Toe transplant hailed a success

Doctors replace Shyam Sundhar's thumb with a toe in six-hour surgery following accident at Umm Al Quwain boat manufacturing plant.

March 21, 2012, Umm Al Quwain, UAE:

Shyam Sundhar had his thumb crushed while operating a wood cutting machine. This made work impossible, he coudn't even handle his tools properly. Then he was given an unorthodox surgery: one of his toes was placed on his hand. Mr. Sundhar is still in pain and cannot do any serious manual labor but he is able to handle his tools and do basic carpentry because of the surgery. He is seen here at the Fish Market roundabout in Umm Al Quwain. 

Lee Hoagland/The National
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A carpenter who lost his thumb in a workplace accident hopes to return to work after having a toe transplanted on to his hand.

Shyam Sundhar lost the digit on his right hand in September while using a woodcutting machine at Gulf Craft, a boat manufacturer in Umm Al Quwain.

"I was totally depressed after losing my thumb as it is quite disabling for a carpenter," said Mr Sundhar, 26, from India. "I could not grip anything with my right hand. I was wondering, 'How will I hold the tools to do my work?'

"I went to the doctor immediately but they said it couldn't be fixed as it was badly damaged. They advised me to go to India and get it done there as the treatment would be much cheaper and my family would be there to take care of me."

He spent six hours in surgery while Dr K Murali Mohan Reddy, a plastic and microsurgeon at Yashoda Hospital in Hyderabad, removed the second toe of his left foot - along with its blood vessels, nerves and tendons - and attached it in place of the lost thumb.

"Thanks to this surgery I have recovered almost 60 per cent of the movement and hopefully in the next few weeks I might recover fully," said Mr Sundhar, who returned to the UAE last Monday.

He still suffers some pain but can now hold most things. "I expect there will not be much problem when I start doing my work. I'm already able to write and eat food with my right hand," he said.

Dr Reddy said Mr Sundhar first consulted him in October.

"Because the patient was not psychologically prepared for the surgery, I asked him to come back to me after a month. He came to me for surgery in November and it was performed on November 4.

"The reconstruction of an amputated thumb is a challenging option. It requires an advanced operation theatre and excellent microsurgery skills. Very few people in India, even in the medical fraternity, know that a toe can replace the amputated thumb."

Mr Sundhar was discharged 10 days after his operation.

"His new thumb now has movement and will have sensation and nail growth in a few weeks," said Dr Reddy. "The disability of the loss of a thumb is low compared with the loss of any other limb, but its real significance can be felt while doing daily chores like holding a cup, writing, eating food and so on."