Because of his condition, Alexandre鈥檚 case was a priority. David Hay, MD, a fourth-year orthopedic surgery resident specializing in hand and upper limb surgery, carefully examined him. He found that Alexandre鈥檚 tendons and nerves were severed and damaged. 鈥淗e was a brave little guy,鈥 Hay recalled, 鈥渁nd surprisingly calm.鈥 After stitching up Alexandre鈥檚 wound temporarily, Dr. Hay explained that Alexandre would need to come back for surgery.
鈥淓ven though the surgeons were completely booked,鈥 said Catherine, 鈥渢hey made room for us.鈥 Alexandre鈥檚 surgeon would be Amy Ladd, MD, chief of Lucile Packard Children鈥檚 Pediatric Hand Clinic and the Robert A. Chase Hand & Upper Limb Center at Stanford. Ladd explained that tendons begin to retract when they are severed. The longer you wait to do surgery, the harder it is to repair them.
The Acras were delighted to have Ladd on their side. 鈥淪he鈥檚 not just the best pediatric hand surgeon in California,鈥 said Catherine. 鈥淪he鈥檚 one of the best in the world.鈥 Plus, 鈥渟he spoke to us in French, our first language, which wasn鈥檛 necessary but made us feel at home.鈥
The surgery would require repairing two major nerves and a finger tendon in Alexandre鈥檚 hand. The team would also patch a large laceration to his wrist tendon by removing a small amount of healthy tendon from another location on his body. Because he sucks his thumb on his left hand, the team avoided that arm. They took the tissue they needed from his right arm near the surgical site. The delicate repair of his nerves required microscopic surgery with specially designed tools for the smallest detail work.
鈥淐hildren have a tremendous chance of recovery after repair, compared to the same injury in an adult. So the odds were very much in Alexandre鈥檚 favor,鈥 said Ladd. 鈥淗owever, the level of complexity required to do the repair is not offered at every hospital, and most hand surgeons don鈥檛 work on children. So they send them to us. There is nothing we can鈥檛 take care of.鈥
After assisting in Alexandre鈥檚 surgery, Dr. Hay explained his recovery plan: a full arm cast for at least 30 days, and then a splint for 4 to 6 weeks, and several weeks of rehabilitation. 鈥淒r. Ladd does a great job of organizing care so that patients are more likely to see the same resident over the course of their treatment, whenever possible,鈥 he said.
鈥淥ccupational therapy for children is all about making the exercises fun, using activities that the kids already enjoy,鈥 said Chan. 鈥淥ur focus is not just on restoring range of motion and strength, but helping children use these abilities for things that are meaningful to them.鈥
From their first arrival at the emergency department to their last visit to the rehabilitation department, the Acra family was delighted with the care they received. 鈥淚t wasn鈥檛 just the operation for us,鈥 said Catherine. 鈥淚t was the whole follow up. They take care of you from pre-surgery through weeks and weeks afterward. They hold your hand鈥攍iterally!鈥攖he entire way.鈥
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