Dr Thomas has an area of sub-specialisation and interest in the field of toe to hand transfer. The procedure is used to create a new finger or thumb, which aims to improve hand function and appearance.
This procedure enables the toe to perform the role of a thumb/new digit and can allow the thumb to perform a pinch grip. Appearance-wise, it has a nail and the joints function by bending and straightening.
The appearance of the hand is improved and the hand functions of grasp and grip also show improvement. The hand will not have the appearance of a normal hand.
Candidates for the procedure include
- People who have lost a digit due to injury or illness
- Children born with symbrachydactyly – congenitally absent fingers
- Children born with amniotic band syndrome / constriction ring syndrome resulting in absent digits
About the procedure
Toe to hand transfer is a highly specialised procedure. Either the second or great toe is transferred to the hand. Each operation is tailored to the individual patient. The details of the procedure, including the risks and benefits, will be discussed thoroughly.
- The toe is removed from the foot. Dr Thomas will take all blood vessels, nerves, bone and tendon associated with the toe and transplant the toe to the hand.
- In most scenarios the toe next to the big toe is the most suitable. This toe contains the nail tissue, tendons and bones to make a suitable finger.
- The gap between the toes will be stitched closed and the entire foot bandaged.
- The toe is attached to the hand bones using a wire to fix them together. The tendon, nerves and blood vessels are then joined.
- The hand will be bandaged to protect the finger.
- The transplanted toe will only ever have the movement capabilities of a toe.
What to expect after the procedure
Dr Thomas will close off the gap where the toe was removed. Patients will still be able to walk, run and jump after recovery.
- This Toe to Hand Procedure takes up to six to eight weeks to heal.
- You will be required to stay in hospital to monitor the blood supply to the attached digit for the first few days.
- Keeping warm and well-hydrated is essential to ensuring the blood flow is adequate.
- Blood thinners will be administered to prevent clotting.
- Painkillers and antibiotics will be administered when required to manage pain and infection.
- The operated hand and foot must remain elevated.
- The operated foot must remain elevated for 2 weeks.
What are the post-operative important instructions?
At the 6 week mark, you will need to revisit Dr Thomas to remove the wire used in the bone joining process and for a dressing change. It can take from three to six months to rebuild the nerve endings and sensations in your foot and hand. It is particularly important to be aware of heat and cold and sharp objects during this time.