Surgery
Electrocuted While Working on Power Lines, Florida Dad Travels to NYC for Surgery to Save His Hands
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Aug 19, 2008 - 2:10:29 PM

(HealthNewsDigest.com) - New York, NY - A Florida man is on the road to recovery after two 10-hour surgeries to save his hands. Last year, a terrible accident almost cost Dan Fibkins his life. He was working on high-voltage power lines in Tampa, Florida, during a lightning storm. “A piece of equipment broke and energized the line,” he recalls. “The line was in my hand, and they told me the electric current went through one hand and out the other. It passed through my body.”

Mr. Fibkins says the electrocution knocked him unconscious and erased his memory of the most horrifying moments. He spent three weeks in Intensive Care, while his wife, Tuesday, prayed for a miracle. Two miracles took place. The first one was that Mr. Fibkins survived. But when he woke up, the doctors gave him devastating news. His hands were severely damaged up to his forearms, and amputation would be necessary.

“The plastic surgeon and hand specialist in Florida said, ‘You’ll need a miracle to save your hands.’ Dr. Michelle Carlson was it,” Mr. Fibkins says. Dr. Carlson, a hand surgeon at the Hospital for Special Surgery in New York, gave Mr. Fibkins hope after five doctors told him amputation was his only option. “The doctors told him he needed amputations because they did not see any way they could reconstruct all the loss of function that he had,” Dr. Carlson explains.

Mr. Fibkins had known co-workers who needed their hands amputated after similar accidents. Yet despite his dire prognosis, he and Tuesday refused to give in. Her father's colleague was head of a medical foundation in New York, and he suggested the Fibkins consult with specialists in this area.

Several doctors in New York City concurred with the need to amputate. Then he met Dr. Carlson. After examining him, she thought long and hard about how she might be able to save his hands and restore function. “When she said there was something she could do, we were ecstatic,” Mr. Fibkins said.

“Basically, the injury caused him to lose all the muscles, tendons, nerves, and skin from his mid-forearm to his fingers,” Dr. Carlson explains. “It was basically like a huge ‘shark bite,’ leaving nothing but bone from his mid-forearm to the base of his fingers on the palm side of his arm.”

To make matters worse, Mr. Fibkins had skin grafts from his thighs applied to his forearms in Florida, but they were infected. The first step was to eradicate the infection and make sure the skin grafts covered his injuries. A plastic surgeon was called in for the procedures.

Once the infection cleared up, Dr. Carlson could undertake the daring 10- to 11-hour operations she had conceived to try to save his hands. In February, she performed the first operation on his right hand and arm. Mr. Fibkins had the second operation to restore movement and function to his other hand in June.

The first step was a tendon transfer, which entails shifting a functioning tendon from its original attachment to a new one to restore action that has been lost. “I took tendons from his legs to reconstruct the missing muscles and tendons in his arms," Dr. Carlson explained. "I attached them in the forearm and then tunneled them under the grafted skin flaps to emerge in the palm and attach them to his fingers. This reconnected all the muscles in his arms to his fingers, so that his fingers could move.” Dr. Carlson also performed delicate microsurgery (under a microscope) to transplant nerves to restore sensation to his fingers.

It was one of the most challenging cases of Dr. Carlson’s career. “It took a lot of ‘creative’ surgery and a lot of willpower and determination on the part of Mr. Fibkins and his wife to have a successful outcome,” she says. “You won’t find this in a medical textbook.” Tuesday Fibkins says she is grateful. “Dr. Carlson is a miracle-worker. We’re so thankful we had her as Dan’s doctor.”

Mr. Fibkins has already recovered some function in his hands and is able to hold various objects to perform activities of daily living. He can hold a cell phone to his ear, and a shampoo bottle, so he can wash his hair. He is figuring out creative ways to adapt, so he can use his hands. Before the surgery, he was dependent on Tuesday to do everything for him. “He’s just amazing,” she says. “I can’t believe how well he compensates for the limited function in his hands. We don’t look at what he can’t do, we look at what he can do.”

Mr. Fibkins still needs one or two smaller procedures to fine-tune the previous surgeries and provide some additional ‘pinch strength’ to his thumbs, according to Dr. Carlson. “His strength will continue to improve over the course of a year. Sensation in his fingers will probably take a year to return, as well,” she notes.

Eventually, he should be able eat with a knife and fork, but will probably require some adaptive aids for certain activities, Dr. Carlson says. For now, he’s happy he can put his arms around his children and hug them. And when sensation fully returns to his hands, he looks forward to holding their hands.

For more information or to make an appointment to see a physician at HSS, visit www.hss.edu/longisland or call 866-606-6888

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