{"id":116320,"date":"2024-10-23T02:00:00","date_gmt":"2024-10-23T07:00:00","guid":{"rendered":"https:\/\/www.unmc.edu\/newsroom\/?p=116320"},"modified":"2024-10-22T15:05:55","modified_gmt":"2024-10-22T20:05:55","slug":"a-skilled-surgeons-hands-and-an-unconventional-patient","status":"publish","type":"post","link":"https:\/\/www.unmc.edu\/newsroom\/2024\/10\/23\/a-skilled-surgeons-hands-and-an-unconventional-patient\/","title":{"rendered":"A skilled surgeon’s hands and an unconventional patient"},"content":{"rendered":"
\n

How passionate is Joseph Morgan, MD, about hands?<\/p>\n\n\n\n

\u201cOne of my favorite analogies,\u201d Dr. Morgan, associate professor of orthopaedic surgery and rehabilitation, said as he excitedly gestured at an X-ray, \u201cis that the hand is the \u2018tool of tools.\u2019 That\u2019s what Aristotle called it.<\/p>\n\n\n\n

\u201cA mole\u2019s hand is perfect for digging. A whale\u2019s hand is built for swimming. A bat\u2019s hand is perfect for flying and nothing else.\u201d<\/p>\n\n\n\n

He was rolling now.<\/p>\n\n\n\n

\u201cThe human hand is not perfect for any one thing, but it\u2019s pretty good at just about everything,\u201d he said. \u201cAnd that\u2019s what sets it apart.\u201d<\/p>\n\n\n\n

He paused just a split second then, realizing his own enthusiasm.<\/p>\n\n\n\n

\u201cI really get nerdy,\u201d he said.<\/p>\n\n\n\n

\u201cThis is the best day of his life,\u201d someone said.<\/p>\n\n\n\n

Well, maybe top 10. There had been another even better just a few days before. Dr. Morgan was supposed to be on paternity leave with a brand-new baby girl. But this was an opportunity he couldn\u2019t pass up. He would have a story to tell her one day. They will talk forever about the time he left for a few hours, when she was just several days old, so he could help a monkey.<\/p>\n\n\n\n

Dr. Morgan normally sees human patients, as a faculty member at UNMC. But this day he was at the animal hospital at Omaha\u2019s Henry Doorly Zoo and Aquarium.<\/p>\n\n\n

\n
\"\"
Joseph Morgan, MD, a surgeon in the UNMC Department of Orthopaedic Surgery, repaired a dislocated knuckle on the hand of a Francois langur named Yuki.<\/figcaption><\/figure>\n<\/div>\n\n\n

Yuki, an 8-year-old Fran\u00e7ois\u2019s langur<\/a>, had \u201ca relatively unique injury,\u201d said Taylor Yaw, DVM, the zoo\u2019s director of animal health, who oversaw the procedure. She sustained a dislocation at her third metacarpophalangeal joint that occurred at an abnormal age due to a previous fracture in this area, putting stress on the ligaments.<\/p>\n\n\n\n

As one can imagine, langurs utilize their hands and feet extensively when navigating their habitat, so a \u201cvery intricate surgery was necessary,\u201d Dr. Yaw said.<\/p>\n\n\n\n

The zoo\u2019s veterinarians, veterinary technicians and animal care teams have the expertise to take care of more than 39,000 animals. They have veterinary team members onsite every day of the year and are always on call for more urgent clinical cases like Yuki\u2019s. After initially assessing Yuki\u2019s hand, the team wanted a second opinion due to the small size of the bones and the high impact a potential surgery could have on her future for grooming, climbing and social aspects of her life.<\/p>\n\n\n\n

\u201cWe wanted another set of eyes on such a sophisticated case. Being a small- to medium-sized primate, we anticipated that her anatomy would not be too different than a human pediatric case,\u201d Dr. Yaw said. So they called in the experts at UNMC.<\/p>\n\n\n\n

Dr. Morgan was excited to say yes. He\u2019d been reading up on monkey anatomy all week. (His favorite hand anatomy textbook, and, yes, he has a favorite hand anatomy textbook, has a whole chapter on ape hands, and he\u2019s read that book three or four times.)<\/p>\n\n\n\n

He brought a team with him. Three residents, Olivia Thomas, MD, Michael Garneau, MD, and Jake Rodgers, DO, and admin Holly White.<\/p>\n\n\n\n

\n
\"\"
Joseph Morgan, MD, led the surgery at the Henry Doorly Zoo and Aquarium.<\/figcaption><\/figure>\n\n\n\n
\"\"
Three UNMC orthopaedic surgery residents observed: Olivia Thomas, MD, Michael Garneau, MD, and Jake Rodgers, DO.<\/figcaption><\/figure>\n<\/figure>\n\n\n\n

The patient came in, carried on a towel. Beautiful black fur. \u201cOh, Yuki!\u201d someone said. The monitor beeped as general anesthesia was induced and the team monitored her vitals.  Dr. Morgan stepped in to get his first look at the hand and after palpating it, determined that, yes, it will work.<\/p>\n\n\n\n

Does Dr. Morgan get nervous before performing surgery? Depends, he said.<\/p>\n\n\n\n

What about today?<\/p>\n\n\n\n

\u201cIn a human, this would not be stress provoking,\u201d he said. But he was very excited. His eyes shone.<\/p>\n\n\n\n

See this earlier feature on the partnership between UNMC and the Henry Doorly Zoo and Aquarium to bring preventive, specialized health care to the zoo’s gorillas.<\/em><\/strong><\/a><\/p>\n\n\n\n

The challenge wasn\u2019t just the intricacy of the surgery itself, but making the fix primate-strong, so it would hold up to the patient\u2019s active lifestyle.<\/p>\n\n\n\n

\u201cWe really want to belt-and-suspenders this thing,\u201d Dr. Morgan said, almost to himself.<\/p>\n\n\n\n

The surgery was not easy at first. Medical language is very similar between human health and veterinary health, but there are some differences in medical instrument names and verbiage used. The two teams, human and veterinary, quickly assimilated in the surgical room to become Yuki\u2019s best hope for a full recovery. Was there a tool they were looking for that was small enough for a primate hand? What would work? The metacarpal kept popping back out. Would it stay? Was this more complicated than they\u2019d thought? \u201cThis would be tough in a human\u2026,\u201d Dr. Morgan said, again almost to himself. They tried again.<\/p>\n\n\n\n

Then, they turned a corner.<\/p>\n\n\n\n

\u201cThat looks nice, that looks really nice!\u201d Dr. Morgan said as his UNMC residents observed their first ever opportunity to scrub into a non-human primate surgery.<\/p>\n\n\n\n

\n
\"\"<\/figure>\n\n\n\n
\"\"<\/figure>\n<\/figure>\n\n\n\n
\n\n\n\n
\"\"
Images of Yuki’s hand throughout the surgery and from X-ray<\/figcaption><\/figure>\n\n\n\n

\u201cLet\u2019s do the ulnar side first,\u201d Dr. Morgan said to Dr. Yaw. \u201cThe other side will be harder.\u201d<\/p>\n\n\n\n

The surgery continued. Steady now. Yes. \u201cI think that looks pretty good,\u201d Dr. Morgan said. \u201cIt looks great!\u201d Dr. Yaw said. They talked as the two worked in unison.<\/p>\n\n\n\n

And then Dr. Morgan got emotional (nerdy?) again about hands.<\/p>\n\n\n\n

\u201cI think about pianists, construction workers who use their hands, helping people be able to do what they want to do.<\/p>\n\n\n\n

\u201cAnd I think about Yuki, all the things she needs to do with these hands. Grooming. Her place in the group \u2026\u201d<\/p>\n\n\n\n

The work was wrapping up. Then, the last stitch.<\/p>\n\n\n\n

They cleaned her off and held up a tiny, furry hand for all to see. The team took post-operative x-rays, and Dr. Morgan and Dr. Yaw agreed the surgery was success.<\/p>\n\n\n\n

\"\"
Yuki’s hand is bandaged following the successful surgery.<\/figcaption><\/figure>\n\n\n\n

When she recovered, she would head back to the Lied Jungle to be reunited with her troop and her animal care team would take over her rehabilitation plan and medications, Dr. Yaw said. They were hopeful the fix will hold long enough to heal.<\/p>\n\n\n\n

And it did. The veterinary team performed a recheck on Yuki a few weeks following the procedure and saw that the area had healed. She has regained her range of motion in her hand and can be seen swinging from branch to branch in the Lied Jungle.<\/p>\n\n\n\n

And Dr. Morgan will have a story to tell his daughter when they visit the zoo, about how he assisted the veterinary team with Yuki\u2019s hand.<\/p>\n<\/div><\/div>","protected":false},"excerpt":{"rendered":"

UNMC’s Joseph Morgan, MD, and a team from orthopaedic surgery join with the Henry Doorly Zoo for an intricate surgery on a monkey’s hand.<\/p>\n","protected":false},"author":75,"featured_media":116324,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"73105,69179,33198,35488,38142,72030","_relevanssi_noindex_reason":"","footnotes":""},"categories":[1],"tags":[],"class_list":["post-116320","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized","topic-community","topic-outreach","department-orthopaedic-surgery-and-rehabilitation","department-unmc-front-page","department-unmc-today-todays-headlines","author_override-kalani-simpson-unmc-strategic-communications"],"yoast_head":"\nA 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