Marathon hand operation draws on surgical skills

Phillip Warburton knew straight away that he was in trouble.

The Yamanto man has practised martial arts for the past 27 years, and for 17 of them had used the same samurai sword in demonstrations and training. It was while he was practising a quick draw technique that things went wrong.

"After 17 years, the case that holds the sword split," said Mr Warburton, 42. "The case hit the ground and nearly removed the fingers. In all the time I have been doing martial arts it’s the first time I’ve cut myself – I guess it was one draw too many."

After that, things happened quickly: calling to his partner for help; the car trip to Ipswich Hospital Emergency Department; the first inspection of the injured left hand; being stabilised by the Emergency Department team; and the decision to operate at Ipswich Hospital rather than sending Mr Warburton to the Princess Alexandra (PA) in Brisbane.

"It happened on Monday at 6pm, and by morning I was in surgery," Mr Warburton said.

Ipswich Hospital registrar Sam Scaife was one of the team of 18 clinical staff – surgeons, anaesthetists and theatre nursing staff – who operated on Mr Warburton's hand.

"After we began, we realised the extent of the damage," Dr Scaife said. "To refer to the PA would have meant waking up the patient and giving him another anaesthetic, and we were happy to do (the operation). We discussed the extent of the damage with Ben and agreed we could repair it here rather than going to the PA."

Ben is Dr Ben Kenny, a Brisbane-based specialist orthopaedic surgeon who was rostered on one of his regular shifts at Ipswich Hospital. Dr Kenny worked between his daily caseload and helping to repair the damage to Mr Warburton's hand.

"Each finger has two arteries, nerves and tendons," Dr Kenny said.

"The nerve and the artery were intact on Mr Warburton's index finger. For the remaining fingers, eight tendons, seven arteries and seven nerves required repair. There was also damage to the joints, as the blade had been in line with the joints."

"When we realised how serious the damage was, Dr Kenny scrubbed in and fixed one side, while we fixed the other side," Dr Scaife said.

In all the operation that was initially expected to take about 5 hours took 15 hours, involved six registrars, six nursing staff and a team of six anaesthetists and support staff.

Dr Luca Daniele was one of the registrars involved in the work to save Mr Warburton's fingers.

"It was definitely a team effort," Dr Daniele said. "Everyone was involved. It was great work but in another sense, it was another day at the office.

"We deal with terrible injuries and we usually have the skills to do that without referring patients to other institutions."

Following surgery, Mr Warburton was in hospital for five days before discharge, where the hospital’s Indigenous Hospital Liaison Officers, nursing team and Allied Health staff provided further care. Mr Warburton has continued his involvement with Ipswich Hospital through physiotherapy and rehabilitation outpatient appointments.

"When I woke up and realised I still had all my fingers, I said 'you're kidding me'," Mr Warburton said.

"I still have no feeling but I can move the fingers a little bit. I know this is going to be a long recovery.

"Everyone did a brilliant job. I don’t stay in hospital, so they did well to keep me there for five days. If it wasn’t for everyone, I wouldn’t have a hand."