James's Story

On April 22, 2017, James White did something he’d never done before in 40 years of riding a motorcycle: He crashed. His left hand and wrist suffered the most damage in the accident. Emergency room doctors at the local hospital where he was taken told him they were doing everything they could just to stabilize them. In all likelihood, he’d never be able to use his hand again.

The pain, he says, was “unbelievable.”

Later, James would undergo surgery on his left hand and wrist and, soon after, begin physical therapy. He was going three times a week and making what he believed to be modest progress until, one day, his therapist told him she believed he’d developed an infection in his surgically-repaired hand.

“I didn’t realize anything was wrong at first,” James says. “My physical therapist said I looked woozy and told me to go straight to the hospital, to see my hand specialist. The next day, I had the first surgery.”

In all, James estimates he underwent about a dozen surgeries to eradicate the infection. He was constantly in and out of the hospital for two months. “After the last surgery, my hand swelled up so much from all the puss that had built up inside,” he says. At that point, his doctor told him there was nothing more he could do for him aside from amputate his arm below the elbow. Before that, however, he asked James to meet with L. Scott Levin, MD, FACS, FAOA, Chair of Penn Orthopaedics, Paul B. Magnuson Professor of Bone and Joint Surgery, Professor of Surgery, Division of Plastic Surgery, and co-director of the Penn Orthoplastic Limb Salvage Center

James was willing, but he didn’t have much hope that his hand could be saved. In fact, he was quickly losing hope that anything good was going to happen to him again. A truck driver by trade, James hadn’t been able to work since his accident.

“I’ve always taken good care of myself. I’m in great shape for my age,” says James, who’s now 68. “But not working, I was so depressed. When something happens that causes your whole life to suddenly change, it’s a nightmare.”

On the verge of amputation

“James had basically lost his entire distal radius and all the bone in his wrist because of infection, in addition to all the tendons that extend the fingers in his hand,” Dr. Levin says. The radius is one of two forearm bones. It’s located on the thumb side. The distal radius is the part that’s connected to the wrist joint.

As far gone as James’s lower left arm and hand appeared to be, Dr. Levin proposed a complex series of surgeries that, if successful, would not only avoid the need for amputation but also restore much of the original function to James’s wrist and hand. Among these were microvascular tissue transfers, a procedure where skin and tissue—with their blood supply intact—would be removed from one of James’s thighs and transplanted to his left hand and wrist.

“He required two microvascular tissue transfers,” Dr. Levin says. “The first one was for coverage. And then, sometime later, we employed a relatively new bone tissue transfer called a medial femoral condyle vascularized bone flap. We rebuilt the wrist and bridged from his metacarpals to his forearm. Following that, we rebuilt his tendons with tendon transfers.”

“I can’t say enough about Dr. Levin. Without him, I would have lost my hand,” James says. “Somehow, he managed to get my fingers moving again and make my hand and wrist stronger than they were at any point after my accident. When I needed it most, Dr. Levin and his whole team took great care of me.”

Back in the driver’s seat

Early last fall, James returned to the driver’s seat after 29 months out of work. It was a day that he never thought he’d see again. With his sense of purpose restored, James says, “Life is great now. I’m working again and doing things with my family, and I couldn’t be happier about it.”

Right around the time he returned to work, James found the confidence to do something else he wasn’t sure he’d ever do again. He climbed back on his motorcycle and drove to the scene of his accident.

“I just had to get over the fear. I couldn’t give up,” he says. “Dr. Levin actually gave me the motivation to do it.”