News from Viet Tiep Friendship Hospital (Hai Phong) said that recently, the hospital had a surgery to “transform” the big toe into a thumb to return an intact hand to a patient.
The patient is TVT (36 years old, residing in Tan Tho, Nong Cong, Thanh Hoa) following a mechanical work accident where the first finger of his right hand was crushed by a press machine and has had the tip amputated since July 2023.
After surgery to remove the stump of the thumb, the patient is in a lot of pain and cannot return to work. In order for the hand to be able to grasp once more, a thumb is needed.
After consultation, the doctors agreed to move the toe up to reconstruct the thumb and restore the patient’s hand.
The hand that is missing the thumb and middle finger of the foot is assigned to be grafted onto the patient’s thumb position. BVCC photo
This is the first toe-to-thumb reconstruction microsurgery surgery performed at Viet Tiep Hospital.
The patient was operated on by two teams of doctors at the same time. After cutting off the big toe, the patient was immediately grafted onto the patient’s hand.
Accordingly, crew 1 prepared the place to receive the thumb on the right hand. After surgery to expose the remaining metatarsal joint bone in the area receiving the flap in the right thumb, the doctors must find the flexor and extensor tendons that are expected to connect with the tendons of the raised toe. Doctors found and exposed the receiving vessel including 1 artery, 2 veins, looking for sensory nerves.
Meanwhile, team 2 designed a V-shaped and zigzag skin incision to remove the toe flap. Take the second toe of the right foot. The dissection of the vascular pedicle must be long enough to connect to the receiving vessel, and at the same time, the flexor and extensor tendons attached to each toe must be dissected.
After surgery, the “toes” on the hand were pink and recovered well, and the foot with 4 fingers was also shaped so as not to affect walking. BVCC photo
After cutting the toe, the doctors transferred the flap and connected the vessels, combined the bones with a screw brace, connected the flexor tendon – extensor tendon, and simultaneously dissected, prepared the vessels, and connected the neurovascular vessels with a microsurgical microscope.
After 6 hours of successful surgery, the toe blood vessels were transferred to the thumb to recreate good circulation, the pink toe buds were stretched and had healthy capillary return. The patient is given a finger protector following surgery
Dr. Nguyen Duc Thanh, Head of the Department of On-Demand Treatment (Viet Tiep Friendship Hospital), head of the Microplastic Surgery team, directly participating in the patient’s surgery said: “One day following surgery, The leg was transferred to recreate the recovered thumb of the TVT patient, who was able to move and feel and was given instructions on rehabilitation exercises.”
Doctors perform surgery on the patient. BVCC photo
According to Dr. Thanh, severe injuries to body parts due to accidents are common in Vietnam. During work, many people have accidents that cause part of their body to be severed or crushed when using saws and cutting machines. In particular, severed fingers, toes, hands, and feet are very common.
With current microsurgical techniques, many severed parts, if well preserved and promptly treated, can be reattached, returning motor function and working ability to the patient.
Even patients with severe burns can have their skin “patched” by taking skin from healthy areas and patching damaged areas…
Dr. Nguyen The May, Deputy Director of Viet Tiep Friendship Hospital also emphasized that successful microsurgery brings hope to many patients, not only connecting severed limbs like TVT patients.
This technique can also reconstruct defective body areas following cancer treatment, microsurgery of disc herniation, and nerves in the cranial and spinal column, bringing a better life to patients.
