A big toe instead of a thumb

Contemporary transplantology has surprising faces. To the young father of the family, who had accidentally cut off his thumb, doctors sewed a large toe onto the site from the foot. Recently, the man proudly presented his new finger for the first time.

Two months ago, James Byrne, a 29-year-old DIY enthusiast, underwent a complex eight-hour operation to fix the big toe. Byrne lost his thumb in an accident that happened while chopping a tree. Doctors fought to sew on and save the right finger, but it was impossible to restore circulation to it – despite several months of treatment, including the use of leeches. In the end, the medics were forced to take an unusual step: they severed the great toe from the patient’s left foot, then reattached it, this time to his hand, carefully recreating the connections between bones, nerves, veins, arteries, tendons, ligaments, and finally skin. James has already nicknamed the new finger Toby and says he is delighted with the effects of the treatment. – People react differently. Some people think it’s something really funny, others show a little disgust, says the father of two. – They ask what I did on my thumb that it is so swollen. They can’t believe it when I explain to them that it is really a big toe. I can’t bend it yet, but I hope to be able to do it soon. So far I can turn it around and wave it quite hard. My son thinks it’s something cool – I showed my friends a finger and for a while I enjoyed the status of a local celebrity in my backyard.

The brave Bristol man decided to undergo an unusual operation, because the dexterity of his hands and hands is crucial in his work – James is a paver and machine operator by profession. He hopes that thanks to the procedure, he will be able to return to work after the New Year. – At first I did not believe that it would even succeed, but the surgeons and nurses did a great job. I am indescribably happy that I decided to do it – he adds. – My attending physician told me at the outset: “You will have a thumb, even if I have to use your big toe.” I thought he was joking, and here you are: it is as he said.

Dr. Umraz Khan was the head of the two operating teams that performed the procedure. The operation was performed at the Frenchay Hospital in Bristol – a clinic famous for carrying out such amazing microsurgical ventures. One group of surgeons worked on the amputation of the big toe, while the other group focused on the patient’s hand at the same time. In the future, James will require one more operation to remove the wire connecting the bone fragments.

“It was a rare case and very complicated at the same time,” admits Dr. Khan. James will have to learn to balance himself without the left big toe, on the sole of the foot, but he will be able to walk normally and even run. The thumb is the dominant finger. Without him, James would not be able to perform activities that we take for granted, such as holding a pen or opening a door. Of course, we’re still at the beginning of the road – perhaps the patient will require additional surgery to make the new finger look more like a thumb. Losing your big toe is not as troublesome as losing a thumb, so with Mr. Byrne, the benefits far outweigh the loss.

Text: Dave Masters

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