Our Summary

This research paper investigates why Dr. Sterling Bunnell, a prominent hand surgeon, started using the term “no-man’s land” in the context of hand surgery in 1948. This term was initially used in World War I to refer to the dangerous area between opposing troops’ trenches. The author conducted extensive research, including reviewing Bunnell’s publications, searching his letters, and consulting hand surgeons who were contemporaries of Bunnell.

The research found that before 1948, Bunnell did not use the term “no-man’s land” in his writings about hand surgery. Although Bunnell was close to the trenches during World War I, this experience did not immediately inspire him to use this term in his surgical work.

The author suggests that Bunnell may have started using the term “no-man’s land” to describe the area of a tendon that is cut and needs to be grafted, comparing the process to the tunnels dug between the trenches in World War I. The term was likely adopted between 1947 and 1948.

FAQs

  1. What is the significance of the term “no-man’s land” in the context of hand surgery according to Dr. Sterling Bunnell’s usage?
  2. What methods were used to research Dr. Bunnell’s use of the term “no-man’s land” in hand surgery?
  3. When did Dr. Bunnell likely adopt the term “no-man’s land” in his writings on hand surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about hand transplant is to follow all post-operative care instructions carefully. This includes taking prescribed medications, attending follow-up appointments, and participating in physical therapy to ensure proper healing and function of the transplanted hand. Additionally, it is important to avoid activities that could put excessive strain on the hand during the initial recovery period.

Suitable For

Patients who are typically recommended for hand transplant surgery are those who have experienced traumatic amputations, severe burns, or other injuries that have resulted in the loss of function in their hands. These patients may have tried other treatments and therapies without success, and a hand transplant may be their best option for regaining some level of hand function.

In addition to physical injuries, patients who have congenital hand deformities or conditions that affect the function of their hands may also be recommended for hand transplant surgery. These conditions may significantly impact the patient’s quality of life and ability to perform daily tasks, and a hand transplant could greatly improve their overall function and independence.

It is important for patients being considered for hand transplant surgery to undergo a thorough evaluation by a multidisciplinary team of healthcare professionals, including hand surgeons, transplant surgeons, psychologists, and physical therapists. This evaluation will help determine if the patient is a suitable candidate for the procedure and if they have the necessary support system in place for a successful recovery and rehabilitation process.

Overall, hand transplant surgery is a complex and challenging procedure that requires careful consideration and evaluation of each individual patient’s unique circumstances. Patients who are recommended for hand transplant surgery are those who have exhausted other treatment options and stand to benefit significantly from the procedure in terms of regaining hand function and improving their quality of life.

Timeline

Before hand transplant:

  • Patient experiences severe hand injury or loss, impacting their daily life and functionality
  • Consultation with hand transplant team to discuss options and eligibility for surgery
  • Evaluation and testing to determine if the patient is a suitable candidate for a hand transplant
  • Waiting period for a suitable donor match
  • Surgery preparation and planning
  • Hand transplant surgery, which can take several hours to complete
  • Post-operative care and monitoring in the hospital
  • Rehabilitation and physical therapy to regain function and strength in the transplanted hand

After hand transplant:

  • Patient undergoes intensive rehabilitation and therapy to learn how to use their new hand
  • Adjustment period as the patient gets used to their transplanted hand
  • Regular follow-up appointments with the hand transplant team to monitor progress and address any issues
  • Potential complications such as rejection or infection, which require prompt medical attention
  • Long-term care and monitoring to ensure the success of the hand transplant
  • Improvement in quality of life and functionality as the patient gains more control and sensation in their transplanted hand.

What to Ask Your Doctor

Some questions a patient should ask their doctor about hand transplant include:

  1. What are the potential risks and complications associated with a hand transplant?
  2. How long is the recovery process and what can I expect during rehabilitation?
  3. What is the success rate of hand transplants and what are the long-term outcomes?
  4. How will I need to take care of my transplanted hand to ensure its health and function?
  5. Are there any lifestyle changes or limitations I should be aware of after a hand transplant?
  6. What type of immunosuppressive medications will I need to take and what are the potential side effects?
  7. How will the transplant impact my daily activities, such as work, hobbies, and personal care?
  8. Are there any alternative treatments or therapies that I should consider before pursuing a hand transplant?
  9. How experienced is the surgical team in performing hand transplants and what is their success rate?
  10. What is the expected timeline for the evaluation process, surgery, and post-operative care?

Reference

Authors: Hage JJ. Journal: Hand (N Y). 2019 Jul;14(4):570-574. doi: 10.1177/1558944717744337. Epub 2017 Dec 14. PMID: 29239250