Thursday 26 April 2018

James gives thumbs-up to medics after big toe transplant

James Byrne shows off his new thumb
James Byrne shows off his new thumb
Mr Byrne's foot after surgeons removed the big toe and grafted it onto his hand

Grainne Cunningham

AN Irish craftsman who accidentally cut off his thumb has had his big toe surgically transplanted on to his hand in its place.

James Byrne (29), who is originally from Carlow but now lives in the UK, severed the thumb on his left hand last December while sawing through a piece of wood.

The thumb was badly damaged in the accident and efforts by Umraz Khan, plastic surgeon at Frenchay Hospital, Bristol, to re-attach it failed.

Mr Byrne, who works as a paver, 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."

Surgeons at the hospital agreed that the next best option was to take the toe from the patient's left foot and attach it to his hand.

As Mr Byrne works as a paver, the loss of a thumb far outweighs the loss of a toe.


Mr Byrne, who has an eight-year-old son, Connor, said he thought Mr Khan was joking at first when he suggested amputating his big toe before realising the surgeon was completely serious.

Before the operation last Thursday, September 8, Mr Byrne, who now lives in Bristol, England, had tried to return to his job as a paver but realised he was completely ineffective.

"I couldn't lift anything with my left hand.

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

And almost a week after the eight-hour operation to attach his toe to his hand, Mr Byrne says his new digit looks "like a cartoon thumb that has been hit by a mallet".

But he added: "The aesthetics of it don't bother me, I am just happy that it works."

And while the pain of losing his thumb was excruciating, he is experiencing little discomfort from his left foot, he told the Irish Independent.

Mr Byrne will now have physiotherapy to help him to adapt to using his new thumb and expects to be back at work within a few months.

The construction worker left the village of Rathvilly in Co Carlow when he was just seven when parents Margaret and Joseph emigrated with their four children.

Many of his relatives still live in Carlow and he is planning a trip 'home' around Christmas.

Frenchay Hospital is a regional micro-surgery centre and has an international reputation for complex surgery.

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.

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 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."

Irish Independent

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