Case study: Pte Andrew Garthwaite

20 January 2011

On September 6, 2010, Private Andrew Garthwaite was serving with the Queen’s Royal Lancers in Helmand when a Taliban rocket-propelled grenade took off his right arm.

In the crucial hours immediately after he was wounded, Pte Garthwaite was taken to the field hospital at Camp Bastion, where he was operated on by trauma surgeons.

He was then flown back to the UK and admitted to the Queen Elizabeth Hospital Birmingham (QEHB) in September 2010. Following successful treatment by the hospital’s Trauma and Orthopaedics teams, he was discharged to the Ministry of Defence’s rehabilitation centre, at Headley Court in Surrey.

He is still undergoing rehabilitation at Headley Court but comes back to the hospital regularly for his injuries to be reviewed.

The next stage of treatment will involve Pte Garthwaite receiving a prosthetic limb so that he can continue his career in the Army.

The “bionic arm” will use Targeted Nerve Reinnervation, a technique which allows an amputee control motorised prosthetic and to regain sensory feedback.

Pte Garthwaite says: “Hopefully, I’ll return to work but I might have to change the sort of job I do because obviously holding the weapon is going to be quite hard – but with this new arm I might be able to. You never know.”

QEHB Professor of Neurology Adrian Williams says: “Recent advances in the design of prosthetic arms have helped upper limb amputees achieve greater levels of function. However, control of upper limb prostheses is limited by the lack of sensory feedback to the user.

“Targeted reinnervation, a novel surgical technique for amputees, offers the potential for returning this lost sensation. During targeted reinnervation surgery, truncated nerves are directed to reinnervate new muscle and skin sites.

“Contractions of reinnervated muscles generate electrical signals that are used to control prosthetic arms. In addition, stimulation of reinnervated skin is perceived on the missing limb. The functional limb sensation following targeted reinnervation could be used to provide prosthesis users with a sense of touch.”


Personal Statement from Pte Andrew Garthwaite:

“I’ve got nothing but praise for both the medics and my own regiment who’ve been there for me all the way since I was wounded.

In hospital and through rehabilitation I’ve been treated like you would be at a five-star hotel. They have been so good with my treatment and the prosthetics side of life.

They’re going to pull the nerves from the stump around and into my chest area. The nerves are going to talk to the muscles within the pec and when I think about doing stuff my pec will move and operate the arm by using different muscles of my body so, with my thinking, the arm will move.

Basically, I’ll have a bionic arm and if it works as it should, it will change my life and will mean a whole better future for me, my girlfriend and my family. It’s amazing that this kind of technology exists and I feel very fortunate that I will be able to benefit from it.

The learnings that clinical staff gain from me will hopefully be used as research to further improve and refine medical advancements to help others in the coming months and years.”