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St. Louis doctors maximize hand function of soldier injured in Iraq

  • November 10, 2006
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A St. Louis man working for a security company in Iraq suffered serious injuries when a roadside bomb detonated under the truck he was driving. Once he was back home, St. Louis doctors devised a creative solution to maximize the function of his hand.

Jacob Beckmann, 25, was working as a triggerman for a private security company in Iraq, carrying a machine gun seven days a week, providing protection for the U.S. military. For security reasons, he can''t tell us exactly where he was.

But the day of the attack, he was in an Army Corps of Engineers convoy carrying two truckloads of volatile C-4, or high-quality plastic explosive used to destroy ammunition from Saddam Hussein''s regime.

"Just driving down the road in the convoy you can see the trail the diesel oil I left behind," says Beckmann as he looks at photographs of the attack.

He thinks about it every day.

On October 27, 2005, an explosively formed projectile (EFP) hit the heavily armored pick up truck he was driving.

"It was completely buried on shoulder of road," says Beckmann of the roadside bomb, "and they''re usually electronically detonated by someone (with a cell phone or garage door opener) as you pass by."

The EFP, a crude ball of molten copper, narrowly missed Beckmann''s head and passed through the driver''s side window.

"This one in particular was a shaped charge that hit us. They can defeat any armor that''s out there.

Two co-workers who were passengers in the seat beside him were killed instantly.

"At the time, I just remember a lot of heat and dust," says Beckmann. "Immediately my vision was obscured.

"I felt a lot of pain in my arms. I figured my hands were gone at the time. It was that bad and I lost control of the vehicle and we ended up turning sideways into a canal about a half-mile down the road."

Others in the convoy rescued him from water up to his neck in the overturned truck.

Beckmann was rushed to a military hospital in the green zone in Baghdad. Burned and missing part of his right hand, he needed 10 units of blood just to survive. Two days later, he was medevaced to Germany. Ten days after that, he was flown by private jet back to St. Louis.

"I lost my thumb on this side and a piece of my bone," says Beckmann as he shows the scars from his injuries.

Safely back home last winter, local surgeons were in a race against time to make the most of what had.

"The most urgent thing is trying to get nerve supply back to the muscles. If the muscles can''t get that back within a certain amount of time, it''s impossible to get them back working again," says Dr. Thomas Tung, a hand surgeon at Barnes-Jewish Hospital in St. Louis.

Because of all of the shrapnel in his body, Beckmann couldn''t tolerate a nerve transplant. So in ten hour operations over two days, doctors grafted nerves from his left arm and leg to replace damaged nerves on his right side. Surgeons also devised a new thumb out of his index finger.

"We shortened the bone and repositioned his index finger so that it was more in the angle of a thumb to be able to oppose his other digits. Some of the tendons we had to shorten because the biomechanics were different now," says Tung.

Beckmann will always carry the scars and shrapnel from the attack, but thanks to his age and determination, this young man is doing well. After all he''s been through, he still talks about going back to Iraq.

"I had fun, actually as messed up as that sounds," says Beckmann. "I liked the job, I liked the people and I don''t know, I thought we were doing something good over there."

Tang says Beckmann will always have limited function, but he also says age is on his side. He says young patients often compensate well once they adjust to life with a newly reconstructed limb.

Along with the thousands of U.S. troops in Iraq, there are also 20,000 private security forces.

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