Toe-To-Hand Transplant Surgery Successful in 10-year-old Boy

Doctors reconstruct a finger and a thumb on a 10-year-old boy's hand, which was amputated after an accident three years ago.

Highlights

Doctors at Safdarjung hospital have reconstructed the fingers of a 10-year-old boy using his toes.
The hands were amputated after the boy was injured after an electric burn.
The boy, Birendra Singh burnt his hands, arms, chest and abdomen when he held onto an immersion rod used to heat water.

The toe-to-hand transplant at Safdarjung Hospital can now help a 10-year-old boy, Birendra Singh, to hold a pencil and pick up items for the first time in over three years.

Birendra lost his fingers and thumbs after both his hands got amputated after an injury caused by an electric burn in April 2014.

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‘Doctors at Safdarjung hospital have used the great toe and second toe to reconstruct the middle and index finger of a 10-year-old boy who suffered deep burns three years ago.’

The toe-to-hand transplant surgery implants part of one foot — including the big toe — on to the hand, helping a person with amputated hands to get opposable thumbs.

“The surgery is risky and rare. If the transplant does not work, the patients stands to lose his feet as well as hands. But, it is worth a try in case of people with double amputation,” said Dr Kain, professor of plastic surgery at Safdarjung Hospital.

The surgery took him around 10 hours to complete. The doctors had to extract the big toe and the toe adjacent to it along with the arteries, veins, nerves and tendons.

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“If the implant is not extracted properly, then establishing proper blood supply would not be possible. And, without the tendons there would be no upwards and downward movement in the thumb making it useless,” said Dr Kain.

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Birendra had burnt his hands, arms, chest and abdomen when he held onto an immersion rod used to heat water.

“He had gone out with his mother and sister when he ran back and asked the neighbours for a key to his house, saying that he needed to use the bathroom. A while later, the neighbours saw smoke and the smell of something burning and rushed into the house,” said Badal Singh, Birendra’s father, a taxi driver.

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The boy was rushed to Safdarjung Hospital from Chattarpur, where the family lived, as the hospital has one of the best burns units in city.

“Initially, all we could do was remove the gangrenous tissue, because at that time saving his life was paramount. It took one-and-a-half years and several chest and abdomen surgeries for Birendra to recover,” said Dr Rakesh Kain, who performed the surgery.

It was only after the serious burns had healed that the doctors started to consider the toe-to-hand transplant.

Patients with double-arm amputation can also benefit from hand donations. “Safdarjung is now starting a programme for implanting hands from brain-dead donors to such patients. It would be of great help to patients who are disabled like this,” said Dr Kain.

Source-Medindia