Just after 5 p.m. on May 12, a male climber (age 29) was attempting to lead Cottonmouth, a 5.10a sport climb at Cotton Top, a small crag on the north side of the New River Gorge. The climber moved quickly through he lower portion of the climb. Once he was within arm’s reach of the fifth bolt, he clipped a quickdraw to the bolt hanger. Taking slack in the rope, the climber attempted to clip the draw with his right hand and at that point fell approximately 20 feet. At some point during the fall, the rope encircled the climber’s left thumb, and when the rope came taut the thumb was amputated at the midpoint of the proximal phalange (just above the MCP joint, the second of the three joints in the thumb).

The climber was immediately lowered by his belayer (24). The climber and belayer retrieved the thumb— first identified on the ground by the climber’s dog—and placed it in a water bottle filled with cold water. The climber removed his shirt, applied pressure to the thumb, and raised his hand above his heart. After stopping to place the amputated portion of the thumb in a plastic bag, surrounded by ice, the climbers immediately went to a local hospital and eventually to a specialized hand-surgery center in Louisville, Kentucky, where the thumb was successfully reattached during a four-hour surgery beginning at 1 a.m. on May 13. (Source: R. Bryan Simon, from interview with the injured climber.)

ANALYSIS

Sometimes in climbing, as in life, bad things happen. In this case the climber took a fall similar to many others experienced daily across the United States. The climber could not recall grabbing for the rope with his left hand, though this may be the case. (Grabbing the rope should always be avoided while falling.) Once the accident occurred, the climbers made a series of good decisions that resulted in saving the victim’s thumb. From placing pressure on the wound to placing the amputated thumb in clean, cool water, to wrapping it in plastic and storing it with ice, to rapidly evacuating to medical care, and finally to self-identifying a hospital with well-trained hand specialists, calm decision-making allowed a successful reattachment, preserved function of the thumb, and allowed the patient to return to climbing and other outdoor activities just three months after the incident. (Source: R. Bryan Simon.)

INDOOR CLIMBING FINGER AMPUTATION: In September, an experienced climber in Colorado had the index finger of his right hand amputated in similar fashion during a leader fall in a gym. The climber wrote in a post at Mountain Project: “I am not one to grab my rope during a lead fall, and I take hundreds of lead falls per year. My belayer knows what she is doing; she has also been climbing for many years. The way I see it, it is a ‘freak accident,’ one that could not have been prevented.” Surgeons reattached this climber’s finger, but complications forced a surgical amputation three days later.