Ronald Malt, Innovator in Reattaching Limbs -- Rest in Peace

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Subject: Ronald Malt, Innovator in Reattaching Limbs

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died Oct. 5

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Date Posted: October 17, 2002 5:15:59 EDT

Dr. Ronald A. Malt, a Boston surgeon who made medical history 40 years ago when he oversaw the first successful reattachment of a human limb, died on Oct. 5 in Wellesley, Mass. He was 70.

The cause was complications from Alzheimer's disease, his family said.

Dr. Malt was 30 and the chief surgical resident at Massachusetts General Hospital on May 23, 1962, when Everett Knowles, 12, was taken into the emergency room. Everett had been hopping a freight train to go to a baseball game, but when he was thrown against a stone abutment, his right arm was ripped off cleanly at the shoulder.

Until then, surgeons had been able to reattach partly severed limbs and restore function. But no one had success with limbs that had been shorn off. Dr. Malt gathered a team of 12 specialists, who went to work reattaching Everett's arm.

Doctors attached the bone with a special pin. They reconnected the arteries. They grafted skin and muscle together. Then they waited to see whether the operation would take, raising their hopes when the hand regained a healthy pink color and a pulse could be felt in the wrist.

None of the individual steps taken that day were new. The novelty lay in their choreography.

"What concerned me was not the technique," Dr. Malt told Life magazine the next year. "I was afraid we might overlook some unseen serious injury to some other part of his body, or that because of insufficient restoration of blood supply, he'd get gas gangrene or some other infection. I was afraid, too, that we might make a psychic invalid out of him, by giving him an arm that mightn't work."

The answer to that question would have to wait. The surgeons decided not to try to reattach the nerves in the arm the first day, suturing them and letting the arm heal. It was not until several months later that doctors spliced the four major nerve trunks. Everett also needed more surgery and extensive physical therapy.

A year after the accident, the boy was able to move all five fingers and bend his wrist. Two years afterward, The Boston Globe reported, he was playing baseball and tennis. In later years, he drove a six-wheel truck and lifted sides of beef for his job.

Dr. Leslie W. Ottinger, a longtime colleague of Dr. Malt at Massachusetts General, said Everett's youth and the nature of the injury were probably factors in the success of the procedure.

"I think this was a favorable case, in that there was not very much trauma, soft-tissue trauma, to the arm," Dr. Ottinger said.

Although Dr. Malt minimized the accomplishment, after news of the case spread, he became a celebrity. So, of course, did his patient, a red-headed Little League pitcher with what Life called "the most celebrated arm in all the world."

Everett was interviewed repeatedly. He received letters and souvenirs from major league baseball players, an astronaut and other complete strangers. A fan club formed. People wondered whether he would ever play ball again.

"I'm not the least bit worried," he assured an interviewer. "Besides, if I can't pitch again, I'll switch to third base."

Ronald Malt was born on Nov. 12, 1931, in Pittsburgh. He earned his bachelor's degree from Washington University and his medical degree from Harvard.

Although he was best known for the groundbreaking operation and traveled around the world to teach the technique, Dr. Malt also conducted research. He developed techniques in gastrointestinal surgery and was a professor of surgery at Harvard. He was co-editor of "The Oxford Textbook of Surgery" and an associate editor at The New England Journal of Medicine.

Surviving are his wife, Geraldine, of Wellesley; his mother, Ruth, of St. Louis; three children, Bradford, of Beacon Hill, Mass.; Barbara, of Allentown, Pa.; and Margaret, of Cambridge, Mass.; and two grandsons.

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