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'Doctors used ribs to save my hand' 'Doctors used ribs to save my hand'
(30 minutes later)
By Jane Elliott Health reporter, BBC NewsBy Jane Elliott Health reporter, BBC News
Neil had hours of surgeryNeil had hours of surgery
Private Neil McCallion was handing out vital supplies to Afghan schools when his convoy was hit by a suicide bomber.Private Neil McCallion was handing out vital supplies to Afghan schools when his convoy was hit by a suicide bomber.
The explosion blasted his Land Rover onto its side, leaving a colleague dead and his left hand feeling numb and badly damaged.The explosion blasted his Land Rover onto its side, leaving a colleague dead and his left hand feeling numb and badly damaged.
"I saw a six-inch piece of metal sticking out of my hand. It was a mess," he said."I saw a six-inch piece of metal sticking out of my hand. It was a mess," he said.
"My index finger was hanging on by a wee white string, a tendon. I had to grab my hand and hold on to it.""My index finger was hanging on by a wee white string, a tendon. I had to grab my hand and hold on to it."
Damaged handDamaged hand
His left hand was shattered by the shrapnel wound - four of the five metacarpal bones (which connect the fingers to the wrist) were missing.His left hand was shattered by the shrapnel wound - four of the five metacarpal bones (which connect the fingers to the wrist) were missing.
Doctors stabilised the Argyll and Sutherland Highlander at a field hospital in Kabul.Doctors stabilised the Argyll and Sutherland Highlander at a field hospital in Kabul.
He can pick up a pint and he's learned to drive Garth TitleyHe can pick up a pint and he's learned to drive Garth Titley
That night, after being heavily dosed up with morphine, he was flown straight to the UK's Selly Oak Hospital in Birmingham, which specialises in treating injured service personnel.That night, after being heavily dosed up with morphine, he was flown straight to the UK's Selly Oak Hospital in Birmingham, which specialises in treating injured service personnel.
Here doctors were able to save his hand. His story is told as part of the NHS Choices' focus on military health.Here doctors were able to save his hand. His story is told as part of the NHS Choices' focus on military health.
Consultant plastic surgeon Garth Titley told the BBC that they had little textbook guidance on how to treat a wound like this and had to adapt surgery carried out in Japan on a foot.Consultant plastic surgeon Garth Titley told the BBC that they had little textbook guidance on how to treat a wound like this and had to adapt surgery carried out in Japan on a foot.
Neil's hand was extensively damaged Neil's hand after surgery
"Personally I had never done this operation before with the ribs," he said."Personally I had never done this operation before with the ribs," he said.
"In plastic surgery we quite often move pieces of tissue around the body using micro vascular surgery to restore the blood supply."In plastic surgery we quite often move pieces of tissue around the body using micro vascular surgery to restore the blood supply.
"It is like a transplant to yourself."It is like a transplant to yourself.
"What we would typically do is take either skin and its blood supply, or a piece of muscle and its blood supply and move that tissue or part of the body to repair a defect and re-establish."What we would typically do is take either skin and its blood supply, or a piece of muscle and its blood supply and move that tissue or part of the body to repair a defect and re-establish.
"Just putting a lid on the back of Neil's hand would not have been enough it would not have had the stability.""Just putting a lid on the back of Neil's hand would not have been enough it would not have had the stability."
The technique involved rebuilding the hand, in a 17-hour operation, using a section of three of his ribs and muscle from the right side of his torso.The technique involved rebuilding the hand, in a 17-hour operation, using a section of three of his ribs and muscle from the right side of his torso.
"It's called a serratus anterior flap with ribs procedure," he said"It's called a serratus anterior flap with ribs procedure," he said
"As far as I'm aware, this has not previously been performed to this extent on a hand.""As far as I'm aware, this has not previously been performed to this extent on a hand."
The ribs were used to join the fingers to the wrist, using tiny plates and screws.The ribs were used to join the fingers to the wrist, using tiny plates and screws.
Basic tasksBasic tasks
After several operations, Private McCallion can now perform basic tasks with his rebuilt hand.After several operations, Private McCallion can now perform basic tasks with his rebuilt hand.
"He can pick up a pint and he's learned to drive," said Mr Titley."He can pick up a pint and he's learned to drive," said Mr Titley.
"He has a hand that enables him to perform most of his daily activities.""He has a hand that enables him to perform most of his daily activities."
Private McCallion, aged 24, from Dunbartonshire, Scotland can now wriggle his thumb and fingers of his left hand and can close them in a gentle grip, something he thought would never have been possible when he was first injured.Private McCallion, aged 24, from Dunbartonshire, Scotland can now wriggle his thumb and fingers of his left hand and can close them in a gentle grip, something he thought would never have been possible when he was first injured.
"After the incident I thought they wouldn't be able to save my hand," he said."After the incident I thought they wouldn't be able to save my hand," he said.
Since then, he has had 14 operations, including one two weeks after the attack.Since then, he has had 14 operations, including one two weeks after the attack.
Neil's hand after surgery Neil's hand was extensively damaged
He said it had been a shock when he first saw the results.He said it had been a shock when he first saw the results.
"The back of my hand looked big, like there were 10 burgers stacked up on it. I started crying and shouting that they might as well have taken my hand off. My mum ran out in tears.""The back of my hand looked big, like there were 10 burgers stacked up on it. I started crying and shouting that they might as well have taken my hand off. My mum ran out in tears."
But a month later he was able to move a finger for the first time.But a month later he was able to move a finger for the first time.
Since then, a couple of setbacks have delayed Private McCallion's recovery by around 18 months.Since then, a couple of setbacks have delayed Private McCallion's recovery by around 18 months.
The ribs in his hand broke when he leant on it after his sixth operation and then a fall snapped the titanium plates that were used to mend them.The ribs in his hand broke when he leant on it after his sixth operation and then a fall snapped the titanium plates that were used to mend them.
But with surgery and rehabilitation, including stretching elastic bands with his fingers, he is making good progress.But with surgery and rehabilitation, including stretching elastic bands with his fingers, he is making good progress.
For five weeks in early 2009, his hand was temporarily attached by a flap of skin to his lower abdomen so that the blood supply could help regenerate skin on the back of his hand.For five weeks in early 2009, his hand was temporarily attached by a flap of skin to his lower abdomen so that the blood supply could help regenerate skin on the back of his hand.
In future operations tendons will be removed from his leg and placed in his hand to allow him to straighten his fingers.In future operations tendons will be removed from his leg and placed in his hand to allow him to straighten his fingers.
But despite his restricted hand movement, he has still passed his driving test and still walks his dogs.But despite his restricted hand movement, he has still passed his driving test and still walks his dogs.
He is now looking forward to the day his hand is strong enough to go fishing again on Loch Lomond.He is now looking forward to the day his hand is strong enough to go fishing again on Loch Lomond.