Left hand attached to right arm.

In a rare surgical procedure performed only twice before in the U.S., an accident victim's left hand was attached to his right arm by plastic surgeons at Southern Illinois University School of Medicine.

The 45-year-old patient, John Evans, was injured severely in a train accident. His left arm was severed at the shoulder and his right hand at the wrist. While the severed left arm was detached and badly mangled, the hand was undamaged. The right arm suffered slight damage except for the mangled hand that was severed at the wrist. Evans, who has a history of epilepsy, does not remember how the accident occurred. One possibility is that he suffered a seizure prior to the accident.

"A hand is much better than a prosthesis," notes plastic surgeon Richard Brown, "even if it is on the opposite arm." With the attachment of the left hand to the right arm, Evans' thumb points in the opposite direction. In deciding whether to attempt the unusual surgery, Brown considered the patient's general physical condition, which is good except for the epilepsy, and his needs. The patient's only other option would have been a prosthesis, a hook to replace the hand on his right arm. Because of severe damage to the left side, partial amputation of the shoulder was required, removing any possibility of using a prosthesis on that side.

The surgery involved removal of the left hand from the mangled arm, leaving ample length of nerves and tendons for reattachment. To gain stabilization of the wrist, the scaphoid and lunate bones in the wrist were fused to the radius, one of the bones of the forearm. While the fusion limits up-and-down movement of the wrist, it was necessary to provide a stable structure for the reattachment...