Mother of four gets second chance after six-hour surgery reattaches severed finger

A complex microsurgical procedure has given a 30-year-old mother of four a second chance at using her hand after she suffered a devastating workplace accident that left three fingers severely injured.

Ann Nyambura Mwangi, an interior designer who worked in a joinery workshop, sustained the injuries in January after her hand was caught by an electric saw while operating machinery. One finger was completely amputated while two others suffered severe damage.

"I just felt pain. My fingers had been chopped off and I started bleeding," Ann recalled, describing the traumatic moments after the accident.

She was rushed to a nearby health facility for first aid before being referred to Aga Khan University Hospital, Nairobi, where specialists assessed whether the severed finger could be successfully reattached.

The surgery was led by Dr. Zenebe Teklu Gebremariyam, a Consultant Plastic and Reconstructive Surgeon and Assistant Professor at Aga Khan University Hospital, Nairobi, who said Ann's quick arrival at the hospital significantly improved her chances of a successful outcome.

"She presented to us after sustaining a workplace injury caused by an electric saw. One finger was completely amputated while another was only attached by skin," Dr. Gebremariyam said.

The medical team first assessed the detached finger to determine whether re-implantation was feasible before undertaking a six-hour operation using an operating microscope.

The procedure involved reconnecting the bone, tendons, arteries, veins and nerves in sequence to restore blood circulation and function to the finger. Following surgery, Ann remained under close observation before being discharged a week later to begin rehabilitation.

Dr. Gebremariyam said clean-cut injuries, such as those caused by electric saws, have a higher chance of successful reattachment than crush injuries.

He also stressed the importance of preserving amputated body parts correctly by wrapping them in a clean cloth, placing them inside a plastic bag and then keeping the bag on ice while seeking immediate medical care.

"If patients arrive early and the amputated part is preserved properly, the chances of successful re-implantation are much higher," he said.

He noted that microsurgical re-implantation is technically demanding because surgeons work on blood vessels measuring about half a millimetre in diameter, requiring specialised microscopes and instruments. The lengthy surgery and need for highly specialised equipment also contribute to the cost of the procedure.

For Ann, recovery has been physically and emotionally challenging.

She says she continues to experience pain and has had to relearn everyday activities using her left hand after losing function in her dominant right hand. Tasks such as washing clothes, cooking and carrying out interior design work remain difficult.

"I have to learn how to use my left hand. It's hard, but I'm hopeful," she said, adding that the accident left her worried about caring for her four daughters and returning to work.

Dr. Gebremariyam said recovery does not end after surgery, noting that patients require months of occupational therapy and physiotherapy to regain movement and function.

In Ann's case, the injury severely damaged one of the finger joints, making full recovery unlikely.

"One hundred per cent recovery is not realistic because of the extent of the joint injury, but with rehabilitation she should regain useful function and return to many normal daily activities," he said.

The surgeon also urged employers to strengthen workplace safety measures, saying prevention remains the best way to reduce life-changing injuries involving industrial machinery.

He added that microsurgical re-implantation can also be performed on amputated hands, forearms, feet, ears and scalp when patients reach specialised hospitals quickly enough.