Nine amputated fingers.

A 41-year-old male patient presented to Khoula Hospital, Muscat, Oman, in 2015 with nine amputated fingers. While operating a paper cutting machine, eight of the patient’s fingers were amputated through the proximal phalanges, while the right thumb was amputated through the distal phalanx [Figure 1].

Please note that this image might contain sensitive content. Click to unblur.

The total ischaemia time when the patient was received at the hospital was approximately two hours and 30 minutes. X-ray images of the hands with amputated parts are shown in Figure 2.

Please note that this image might contain sensitive content. Click to unblur.

The fingers perfused immediately following replantation. There was a significant amount of blood loss during the latter part of the operation, possibly due to the heparin injection given when the arterial clamps were released.

The wounds continued to ooze postoperatively and the patient was monitored in the intensive care unit (ICU) for the following 48 hours where he received a total of eight units of blood transfusion including the intraoperative and postoperative period.

Follow-up was done with the same institute in India and all his wounds have healed well [Figure 3]. He had reasonable functionality of his hands and was able to manage daily tasks [Figure 4]. Additionally, he began working four months following the replantation procedure.

Please note that this image might contain sensitive content. Click to unblur.

Please note that this image might contain sensitive content. Click to unblur.

His range of movement can be improved by tenolysis and arthrolysis, as was suggested to him from time to time. However, the patient refused further interventions as he was the sole source of financial support for his family.