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Monday, April 12, 1999 Published at 13:42 GMT 14:42 UK


Health

Prince is good patient in difficult operation

The bones in the hand are very small

Prince William cracked jokes as he prepared for a challenging operation to mend a fragmented finger, said the lead surgeon involved.

Professor Frank Burke from the Derbyshire Royal Infirmary told BBC News Online that William was a very good patient.

"He was helpful, co-operative and had a good sense of humour," he said.

The operation to fix the tiny bone in the prince's finger was a delicate one and made more complicated because the fracture had affected a joint.

"It is a reasonably straightforward operation if the injury is a fresh one, although it still has its challenges then," said Professor Burke.

"With an injury which is a few months old, as in the prince's case, it is quite challenging."

This is because the fracture has not healed and scar tissue has formed around the end of the bone.

This makes it difficult for surgeons to make sure the bone is reset in the correct position.

Bone surfaces also tend to change as time passes, increasing the difficulty of aligning the bone.

Trepidation

Professor Burke said that in a fresh cut, it was easier to see where the bone should fit.

"We has some trepidation about how difficult the operation would be, but we had a lot of time to prepare and analyse the best way of proceeding," he added.


[ image: Prince Wiliam injured his finger playing rugby]
Prince Wiliam injured his finger playing rugby
Unusually, the operation by Professor Burke and his assistant, hand surgeon Mr Peter Lunn, went entirely to plan and no alterations had to be made on the day.

The surgeons put the fragmented bone back "as accurately as possible" and tried to get the joint surface to be smooth.

An unsmooth surface could lead to arthritis in later life.

Professor Burke said the operation had been "stressful but enjoyable".

"It was a huge privelege to be asked to be involved and we felt all aspects of the day went very well.

"We are a casual team and there tends to be a bit of banter, but the prince played his role in that and maintained everyone at their ease.

"He was a very good patient."

The operation took two hours, but the prince was at the infirmary from 9am to 4.30pm to prepare and to come round from the general anaesthetic he was given.

The prince is now resting his finger, but will have to begin hand therapy exercises in the next few days.

Professor Burke said he will have a good idea of whether the operation was totally successful in eight to 12 weeks.

Tiny tools

Operations on fragmented bones in the hand have been carried out for many years, but in the last decade there have been major advances.

Previously, pins were used to fix the bone, but now screws, many smaller than 1.5mm in diameter, are used.

The Derbyshire Royal Infirmary's hand centre has been holding workshops on minute fragment fixation for several years and has become known for its work.

Professor Burke said: "We train people in the specific problems of fixing very small fractures in the finger where the bones are extremely small.

"The tools have to be very delicate."



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