75-year-old Mumbai woman's nearly amputated finger saved after 18-hour delay following freak accident

What began as an ordinary evening ended in a freak accident for a 75-year-old Mumbai woman, whose index finger was nearly amputated after a powerful gust of wind slammed her apartment door shut on her hand. Despite reaching a specialist centre nearly 18 hours after the injury, well beyond the ideal time window in many such cases, a team of surgeons at Gleneagles Hospital, Parel, Mumbai, successfully replanted the finger.

The incident has drawn attention not only because of its unusual cause but also because specialists say it highlights the importance of prompt referral to dedicated hand trauma centres and the possibility of limb salvage even in elderly patients with multiple health risks.

According to the hospital, Bhagwani Singh, 75, a resident of Lower Parel, had just returned from her routine evening walk when strong winds caused the heavy door to slam shut on her hand. The impact nearly amputated her index finger and severely injured another finger. As she tried to free her hand, another gust reportedly pushed the door again, striking her forehead and leaving her with injuries that also required stitches.

Initially taken to a nearby hospital, her family later searched for a centre with expertise in complex hand microsurgery before she was transferred to Gleneagles Hospital and by then, nearly 18 hours had elapsed since the injury.

"The elderly patient suffered a devastating crush amputation of her finger at the middle phalanx level after her hand was caught in a door. The patient reached the specialist team several hours after the injury, as her family initially admitted her to a nearby hospital while searching for the right centre with expertise in complex hand microsurgery, making the procedure technically demanding due to prolonged warm ischaemia. The treating surgeons decided to proceed with replantation after carefully assessing the condition of the amputated part and counselling the family regarding the guarded prognosis," said 

Dr Kushal Shah, hand, wrist, brachial Plexus and reconstructive surgeon who led the skeletal reconstruction, performed fracture fixation and repaired the flexor and extensor tendons before the microsurgical reconstruction began.

He said that preserving finger length, sensation, and function was the primary goal, and that some elderly patients can benefit significantly from replantation rather than revision amputation.

"The success of finger replantation is never determined by surgery alone. Every effort must be made to preserve length, sensation and function, especially in the hand. Even in elderly patients, a replanted finger can provide superior functional and psychological outcomes compared with revision amputation, provided the patient understands the risks involved," Dr Shah explained.

The microvascular reconstruction was carried out by plastic and reconstructive surgeon Dr Raghav Mago, plastic and reconstructive surgeon who restored blood flow to the amputated finger through arterial and venous anastomosis under an operating microscope.

"Restoring circulation is one of the most technically demanding aspects of replant surgery. However, surgery is only one part of the battle. Factors such as diabetes, tobacco use, and the nature of the injury significantly influence healing and long-term survival of the replanted finger," said Dr Mago.

According to the experts, the case was especially challenging because the patient had uncontrolled diabetes and a long-standing tobacco-chewing habit, both known to impair blood circulation, delay wound healing and increase the risk of infection, clot formation and tissue loss.

Unlike clean-cut amputations, crush injuries caused by heavy doors often damage arteries, veins, nerves and surrounding soft tissue extensively, reducing the chances of successful replantation.

Experts say finger replantation is not merely about saving a digit. Restoring sensation, grip strength and hand mechanics can significantly improve quality of life, especially in older adults who depend on hand function for everyday tasks.

The treating surgeons stressed that age alone should not determine whether replantation is attempted. Instead, they said decisions should be based on factors including the pattern of injury, ischaemia time, associated medical conditions and the patient's functional expectations.

This case is a reminder for patients that controlling diabetes, avoiding tobacco, and seeking immediate medical attention after an amputation are critical factors that influence the outcome.

Recalling the accident, the patient's granddaughter, Diksha Singh, said the family never imagined a strong gust of wind could lead to such a devastating injury.

"It all happened within a few seconds. She had simply returned home after her regular walk and was taking off her footwear when the wind suddenly slammed the door on her hand. We never imagined that something as ordinary as a strong gust of wind could cause such a devastating injury. Seeing her in so much pain was heartbreaking, and we feared she would lose her finger forever," said Singh.