BACK TO LIFE: Nguyễn Đoàn Quý (2nd left) and his wife (3rd left) went to their cousin's wedding in Quảng Ninh only one day after leaving the hospital as inpatient. — VNS Photo courtesy of Quý's family

By Nguyễn Mỹ Hà

On a fine October day, Nguyễn Đoàn Quý left Military Hospital 108, where he had been an inpatient for five months to rehabilitate after what had been a gruelling operation. He made his way home to his wife and 8-year-old daughter in the craft village of Trát Cầu in Thường Tín District of Hà Nội.

It was a special trip home for Quý, 30, who went to the hospital five months earlier having lost his right arm in a horrific work accident at a mattress manufacturing factory in 2021. At one point, he didn't know if he was going to make it. Now he's coming home again, with a brand new arm.

"When I left in spring, it was still cold and damp," Quý said. "Now that I can go home, it's autumn already, a full summer has passed."

Dr. Nguyễn Thế Hoàng is the senior surgeon behind three recent and pioneering limb graft surgeries conducted at the hospital in recent years.

"One night when we were on duty at the hospital, at 7 p.m., we received a patient (whose name was withheld) with severe injury, where all his right arm was cut off, and his right shoulder as well as the upper part of his arm was wounded badly. The forearm was preserved quite well by our colleagues in the previous hospital, but the patient was in a serious condition and our job was to keep him alive," said Dr. Hoàng.

SPECIAL BOND: Dr. Hoàng checks the function of Quy's hand each week when he goes to therapy at the hospital. — VNS Photos Đoàn Tùng

"The injury was bad because the whole right arm was crushed under a brick-making assembly line, so all structures were crushed, all the nerves were split off, and so were the veins. There was no possibility to preserve the arm. The main focus then was to save his life."

The doctors diagnosed it as a multiple injury, with all the anatomic structures destroyed, and it was impossible to reconstruct any of the remaining arm.

"Military Hospital 108 has been conducting a project on grafting organs, and grafting limbs is part of it. During the consultation, we concluded that the lower arm from the elbow down and hand were still intact, so we could use it to graft for another patient, who also lost his right hand. But before we could embark on giving the hand to a receiving patient, we had to have a long talk with the family of the potential donor. He needed to agree to gift it to a suitable receiver before we could do anything," said Dr. Hoàng.

"We were lucky that the family realised the humanitarian meaning of the donation, and they were very noble and agreed to gift the intact part of the well-preserved forearm to a suitable patient." 

The doctors then saved the patient's life, and in a rare practice, had to temporarily graft the cut forearm to his lower limb, to keep hot blood running through it, while they screened other patients to find a suitable recipient.

"We finally kept the split hand on the patient's leg for two weeks until all screening tests were done," said Dr. Hoàng.

"Among a handful of patients who could receive this gift, all we could say about Quý is that he's a young, energetic and a positive soul. He still has a long life ahead of him. If he gets a new hand, he can make his life so much better," Dr. Hoàng said.

"After a check with blood group, the skin tone and, most importantly, that the receiver has maintained good energy and desires the limb, then we must decide."

The recipient's wishes play a decisive role in integrating the new grafted limb to function well with a new body. They need to be mentally prepared and willing to do physical therapy after the surgery.

Quý's wife, Lê thị Duyên, 29, told Việt Nam News: "I got a phone call from the hospital's Social Affairs office in March when I was travelling on the road then and burst out crying. I called my husband right then and we both were utterly happy because we didn't believe we could have been offered such an invaluable gift so soon."

Quý had a work accident in 2021. That year 5,797 workplace accidents took place, causing 602 deaths, and leaving 1,226 severely injured cases like his.

"It was awful, he got his right arm rolled into the mattress presser," Quý's aunt said. "When they pulled him out, he was lying in a pool of blood. His parents are from this village, but they weren't here when the accident happened. God forbid. I am so grateful that today doctors can work miracles and give our nephew his hand again."

The pair went to the hospital the next morning to do all the required tests. "I never thought such luck would come to my family just like that," Duyên said.

Dr. Hoàng remembers the day of the surgery well.

"Everyone was ready, all medical indicators were well-matched and carefully checked, and psychological tests and checks were done. The surgery took 11 hours to complete, from 7 p.m. until 6 a.m. the next morning," he said. 

Four teams, total of 20 people, took turns in the operation, which went well.

"We had connected two arteries, six veins, three nerves (radial, cubital and medial nerve), performed osteosynthesis the two forearm bones (radius and cubitus) and 20 groups of muscles to ensure the future functioning of the hand," Dr. Hoàng said.

"This was our third case of grafting a lost arm, and everything went well. Our colleagues knew their work well and things went smoothly from consultation to preparation, to surgery and recovery."

In 2008, at the Hospital Rechts der Isar in Munich, Dr. Hoàng was one of five principal surgeons in a 16-hour operation to graft two arms for a patient who lost both in an accident. The surgery was so successful that the patient's life was turned around with him being able to use his new arms to perform daily tasks. 

This surgery was among the best the hospital had accomplished, with Quý in good health, and recovering well. He can now pour water from a bottle, pick up small things, and put them back with his new hand. He can use a smartphone and text on the screen with the fingers of his right hand too.

It's a modern miracle of science.

"I believe in a year he will regain all the functional activities he used to have before the accident," said Dr. Hoàng.

Grafting the wounded hand onto the calf of the same patient for two weeks to wait for the recipient was something the hospital had never done before.

"When we grafted the hand to the calf of the patient, his leg still functioned normally. This method shall open a new door to nurture wounded limbs for a longer time to find a suitable limb receiver."

Dr. Hoàng's method may have wider implications for surgery worldwide, as previously the only source of limb donation came from patients whose brains were dead. By trying to spare the still intact part of large limbs with the consent of living patients, there will be considerably more options available in the future.

"Today, wars and conflicts, natural calamities such as earthquakes, labour and traffic accidents all can hurt or wound people. We hope that our method can be used to help those in need, by giving a chance to people who lost their limbs to feel complete once again," Dr. Hoàng said.

Nguyễn Đoàn Quý was very lucky to be the first patient to benefit from this method. He and his family knew how fortunate they were, and worked hard to make it function as smoothly as possible.

"I will work to be able to hold my motorbike handlebars again and drive my bike once more," Quý said.

"Quý was transferred here back in July," said a physical therapist who patiently opens and closes Quý's fingers. "Now he undergoes many different activities, such as pulsed electro-physical therapy, and others."

"Each time he comes, I'll give him a hand massage to make sure all the joints in his palm get to move. The aim of this session is to stimulate blood circulation in the right hand, warm up the muscle, teach them to move accordingly and get all the tendons working as well."

FINGER TRAINING: Quý must lift each and all of these wood pieces and drop them in a basket, then pick all of them back to their holes on the board again. VNS Photo Đoàn Tùng

BAND AID: On weekdays, Quý goes to Military Hospital 108 for therapy, where everyone knows him well. VNS Photo Đoàn Tùng

Quý will have to do this for a year and a half or two years from now on, depending on how diligent he is.

Now he is encouraged to do daily work with his hand, like picking up a glass of water to drink. Daily activities can also be therapeutic for him to train his hands and fingers to work properly. It takes time, but he is making steady progress.

Duyên said that after the surgery, what worried her the most was that her husband would feel too much pain because the post-surgery recovery would last too long.

"After surgery, the doctors told me it was 99 per cent successful," Duyên said. "Thank God, my husband's recovery is good. We had faith that he would recover well."

Duyên was under a lot of pressure due to the long treatment time that her husband was away from home. She said that she would feel worried and could not sleep and felt alone taking care of their 8-year-old child.

TOUCHED: A handshake that changed Quý's life for the better after his accident. VNS Photo Đoàn Tùng

MORE MOBILE: Quý has trained himself delicate finger work such as texting messages on his phone. VNS Photo Đoàn Tùng

NEW CONNECTION: "Now take my phone, text yourself a message," Dr. Hoàng tells Quý. VNS Photo Đoàn Tùng

"Now that he's home, I feel all my worries and nervousness are gone. When I went to get him from the hospital, we were all thrilled," she said.

GOLDEN HANDSHAKE: Now Quý can touch with his new hand, which brought him a new life. — VNS Photo Đoàn Tùng

 During Quý's treatment at the hospital, Duyên wanted to meet with the generous donor who had agreed to let his arm be used in this way.

"I met him to thank him and his family," Duyên said. "He was a bright young man, who had a very positive attitude in life. We had a great talk."

"I'd like to tell anyone out there who might have had an accident like my husband, to keep an upbeat attitude, be positive and courageous. Even after the accident, my husband was very courageous, and he had faith that in the future everything would turn out to be good for us. It did."

Quý has good reason to be positive.

"I'm back to work again," he texted. "I still work at my old company where I had the accident. My salary has been kept the same, but now I only work in the afternoon, as in the morning I have to go to the hospital for rehab." —  VNS

WAVE: Quý raises his hand to say goodbye. — VNS Photo Mỹ Hà