Aberdeen surgeons pioneer hand surgery in the UK
A Russian professor of hand
surgery is visiting Aberdeen in
Scotland to teach a pioneering
technique to lengthen congenitally
underdeveloped or amputated
fingers. Professor
Husseinali Ismailov, head of
hand and foot surgery at the
Russian Ilizarov scientific centre
for restorative traumatology and
orthopaedics in Kurgan, Russia,
is teaching his method (the
Ilizarov method, or transosseous
osteosynthesis) to plastic and
orthopaedic surgeons at
Aberdeen Royal Infirmary.
Professor Ismailov said, "The
technique involves external fixation
of the long, small, and
spongy bones in which wires are
passed through the skin and
bones and attached to external
rings and other metal supports
connected by rods. Also, the
technique involves performing
various types of osteotomy to
break the bone to lengthen, correct
its deformity, and form a
new shape.The wires then pull
the broken fragments apart in
the desired direction and the
tension along the rods is gradually
increased so that the bone
grows at a rate of 1mm per day."
The technique originated in
Russia in 1951 and has been
established in the West since the
1980s for leg lengthening, nonunion,
correction of deformities,
and tibial fractures. Although
British orthopaedic surgeons
learnt this technique in 1995,
this is the first time that hand
and foot surgery using the
Ilizarov method will be taught to
British surgeons, who intend to
develop a centre of excellence
for this technique in Europe.
The professor was invited
to Aberdeen after Mr
Paddy Ashcroft, a consultant
orthopaedic surgeon, visited
the Russian centre. Mr Ashcroft
said, "The Ilizarov method can
be used to regrow fingers
which will allow useful function
and a return to a relatively normal
life. Within Aberdeen, we
have a number of patients who
have lost all their fingers, or the
majority of fingers, due to accidents
at work. Many of these
come from the oil, fishing, or
forestry industries. It will make
such a difference to the quality
of life of many people, especially
the number of younger fit men
in the oil industry who have
accidents where digits are lost
and cannot work without them."
Mr David Metcalfe, an engineer
from Cheshire whose
index, middle, and ring fingers
of his dominant hand were surgically
amputated after a crush
injury at work, is one of the first
patients in the UK to benefit
from the surgery. The middle
finger has been treated first as it
sustained the greatest loss. He is
clearly delighted with the
increased length, believing "the
surgery has made me more confident
and will enable me to grip
things far more securely." His
surgeon, Mr John Holmes, said
that although the technique was
very promising, only four
patients had undergone the
treatment; so the results needed
to be evaluated before more
patients could receive this form
of hand surgery.
Roger Stevens, Aberdeen
More information can be found out at www.ilizarov.ru/
studentBMJ 2001;09:217-260 July ISSN 0966-6494
