Middlemore surgeons replaced joiner William Longbottom's thumb with a toe after a spindle moulding machine accident. Photo /Brett Phibbs
Middlemore surgeons replaced joiner William Longbottom's thumb with a toe after a spindle moulding machine accident. Photo /Brett Phibbs
William Longbottom jokes that his new thumb looks "a bit Frankensteinish" because, after all, it is really a toe.
But the 24-year-old Aucklander knows the successful transplantation of the second toe of his right foot in place of his left thumb is his ticket back into his trade as a joiner.
Right-handed and left-footed, Mr Longbottom's thumb was amputated on June 14 when he was shaping tongue-and-groove door timbers on a spindle moulding machine - a steel bench-top with a rapidly rotating cutter akin to a router.
"My thumb slipped in just at the end and got caught on the other side and [the cutter] took it off."
He was alone at the Pakuranga workshop and briefly entered "a dream-like state" before working out it was all too real.
"I grabbed my wrist so no more blood would rush out," Mr Longbottom said from Middlemore Hospital. He didn't want to release the wrist so couldn't use his phone.
He went to the house next door where a man phoned for an ambulance.
The ambulance officers could not find his severed thumb.
"It probably would have gone up the dust extraction straight away. My boss found a little bit the next day - a bit of mulched flesh."
At hospital, he feared the worst.
"I thought it was going to be a stump and I wouldn't be able to do what a qualified joiner should be able to do."
So he was surprised when plastic and reconstructive surgeon Zac Moaveni offered to transplant a toe from his right foot to his left hand.
Zac Moaveni
Several procedures followed to remove damaged tissue and to wash out the thumb wound to avoid infection ahead of Monday's 10-hour transplant operation involving four surgeons, up to five nurses, two technicians and two anaesthetists.
The transplant involved connecting structures such as blood vessels 1mm-2mm in diameter with 10 permanent stitches around each join, using thread finer than human hair; and nerves less than 1mm with 4 or 5 stitches around each.
The painstaking, delicate work was the first operation done with Middlemore's new $500,000 surgical microscope in which, Dr Moaveni said, "the optics are amazing".
Mr Longbottom's hand was re-dressed yesterday and Dr Moaveni said the transplant was doing well.
"In the best case he would get 80 to 90 per cent of his thumb function back. The sensation should feel just like a thumb would, the movement should be pretty good. It should pretty much function just like a thumb but just slightly different in size and shape."
Most people's toes were bent, but Mr Longbottom's were straight and the second toe was a perfect match. Its removal from the foot should not affect his balance or ability to run or play sport.
