In an instant, Josh Williams—just 21 at the time—saw his future disappear.
Williams was prepping materials for his work at a glass fabricating company when a raw piece of plate glass—unseen by Williams—came crashing down on his left shoulder, severing the nerves responsible for muscle control in his shoulder, arm, elbow and hand and nearly severing his left ear.
He was rushed to UC Health University Hospital where he had emergency surgery aimed at salvaging his arm function. Williams was told he may never regain left-side function, news made even more devastating because he is left-handed.
"I thought my life was over. I didn’t think I would ever be normal again,” says Williams. "Laboring is all I’ve ever done … it’s what I know. I don’t have a college degree, so I was shocked to think I might never be able to work again.”
After several months, it was clear the initial surgery was not enough to repair the nerve damage. David Megee, MD, a UC Health plastic and reconstructive surgeon and assistant professor at the UC College of Medicine, suggested nerve transfer surgery.
The procedure involves taking nerves from another part of the body and rewiring them to trigger muscle function in an area where a patient has had a nerve injury that resulted in complete loss of muscle function or sensation.
Megee explains the procedure like this: "Think of nerves as cables with multiple wires inside. This surgery involves stripping an individual redundant wire (i.e., nerve) from inside that cable and then rewiring it to trigger muscle function in the area where the nerves were more severely damaged.”
For Williams’ case, Megee harvested redundant nerves that usually bend the wrist and fingers and used delicate microsurgical techniques to rewire the nerves into his left shoulder and elbow. The recovery is slow—the patient’s muscles must be retrained through regular physical therapy to help the newly wired nerves understand when to trigger specific muscle movements, for example elbow or finger bending.
"Many patients with nerve injuries in the shoulder area experience shoulder pain from sagging of the humerus head out of the shoulder joint even if some of the arm function is restored. The nerve transfer procedure is perfect for this type of injury because it also helps stabilize the shoulder joint by enabling the patient to rebuild the muscles around the full joint—not just in the upper arm,” adds Megee.
The success of the procedure relies on both the expertise of the surgeon and the patient’s commitment to do the work to rebuild muscle strength. Megee says that with time, he expects Williams to regain substantial function of his arm.
"I feel stronger and stronger every day. I can curl dumbbells again and have started doing push-ups to strengthen my shoulder. Dr. Megee gave me my arm back; he is my savior. The sky is the limit now, and I am so thankful,” says Williams.
Appointments and More Information
Megee is fellowship-trained in microvascular reconstructive hand surgery, making him uniquely qualified to correct delicate peripheral nerve injuries—including complex brachial plexus damage—related to the upper extremities. He sees patients at the UC Health Physicians Office in West Chester and University Hospital in Clifton. For appointments or referrals, call 513-475-8881. To learn more about UC Health Plastic and Reconstructive Surgery, visit ucphysicians.com.