A harrowing journey preceded the operation to reattach appendage

By Alan Bavley from The Kansas City Star

Antwaun Handson still doesn''t know just how it happened.

He was rushing to cut the last few pieces of baseboard trim so that carpet installers could get to work in the house he was rehabbing. The miter saw he was using on the front porch was built for safety.

But before he knew it, the saw''s blade, spinning at 4,000 revolutions per minute, dropped on his arm about an inch above his left wrist.

"My hand came off with the wood. The whole hand and everything," Handson said.

"I didn''t even feel my hand get cut. I saw my hand fall down to the porch and then the blood on my jacket. That''s when I knew my hand was gone."

That was 16 days ago. Today the 31-year-old Kansas City construction contractor has his hand back. The hand is swollen, but Handson already can move his fingers. And doctors say Handson has a good chance of recovering full use of his formerly missing appendage.

How that happened is a story of luck, skill and generosity.

As soon as Handson''s hand hit the floor, he let out a yell that brought out everyone on his construction crew.

Handson''s wife, Tessa, was painting in the back of the house.

"That holler he gave out made me realize he had cut something off," she recalled Saturday.

Handson''s stepfather put the hand in a plastic shopping bag. Tessa Handson packed her husband and his hand into his pickup truck and sped to Truman Medical Center, honking the horn as she ran through stop signs and red lights.

Then the truck ran out of gas.

They flagged down another truck that took him to the hospital.

Workers in the hospital''s emergency room chilled Handson''s hand and bandaged his arm in gauze.

"They made it look like a big Q-Tip," he said.

But the hospital staff could not find a local surgeon to perform the operation, Handson said, so they looked out of town. Barnes-Jewish Hospital in St. Louis agreed.

Transportation was the next hurdle. An air ambulance based in Sedalia, Mo., volunteered to take Handson. On the way to St. Louis, the helicopter had to stop for a half hour in Columbia to refuel.

Handson was sedated but conscious the entire time.

Doctors at Barnes-Jewish Hospital quickly determined that Handson was an excellent candidate for surgery.

"Injuries that are clean or sharp are more amenable to reattachment. There''s less damage than a crush injury or limb that''s been pulled off," said Christine Cheng, the hand surgeon who took Handson''s case.

"This was a clean cut," she said.

It was so clean, Handson bled very little. Blood vessels are small at the wrist, Cheng said. When they are cut completely, they naturally contract.

Assisted by three other surgeons, Cheng labored eight hours to reattach Handson''s hand.

She used metal plates and screws to hold together the two bones of Handson''s forearm. She reconnected the two major arteries that bring blood to the hand and the two veins that take the blood out.

Cheng reattached two major nerves, and she sewed together 21 tendons that operate the fingers and allow the hand to open and close.

As they sewed, the surgeons wore magnifying glasses. Although the blood vessels and nerves were large enough to be clearly visible, each of the sutures that tied them together was thinner than a human hair.

"That''s why magnification is critical," Cheng said.

Right after the operation, Handson was able to move his fingers.

"I said, ''Thank God.'' It was a beautiful sight," Tessa Handson said. "I didn''t know if his hand was going to make it or not."

"The prospects for (Handson) are actually very good," Cheng said. "Because of the location of the cut, we expect all the muscles in his hand to survive."

It may take Handson 12 to 18 months to regain full sensation and recover fine control over his hand muscles.

"The nerves will regenerate. The question is whether it''s 90 percent or 80 or 70 percent," Cheng said. "Even though you put two ends together, you don''t always get the same result."

Handson starts occupational therapy on Monday at Truman Medical Center to regain muscle strength and control and to keep his joints and tendons supple.

"It does dramatically affect how the outcome will be," Cheng said.

Handson likes to work with his construction crew, but for now he will hang up his tool belt and stick to paperwork.

While Handson had insured all his employees, to save money he did not insure himself. Barnes-Jewish Hospital picked up the tab for operation.

"That was the blessing," he said. "I want to get back there and thank (Cheng) and the crew for all they did."