Techie gets a toe for lost thumb in fire cracker injury

Bengaluru: It was a festive day for 23-year-old Vasanth (name changed), an IT professional, who was in his hometown near Chikmagalur. It was a fun filled day to begin with, but a fire cracker burst injury, misfired made his right hand go in tatters. This freak incident resulted in him losing his right thumb, index finger completely and ripped the entire soft tissue covering of the middle finger, compromising the circulation of the ring finger, leaving only a viable little finger.

He was taken to a local hospital, where first aid was given, he was told about the grim realities of permanent disability of his dominant hand. Vasanth’s dreams shattered as he was on the verge of losing his hand.

His sister being a doctor, Obstetrician, kept her hopes and contacted Dr Darshan Kumar A Jain, Consultant Hand Surgeon at Apollo hospitals, Sheshadripuram. He had to travel 4 hours to reach Bangalore. Immediately upon examining him, he was told that he can be made better, not to lose hopes, but he has to brave for 5 months and has to undergo 3 surgeries with the last one being a major one. He took a quick decision to undergo the surgery.

Complete loss of thumb alone accounts for 30-40% disability, with complete loss of index and partial loss of middle finger accounts for 60-70% of disability of his dominant hand. Initially, thorough wound cleaning was done, and fingers were saved as much as possible, and all nerves, arteries, veins and skin was marked to plan for the next surgery. Abdominal flap/soft tissue cover was done to get the contour and shape of normal fingers.

The final stage was planned 3 months after the injury. The aim was to give him a thumb. With the loss of the thumb, the hand is significantly disabled and even to do the basic work like brushing, picking up objects, writing etc.

The 2nd toe of the foot was transferred to the right hand to replace the lost thumb. This is a major microsurgery, where in the toe with the bone, skin, tendons, artery, vein and nerves are harvested and transferred to the hand. This surgery will enable him to use his right hand as earlier although the appearance may not be the same as a normal hand.

Dr Darshan Kumar Jain with his surgical team Dr Varun, Dr Sarvajith, Dr Prathap and with the help of Anesthesiologist Dr Santhosh carried out this meticulous procedure successfully. It is 6 weeks post the last stage of the surgery, he has started using his hand for light activities like writing, typing, picking up objects etc; eventually he will be able to lead a normal life like us.

This type of surgery is beneficial even to individuals who have lost fingers in the past. This surgery (toe transfer) surpasses a prosthesis by providing dexterity, sensation.

At the same time, it causes the least disability in the foot in the long term.