Thumbs up… or should that be TOES? Paver has big toe grafted on to his hand after horrific saw accident



Doctors used toe after severed thumb failed to reattach



Father-of-one will need to relearn how to balance

A man who accidentally cut off his thumb has had his big toe attached in its place by surgeons.



James Byrne, 29, was left in excruciating pain after he severed the thumb on his left hand last December while sawing through a piece of wood.



After an attempt to re-attach his damaged thumb was unsuccessful, Umraz Khan, plastic surgeon at Frenchay Hospital, Bristol, transplanted the big toe from his left foot on to his hand.

Thumbs up - with his toe: James Byrne shows off his novel new digit

Surgeons at Frenchay Hospital in Bristol transplanted James's big toe on to his left hand

Mr Byrne, a paver and plant operator from Fishponds, Bristol, has an eight-year-old son - and with the thumb being the 'dominant' digit, surgeons say that while losing his toe may affect him in the short term, its use on his hand far outweighs the loss to his foot.



DO WE NEED OUR BIG TOES?

The big toe is important because it bears about 40 per cent of the load placed on the toes.

It is also the last part of the foot to push off the ground before taking the next step. However, while a nine-toed gait is less efficient, slower and shorter, it is no less effective.

'If you have your toe amputated, it doesn't mean you'll never run again,' Sheila Dugan, from Rush University Medical Center in Chicago told Scientific American. Amputees can train to improve their balance and relevant muscle groups to take the strain.

You can even walk if you lose all your toes by wearing shoes with inserts and toe fillers.



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

Mr Byrne tried to return to his job as a paver but realised he was completely ineffective because he couldn't lift anything with his left hand.



'You can't lay one-handed, you might as well go home,' he said.

'Then 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. '

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. The eight-hour operation took place on September 8.

He 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, on to the ball of the foot but he will be able to walk and jog normally.

'The loss of the toe is not as disabling as losing a thumb, so the gain outweighs the loss.'

Operation: An X-ray shows James Byrne's hand without the thumb and (right) his bandaged foot following his toe amputation. Two teams worked on Mr Byrne's hand and foot at the same time



Mr Byrne, who is originally from County Carlow in Ireland, said he was delighted with his new digit despite it looking like a 'cartoon thumb' that had been hit by a mallet.



'The aesthetics of it don't bother me, I am just happy that it works,' he said.

'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.'