Italian may regain use of hand after nerve transfer from amputated leg

[December 28, 2023]  By Alex Fraser

TURIN (Reuters) - A man may regain the use of his hand, left paralysed by a severe road accident, thanks to a pioneering nerve transfer operation from his partly amputated leg, doctors in northern Italy said.

Surgeons at Turin City Hospital (CTO) transferred part of the man's sciatic nerve, which controlled the movement of his amputated foot, to his brachial plexus, the network of nerves that connect the spinal cord to the shoulder, arm and hand.

"It's the first time that someone transfers a component of the sciatic nerve to the brachial plexus", Paolo Titolo, one of the surgeons who performed the operation, said in an interview with Reuters on Wednesday.

Marcello Gaviglio, a 55-year-old healthcare worker had to have half his left leg amputated after he was hit by a motor-bike five months ago while travelling to work on his moped.

He suffered serious injuries to his brachial plexus as well as his leg, leaving him unable to use either of his hands.

Because the part of the sciatic nerve that controlled his left foot was no longer needed, it could be transferred to the shoulder area in the operation carried out on Dec. 21, potentially restoring the mobility to one of his hands.

Before it is clear if that is possible, Gaviglio will have to undergo around 5 months of post-operative care. For now, he is still unable to move the hand at all.

Nerve transfer surgery is not new, but it has not previously involved moving a nerve that normally controls the foot to an area that controls the hand.

Surgeon of Turin City Hospital, Paolo Titolo and 55-year-old healthcare worker Marcello Gaviglio, who had a nerve transplant from his amputated foot to restore his paralyzed hand, pose for a picture in his hospital bed in Turin, Italy December 27, 2023. REUTERS/Massimo Pinca

"We think this is pioneering surgery because if it works it means that the brain plasticity can control also other parts of the body that we didn't expect and also opens new fields in neuro studies," Titolo said.

The aim is to restore "some grasp function" to the hand, which will then also be able to help the other hand to do things, he added.

The procedure was the result of four years of research and was published in the medical journal Injury.

Gaviglio, the patient, said he had given little thought to the pioneering aspect of the surgery, he just felt it was an opportunity he should take advantage of.

"I thought about relying on a team of very good doctors and being able to move my hand again a little bit," he said.

(additional reporting by Massimo Pinca, writing by Alvise Armellini and Gavin Jones, editing by Alexandra Hudson)

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