Microvascular Hand Surgery Saving Limbs and Restoring Function

Denver Health Orthopedics Cutting-Edge Surgery Salvaging Severely Injured Hands

If you find yourself in the unfortunate situation of having a severe injury to an arm, hand or finger, such as through a car wreck, bad encounter with heavy machinery or a slip up with a kitchen knife, Denver Health is here for you and this is where you want to be for your treatment.

Surgeons in our leading Orthopedics Department are salvaging hands of some of the most severely injured patients in the country. The specialized team provides the only academic (and longest-running) 24/7 hand micro-vascular replantation services for adults and kids in the eastern Rocky Mountain states.

According to Denver Health's chief of hand and microvascular surgery, Kyros Ipaktchi, MD, Denver Health has been the foremost provider of hand microvascular care in Colorado and has maintained a core group of specialists in this area for the last two decades.

What is Microvascular Hand Surgery?

The hand contains several essential structures that are on the microscopic level, such as nerves and blood vessels. You have probably heard about orthopedic doctors getting involved when a bone is broken in your arm, hand or finger, but whenever blood vessels and nerves in the hand are injured, it is necessary to bring in a specialist who is trained to make the necessary repairs under a microscope. This type of surgery often uses sutures which are thinner than a human hair.

These types of surgeries can be very long, lasting up to 10 hours and require not only the surgical specialists to be successful, but also highly trained operating room technicians and nurses. "Without that support, we could not do these types of surgeries," said Dr. Ipaktchi.

Examples of Hand Microvascular Surgery

Patients who need microvascular surgery or hand reconstruction surgery often arrive at Denver Health after being flown here on a helicopter, from all over the eastern Rocky Mountain Region. "These injuries are dismal, and the only hope of saving limbs and restoring function is to get patients to a center like ours right away," said Dr. Ipaktchi. Over the past five years, more than 120 hospitals have referred patients to Denver Health for limb salvage, from as far away as Montana, South Dakota, Kansas and New Mexico.

Some examples of severe hand injuries treated through microvascular surgery or hand reconstruction surgery include:

• Severe, deep cuts to the hand that go into the nerve
• Hand and finger amputations
• Having a hand or arm crushed to the point where the blood flow is interrupted
• Nerve damage caused by too much pressure or stress on the arm or hand (brachial plexus)
• Injuries caused by cancer

 

"While we cannot save every limb – we can assure each patient that we will do whatever possible to give them the best chance," said Dr. Ipaktchi. "We have saved many limbs and fingers and have a lot of grateful patients and parents for the care they received here by the hand microvascular team."

His success stories include:

• A young woman who had her arm amputated in a car accident two years ago and now has full use of her hand for all activities
• A child who had her hand crushed in a car accident and needed tissue reconstruction and now has no pain and has since started playing the piano again
• A man who cut off his thumb in a log splitter and had it successfully replanted and regained all function
• Mike Maloney, profiled in this video about how he ran his thumb through a saw while building longboards – and another finger a separate time – regrew his thumb and finger both times and returned to full function through a procedure called granulation or secondary wound healing, requiring very little surgery

 

Denver Health's Hand Surgery Team

Denver Health's hand microvascular team includes Alexander Lauder, MD, who specializes in orthopedic hand microvascular surgery, Stephanie Malliaris, MD, specializing in plastic hand microvascular surgery and Dr. Ipaktchi, who oversees the team. Corinne Wong, MD, Denver Health's expert plastic microvascular surgeon, also works with this team on a regular basis.

Earlier this month, the hand microvascular team hosted a four-day course for residents and fellows at Denver Health and the University of Colorado. Topics covered included nerve reconstruction in the arm and blood vessel repair.

For more information on Denver Health Orthopedics and our cutting-edge surgeries, along with non-surgical treatments for all parts of the body, visit DenverHealth.org/Orthopedics, or call for an appointment at our Orthopedics Clinic at 303-602-1590 (please note: referrals may be needed from your primary care physician to be seen at the clinic). Please ask to see if a telehealth appointment (phone or video visit) is available from the safety and comfort of your own home.