Dr. Susan Mackinnon instantly realized there was something special about the case as she stepped into Room 6 of the plastic-surgery clinic at Washington University. Before her sat Dr. Martin Robson, a renowned plastic-surgery colleague, who’d traveled to St. Louis with an elderly gentleman in a wheelchair. The man, it turned out, was a former Phoenix surgeon who’d endured a car accident two years earlier that crushed his C7 vertebra and left him a quadriplegic. The two were there to see whether Mackinnon, a plastic surgeon who’d earned a reputation for transferring healthy peripheral nerves into areas left paralyzed by damaged ones, could return movement to the man’s hands.
A thought came to her instantly: brachialis to anterior interosseous nerve (AIN) transfer. In layman’s terms, she would reestablish the connection to the brain by stealing a nerve from above the spinal-cord injury—one that helps flex the elbow, a movement that’s already accomplished by the bicep—and connecting it to the nerve running to the muscles in the forearm that allow the thumb and index finger to pinch. After the procedure, all she could do was wait.
Six months later, his fingers began to twitch. A year later, he could feed himself again.
Since then, Dr. Ida Fox has picked up where Mackinnon left off, performing the procedure on several other quadriplegics—those with injured C5, C6, or C7 vertebrae—and learned the nuances of the operation, which is relatively affordable and straightforward.
As Mackinnon emphasizes, though, it all started with the coincidence that the one-time surgeon would come to her clinic. “That’s why they’re called medical miracles,” she says with a smile. “They come from the big surgeon in the sky.”
