Surgeons Replace Man's Severed Thumb With Big Toe

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Main Category: Cosmetic Medicine / Plastic Surgery
Also Included In: Transplants / Organ Donations
Article Date: 15 Sep 2011 - 1:00 PDT


Surgeons in the UK have given a man who accidentally sawed off his thumb a new thumb by attaching his big toe in its place.

James Byrne, a 29-year-old man from Fishponds, Bristol, England, cut off his thumb while sawing wood last December.

Byrne told the media he felt "really really lucky", according to a BBC News report on Wednesday.

Surgeons had tried to re-attach the damaged thumb but that did not work.

Surgeon Umraz Khan performed the operation at Frenchay Hospital, a regional micro-surgery centre in Bristol. The hospital is well-known for carrying out this type of procedure.

Byrne hopes to be back at work as a paver in a few months. He said he thought Khan was joking when he told him "you'll have a thumb even if I have to take your toe".

Khan said losing a toe was "not as disabling as losing a thumb".

Byrne said the surgeons had tried everything to re-attach the severed thumb, even applying leeches to get the blood circulating again, but that didn't work.

He would not have been able to continue his work as a paver without the use of his thumb as he would not have been able to pick up bricks, he told the press.

Byrne will undergo physiotherapy to help him get used to using his toe as a thumb and also to balance on his feet without his big left toe.

He may need more surgery to make the toe look more like a thumb, said Khan.

Although not common, the procedure happens more often than one might think.

Last year, a woman from Long Island in New York also had her big toe transplanted to replace a lost thumb.

25-year-old Shannon Elliott lost her thumb when someone tossed a firework out of a passing car and she bent down to pick it up, wondering what it was. It blew up in her hand.

That surgery took 11 hours. The surgeons said the toe should adjust to fit Elliot's hand.

More unusual is to grow a new thumb altogether, which is what happened about ten years ago in a case reported in the May 2001 issue of the New England Journal of Medicine. In that case, doctors successfully grew a replacement thumb bone using tissue from the patient's own body.

The tissue engineering procedure was pioneered by Dr Charles Vacanti at the University of Massachusetts, who took a small sample of cells from the patient's arm bone and multiplied them in a lab culture. First they fashioned a scaffold made of sea coral in the shape of the missing thumb and implanted it into the base of the thumb and then injected the bone cells into the scaffold.

28 months later, the patient was using his thumb normally, with some loss of sensation, and the surgeons reported that the patient's own bone cells were taking over from the coral scaffold which was slowly disappearing.

Written by Catharine Paddock PhD
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

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