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May 23, 1962: Give That Kid a Hand!

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Old 05-23-2008
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May 23, 1962: Give That Kid a Hand!
1962: A team of 12 doctors at Massachusetts General Hospital in Boston reattach the severed arm of an injured boy. It is the first successful reattachment of a human limb.
Freckle-faced Everett "Red" Knowles had been trying to hop a freight train in Somerville, Massachusetts. He was thrown against a stone wall that ripped his right arm off cleanly at the shoulder. Knowles walked away from the tracks, using his left hand to hold his right arm inside a bloody sleeve. A police ambulance rushed the 12-year-old across the Charles River to Boston, where emergency-room staff discovered the extent of his injury.
Surgeons had successfully attached partly severed limbs before, but never had the ideal candidate for a complete reimplantation, or replantation. Mass General's 30-year-old chief surgical resident, Dr. Ronald Malt, had Knowles' arm put on ice, and he assembled the team of experts he needed. All of the techniques they used that day had been used before, but never in the complete combination that saved an entire limb.
In hours of surgery, doctors reconnected the blood vessels, pinned the arm bone together, and grafted skin and muscle together, but they decided to wait to reattach the nerves. To their delight, Knowles' hand turned pink and a pulse returned to the wrist.
Malt became a celebrity. Knowles became a celebrity. The Little Leaguer got souvenirs and letters from Major Leaguers.
In September, doctors reattached four major nerve trunks. Within weeks, Knowles was complaining of severe pain in the arm, which in the unusual circumstances was a good sign.
A year after the surgery Knowles' arm and fingers were sensitive to heat, cold and touch, and he could move his fingers and bend his wrist. He could also play first base -- but only with his one good hand. The year after that, he was playing tennis and baseball. After four years of recovery, Knowles had the same use of his right arm and hand as a natural lefty. He eventually drove a six-wheel truck and lifted sides of beef at his job.
By 1966, surgeons had performed dozens of similar operations, failing at least half the time. That led to a editorial in the Journal of the American Medical Association suggesting that limb replantation be performed only if the patient is under 30 with no other major injury, with the severed limb in good shape, and is in a hospital with top-flight medical facilities. For all other cases, JAMA wrote, an artificial limb might be the better solution.
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