ZINTAN/TRIPOLI, Libya - Muammar Gaddafi's son Saif al-Islam needs surgery to remove gangrenous flesh from a severed thumb and finger which if not treated could make him seriously ill, a doctor who examined him told Reuters on Thursday.
Saif al-Islam has been nursing injuries to his right hand which he says were sustained during a NATO airstrike weeks ago. No further details have been available on the state of his heavily bandaged thumb, index and middle fingers.
"This wound is not in good condition and requires amputation," Andrei Murakhovsky, a Ukraine-born doctor working in Zintan, the town where Saif al-Islam is being held, and who treated him three days ago told Reuters.
"The wound is covered with gangrenous tissue and necrotic tissue," Murakhovsky added.
Fighters from Libya's Western Mountains captured Saif al-Islam in the southern desert on Saturday and flew him to their stronghold town of Zintan, where he is being held pending a handover to the country's provisional government.
Saif al-Islam's middle finger did not require surgery but the two other bandaged digits had been severed and were weeping pus, said Murakhovsky, who was interviewed by Reuters television in English and later by telephone in Russian.
"His index finger has been ripped off at the level of the middle phalange (finger bone), the bones are all shattered ... It's the same thing with the thumb of that hand," he said.
When a picture of Saif al-Islam's bandaged hand was aired, many Libyans thought his captors had cut off his fingers in retribution for televised remarks in which he threatened anti-Gaddafi rebels, pointing and making other hand gestures.
Murakhovsky, however, said the injuries were consistent with "some kind of explosion".
The surgical intervention required was relatively simple and could be performed in Zintan under local anaesthetic, Murakhovsky said, but the town's militiamen were worried someone would try to kill Saif al-Islam if they took him to hospital.
"I would have done it the day before yesterday. It's not so urgent. It's already been like that for a month. But it's preferable that it should be done soon," he said.
Libyan Prime Minister Abdurrahim El-Keib has said Saif al-Islam is receiving the best possible treatment, but for now he is not in the hands of the provisional central government.
Zintan's fighters have said they will hand him over to the provisional government once it is formed. The cabinet was sworn in on Thursday, with the defence minister's post going to the head of Zintan's military council.
Murakhovsky said only a small part of Saif al-Islam's thumb and index finger needed to be removed, and while he did not need to be operated on urgently, if there were no intervention there could be serious consequences.
If left untreated, the gangrenous infection could spread into the bloodstream and lead to osteomyolitis, which Murakhovsky said was "an infection of the bone marrow, which could have an impact on his general condition".
The International Criminal Court has indicted Saif al-Islam for crimes against humanity and issued a warrant for his arrest. Libya, however, says it will not hand him over to the Hague, and the ICC's prosecutor says Tripoli can try him if it wants to.
Saif al-Islam has not been charged in Libya, but ICC Prosecutor Luis Moreno-Ocampo said his Libyan counterpart has launched investigations into the same events as the ICC, in which protesters were killed during this year's revolution.
If Libya were to charge him with similar crimes as the ICC, Saif al-Islam would face the death penalty. The maximum sentence the ICC can pass is life in prison.
Libya is also investigating five counts of alleged corruption by Saif al-Islam, Moreno-Ocampo said on Thursday.
(Writing by Francois Murphy; Editing by Jon Hemming)