Posted Nov. 04, 2005

Houston Orthopedic Surgeon & Hand Specialist Saves Civilian's Arm

As the 23-truck convoy traveled toward Baghdad, Tom Chamberlain and his coworker saw something that made them uneasy. A group of Iraqi men dressed in orange construction vests mingled suspiciously up ahead.

"They overdid making themselves look good. Chamberlain said "We knew something wasn't right." Apprehensive, but with nowhere else to go they continued driving down the road. And then came a flash, as a bullet from an AK-47 assault rifle came through the truck "like a saw blade."

Chamberlain, a Halliburton truck driver, was shot by Iraqi militants and nearly lost his right arm on June 9, 2004. "We got hammered" Chamberlain said. "It looked like a slaughter pen inside the truck." When they were out of immediate danger from gunfire. Chamberlain looked down to inspect his and his coworker's injuries.

Feeling no pain, he tried moving his bloody arm from the gearshift, worried it was no longer attached. It was, but he had to use his left arm to pick up the dangling right arm and put it in his lap. That's when the throbbing began. "I poured water on the back of my neck and just concentrated on the road." "I knew I could let myself go into shock."

Chamberlain, a convoy command driver, sped through the next seven miles to escape the kill zone and immediately went to the hospital where doctors cleaned out his wounds. "It felt like a water hose going through my arm - very painful" he said.

Chamberlain was released from the hospital the next evening and transferred to Germany, where he underwent a second cleanout.

Meanwhile, the German staff contacted orthopedic surgeon and hand specialist Dr. Evan Collins at Houston Methodist Hospital. Collins immediately began preparing for Collins arrival, contacting various colleagues, including reconstructive surgeon Dr. Michael Kleubuc.

"It's difficult to get a true sense of what a patient needs until you assess them in person" Collins said. After a high velocity injury such as Mr. Chamberlain's, things can change within a matter of hours."

Collins said Chamberlain was definitely at risk of loosing his arm, and that infection was his biggest concern when Chamberlain arrived three days after the attack.

When Chamberlain reached Methodist, Collins performed one last cleanout.. He decided to let Chamberlain go home before his much-needed surgery - just in time for Father's Day weekend to spend with his four children. Chamberlaing had been I Iraq for seven months and 10 days when he was shot.

On June 23, 2004, Chamberlain underwent his first surgery. In a six-hour procedure, Collin's worked diligently with Kleubuc to reconstruct what was left of Chamberlain's arm.

With bone tissue missing, Collin's implanted a plate and several screws into Chamberlain's ulna bone to provide a base for new bone growth. He then used microscopic stitches to reattach the blood vessels and nerves that were severed by the bullet. Because large portions of Chamberlain's tendons were missing, Collin's had to reconnect the muscles to his bones. This portions of the procedure restored movement in his fingers.

It's one thing to reconstruct a broken arm or damaged vessels, but it's a completely different animal when pieces of the arm are left behind, "Collins said".

Once Collin's reconstructed Chamberlain's arm, Klebuc performed a local flap, stretching and rotating the skin and fat tissue in Chamberlain's arm to cover the repairs Collin's made. He also used a small skin graft to cover the rest of the open wound.

"Utilizing geometric principals is key in knowing how to close an open wound," Klebuc said. "Ultimately, I hope to perform another surgery on him to remove the skin graft and achieve the best cosmetic result we can."

Klebuc, who has seen nearly 20 of 50 Halliburton employees treated at Houston Methodist Hospital, said although Chamberlain's injuries almost caused him to loose his arm, he was very fortunate to have sustained life threatening injuries. Collin's and Klebuc both said they see similar injuries outside the war in Iraq from patients who are injured in car, motorcycle and industrial accidents.

In the days and months following his surgery, Chamberlain underwent extensive physical therapy to regain what function he could. He said his hand looked like a catcher's glove, and he struggled to perform even the most basic task, like getting dressed and buckling his belt.

Exactly one year after the shooting, on June 9, 2005, Collin's performed a second surgery on Chamberlain to clean up the scar tissue in his arm, and maximize his range of motion, particularly in his fingers, Collin's said.

Still on medical leave, Chamberlain continues physical therapy three times a week. Every six weeks he makes the two-hour trek from Vidor, Texas to visit Collin's, who plans to complete a thorough evaluation of his improvements after the first of the year to decide the next plan of action.

"It will never be as if nothing happened, but we try to minimize as much of the permanent damage as we can," Collin's said. "Nature plays a great part in the healing process, so we will continue to work on improvements as long as she allows."

"Chamberlain said he hasn't reached a plateau, so he just keeps going. He hopes one day he can make a full fist. "The doctor says I came as close to loosing my arm as you can come without actually loosing it," he said. "I still have some pain, and the top side of my arm is numb, but I'm glad to have it."