Frenchay micro-surgery experts create a new thumb out of a toe for patient in saw accident

Tuesday, 13 September 2011

A patient who sawed his thumb off has had his big toe reattached by expert surgical teams at Frenchay Hospital, Bristol.

James Byrne, 29, lost the thumb on his left hand in December 2010 while sawing through a piece of wood.

After an attempt to re-attach his thumb was unsuccessful plastic surgeon Umraz Khan transplanted the big toe from his left foot in an eight hour operation on September 8 at Frenchay Hospital, in Bristol.

Less than a week after the surgery, Mr Byrne already has movement in the new thumb and is walking.

Mr Byrne, from Fishponds, Bristol, has an eight-year-old son and works as a paver and plant operator.

He said:  “Mr Khan re-attached my thumb but it had been badly damaged and although we tried everything, including leaches, to get the blood flowing again it didn’t take.

“Mr Khan said to me ‘You will have a thumb even if I have to take your toe’, I thought he was joking, but he was serious and nine months later here it is.

“The aesthetics of it don’t bother me, I am just happy that it works, my work as a paver would have been destroyed without the use of my hand because I couldn’t pick up a brick without a thumb but now I hope I can be back at work in a few months.

“I never thought it would work but the surgical teams and the nurses have done such a fantastic job and the care has been amazing.”

Mr Byrne will now have physiotherapy to help him to adapt to using his new thumb.

Frenchay Hospital is a regional micro-surgery centre and has an international reputation in results and outcomes for patients needing this sort of complex surgery.

Mr Byrne is only one of a few patients in the past five years to have had a toe re-attached as a digit.  

Mr Khan led two teams of surgeons and anaesthetists – one working on Mr Byrne’s toe while the other worked on his hand at the same time. 

Mr Khan said: “It is quite a rare thing to do and is a very complex micro-surgical procedure which involves re-attaching the bone, nerves, arteries, tendons, ligaments and skin of the toe to the hand.

“James will have to learn to re-balance, without his left great toe, onto the ball of the foot but he will be able to walk and jog normally.

“The thumb is the dominant digit, without it James would not be able to do the things that we take for granted, like holding a pen or opening a door.

“It is still early days for him and he might need additional surgery to make it look more like a thumb.

“The loss of the great toe is not as disabling as losing a thumb so the loss far outweighs the gain.

“We are very proud of our success rates in micro-surgery at Frenchay Hospital and that is down to the expert, dedicated teams from surgery and nursing to rehabilitation.”