Life took a detour for 19-year-old Kyle Smith on July 27, 2020.
It started as a typical day at the lumber yard in New Boston, Michigan, where Smith worked while finishing high school. But it turned into a tragedy when, while cutting 2 x 4s on a table saw, he cut off his left hand.
In shock and excruciating pain, Smith sought help from a colleague. They ran into the lumberyard office where faces dropped when they saw the extent of his injury. His boss took quick action by calling 911, then helped compress the bleeding arm with a bandage and ice. A colleague removed the hand from outside and placed it in a Ziploc bag with ice.
About four minutes later, Smith was in an ambulance en route to a Detroit hospital.
“When it happened, I was thinking about the future — how I lost my opportunity to live a good life at age 18 and what my life would be like with one arm,” said Smith, who lives in Carlton, a small village in Monroe County.
An emergency medical technician told him there was a chance doctors could reattach his arm, and the ambulance driver assured him that Detroit Receiving was the best hospital in the area for treating trauma cases.
Meanwhile, Wayne Health plastic and reconstructive surgeon Ahmed Hashem, MD, clinical professor of surgery at Wayne State University School of Medicine, was paged by a medical student for an arriving patient with an amputated arm.
“In these types of operations, we are racing against time because the amputated parts are only viable for six hours from the time of injury,” said Dr. Hashem. “After that, the muscle is dead and can’t be reattached.”
Dr. Hashem rushed to the emergency room to examine the amputated arm under amplification to determine if reattachment was possible. It examines and marks arteries, nerves and tendons.
Once the feasibility of reattachment was determined, Smith was rushed to an operating room.
“Reattachment is a complex operation,” said Dr. Hashem. “It’s not a one-man show, it’s a team show.”
Along with Dr. Hashem, Smith’s surgical team included plastic surgery fellows Ashraf Elzanie, MD, and Gretchen Stieg, MD, along with Kerellos Nasr, MD, orthopedic sports surgeon and trauma surgeon; and anesthesiologist Katie Zaharzewski, DO, supported by surgical nurses and technicians.
In a grueling and complex 14-hour surgery, Dr. Nasr performed bone shortening, bone alignment, and bone fixation with plates and screws. The plastic surgery team removed dead tissue from the area of injury and reconnected the tendons, nerves, arteries and veins of the forearm to the hand. Critical blood flow to the reattached arm was restored as the arteries and veins were reconnected. Arterial reconnection had to be performed twice due to the extent of the injury.
The demanding surgery requires the alignment of 11 tendons on the front side of Smith’s forearm, 12 tendons on the back side and the alignment of two major nerves to ensure a good functional outcome.
Smith was hospitalized at Detroit Receiving for nine days after the surgery. After a night at home, he developed a bleeding complication and returned to the hospital for surgery to stop the bleeding, followed by a five-day hospital stay.
Since then, Smith said, his recovery has been “pretty phenomenal.”
Dr. Hashem said Smith is on the way to regaining function, has reasonable movements and is beginning sensory recovery.
“Kyle’s recovery has exceeded my expectations. He has regained significant function in his left arm with satisfactory movement and sensation,” he said. “He can use it in daily activities without problems. I’m really impressed with the result so far. He continues to improve fine motor skills and greater sensory discrimination.”
“Rehabilitating my arm is my full-time job right now,” said Smith, who attends occupational and physical therapy three times a week and has regular appointments with Drs. Hashem and Nasr. “I can open, close, squeeze, grip and lift 5-pound barbells by hand. I’m missing small movements in my hand, but feeling in my wrist and palm is coming back. I can’t pinch my fingers around anything, so picking up the Q-tip off the floor the other day was a challenge.”
It takes at least one year to achieve the full extent of recovery after reattachment surgery.
Smith said Dr. Hashem and Nasr “are like my personal doctors. They always check in to make sure I’m okay. They have all the answers and I have never doubted them. They are phenomenal.”
As for what’s next, Smith said the injury “made me a better person. It definitely taught me to be humble… And now I make smarter decisions and double and triple check everything. As soon as I have the ability, I’m ready to take on life.”
Dr. Hashem joined Wayne Health in October 2020. He is a clinical professor of plastic surgery at Wayne State University School of Medicine who enjoys teaching and research because it allows him to stay at the top of his field and contributed to the advancement of his specialty.
Dr. Hashem is a Fellow of the Royal College of Surgeons of England and completed a three-year advanced residency at the Cleveland Clinic, honing his skills in reconstructive microsurgery, craniofacial surgery and cosmetic plastic surgery. He previously completed advanced training in pediatric plastic surgery at Nationwide Children’s Hospital in Columbus, Ohio, and training in hand surgery at the French Institute of Hand Surgery in Paris.
This advanced training in multiple subspecialties of plastic surgery qualifies him to perform reconstructive plastic surgery, craniofacial/maxillofacial surgery, hand surgery, pediatric plastic surgery, as well as cosmetic surgery. To make an appointment with Dr. Hashem, visit https://www.waynehealthcares.org/appointments/ or call 877-929-6342.