Rare operation gets thumbs up Doctors help injured artist 'grow' a finger

August 10, 1993|By Donna E. Boller | Donna E. Boller,Staff Writer

Thomas J. Sterner was in his studio, a barn at the western edge of Westminster, on July 17, making wooden backing frames for the plywood paintings he occasionally mounts on the barn roof.

The mixed media artist decided some of the cuts were a little too rough. So he put down his saw and picked up a jointer to shave the wood. Within seconds, he was a statistic, one of about 775,000 people who suffer hand injuries each year.

Mr. Sterner said he doesn't know how he made the diagonal cut that removed about one-third of the flesh and a piece of bone from his right thumb. But he understood right away that it couldn't be retrieved and reattached.

"It was shaved off in several pieces because of the nature of the tool," he said.

He was to learn that surgeons at the Curtis Hand Center of Union Memorial Hospital in Baltimore could restore the pinching surface of his thumb -- if he didn't mind living with it sewn to his chest for two weeks.

But first, he needed emergency medical attention. Jay Hammond, a Westminster woodworking artist who shares Mr. Sterner's studio, drove him to the Carroll County General Hospital emergency room. He was treated and referred to the hand clinic at Union Memorial.

Mr. Sterner "was left without a good portion of the pulp" of his thumb, said hand surgeon Dr. Keith A. Segalman. The medical challenge was to restore the pinching surface of his thumb.

Mr. Sterner said another surgeon at the center, Dr. Michael McClinton, explained that the doctors could try lifting a flap from his middle finger and grafting it to the thumb, but he would almost surely be left with prolonged stiffness in the finger.

He wanted an option that would restore his thumb as fully as possible. An artist must be able to work with his hands. "I want to be an artist until the day I die, and I don't want to have pain in

my right hand," Mr. Sterner said.

The surgeons' answer was to sew Mr. Sterner's thumb to his chest. Blood vessels from the chest grew in the thumb, Dr. Segalman said. The blood vessels nurtured skin and fat from the chest that would replace the shredded portion of the thumb.

On a scale of 1 to 10 in complexity, the surgery performed on Mr. Sterner was probably about a 7, Dr. Segalman said. He said the operation is "fairly sophisticated," but not as complex as the microsurgery required to replant a severed finger.

Mr. Sterner said he was initially depressed after the surgery, although he knew it was the right decision. He had recently been invited to place works at the Artists Gallery in Frederick, and he had etchings to print for a craft show in Woodsboro. But with his thumb stitched to his chest, he couldn't paint or draw.

He went into the studio and tried to work with his left hand, but he couldn't accomplish much.

He managed to get to his job -- he is laser division manager at Laser Applications Inc. in Westminster. He could work the computer, but had to stop trying to carry a clipboard around to make notes. He abandoned his tie shoes for loafers, and found that he couldn't put his hair into his trademark ponytail without help.

But the worst part was not being able to work in art. He has a concept for the next barn roof painting. This one will be a little more challenging than the 8-foot square heart or the 8-by-12-foot fish or the 18-by-24-foot fish eating a smaller fish, he said.

The audience for the barn roof paintings is the commuter traffic along Route 140. He gets feedback, sometimes directly and sometimes from friends who have heard comments about the paintings.

A quick preview of coming barn roof paintings: objects such as a hand attached to a body will float across the roof.

The hand surgeons at Union Memorial detached Mr. Sterner's thumb from his chest Aug. 3, a procedure he referred to as "being set free."

Dr. Segalman said the artist will need a third operation for "debulking," the technical term for trimming the restored flesh down to regular thumb size.

Injuries similar to Mr. Sterner's are all too common. "We probably see one saw injury a day" at the hand center, Dr. Segalman said.

He said many of the patients are men in their 30s and 40s who are accustomed to using power saws, but who get hurt when they try to use the saws after drinking or taking drugs or when they are tired. Dr. Segalman said the hand specialists also see frequent power blade injuries to retired men, "who have used a saw for years and years and they're cutting late at night in the basement." His advice is to use a piece of wood to push the piece you're sawing.

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