hospitals. Just then, someone reminded the Chinese medical team at Mali Hospital might have the ability, and Mr.Yan saw his hope. His colleague immediately dialed the 24-hour medical duty telephone number of the Chinese medical team to Mali. “Be quick! Immediately come to Mali Hospital, properly wrap his wound with clean clothes, and guide to stop bleeding, the medical team will do our best to keep his finger”. Hearing such a reply, the patient Mr.Yan showed a little at ease and immediately drove to Mali Hospital.

     When the patient arrived at the hospital, it was already more than an hour after the injury. Dr. Zhu Leibo, and I had just finished 3 continuous hours of ward rounds, dressing change and consultation, immediately checked the patient and cleaned the wounds for the patient by wearing our “Class-II protective gowns” regardless of the fatigue, and we accompanied the patient for various preparations before operation, and a “defense war” for broken finger is tensely and orderly undertaken like a race against time.

    However, Dr. Zhu Leibo and I were also "puzzled" after examining the wound of the patient's right hand. The patient’s right thumb was seriously damaged from the interdigital joint to the metacarpal transverse pattern, irregular muscle tissue section, the first metacarpal bone and phalanx were exposed, the metacarpopareal joint was damaged, the proximal wound was largely fresh and bleeding, only about 5 mm of the skin and soft tissue were connected, and the thumb broken end was pale.

“What to do, could the thumb be saved?”, “If the broken finger needs replanting, are there corresponding surgical instruments, materials and equipment?”, “Are there corresponding therapeutic drugs?”, “The C-arm machine of the hospital has been broken for a long time”, “there is no microscopy and the fine sutures for suturing the blood vessels and nerves”, “if the blood vessels and nerves cannot be sutured, then the patient’s thumb might lose”, Dr. Zhu Leibo and I discussed tensely. Many problems were placed in front of us, but the patient’s condition was urgent, looking at the patient’s expected eyes, we decided to “grasp the nettle”, in order to keep the patient’s thumb, we must create conditions even there were no conditions. At 13:00 on May 18^th, 2022, a finger-saving operation was conducted at Mali Hospital in a foreign country by racing against time.

During the operation, it’s examined to find out the right thumb was nearly disconnected at the metacarpophalangeal joint, the section had serious contusion and tear, and the wound surface was seriously contaminated. The blood vessels and nerves from the ulnar side to the thumb were broken. Fortunately, the dorsal artery continuity of the patient's right thumb remained, and we saw hope of preserving the patient's thumb. Careful debridement, fracture reduction, articular surface fixation, vascular suture, tendon repair, and the operation was performed methodically. Finally, with the precise cooperation of nurse Zhang Ruxin in the operating room, the operation ended successfully after nearly two hours of operation.

    On the morning of May 19th, during the ward rounds, when we saw the “ruddy” thumb of his right hand, the hanging hearts of our two orthopedic surgeons were finally relieved, and the right thumb of the patient was saved. The fellow compatriot Mr. Yan had calmed down, but he still had a lingering fear when mentioned about the scene at that time, because a simple action had brought himself a lifetime of unforgettable pain. However, Mr. Yan felt he was very “lucky” when he saw his thumb was saved.

Currently, after nearly three weeks of treatment, the wound of Mr. Yan’s thumb of right hand is free from obvious infections, the skin is free from obvious necrosis, and the thumb has a good feeling and blood supply. “Thanks to the Chinese medical team, thanks to the motherland, and thanks to the Chinese medical team!”, Mr.Yan sighed heartily and wrote a thank-you letter to the medical team with his index finger and middle finger of his right hand.