Man replaces severed thumb with toe

January 9, 2008 12:00:00 AM PST
A new surgery center at St. Mary's Hospital in San Francisco uses a teamwork approach to complex reconstructive surgeries. Specialists from St. Mary's and UCSF are partnering to offer state-of-the-art treatment for patients like Garrett La Fever, who lost part of his hand in a woodworking accident.

"The piece I was cutting got bound up in-between fence and popped back and cut my thumb off," says La Fever.

Doctors reattached what was left, but the results were poor.

"The circulation was just so bad, I never fully recovered. it was kind of stuck in a downward position."

The thumb is responsible for 40 percent of the function of the hand which is why when doctors proposed removing Garrett's big toe and using it to create a new thumb, Garrett felt it was his best chance of regaining the use of his hand.

"I wanted to do it. I was sick of having that thumb and there was an option to get out of it."

"The ambulation and the function of the foot is minor compared to the gain that he gets in his hand," says Charles Lee, M.D, St. Mary's Microsurgery Director.

Dr. Charles Lee and UCSF plastic surgeon Scott Hansen performed the complex, 6-hour procedure as a team at St. Mary's Plastic Reconstructive and Orthopedic Surgery Center.

Dr. Hansen removed Garrett's toe and says "it takes about an hour, hour and half to dissect the tendons, nerves, blood vessels, the bone to get it prepared to detach it."

"While he was doing that, I prepared the hand, meaning I got all the blood vessels and nerves out for disection, and for us to be ready to do the osteosynthesis, meaning reconnect everything," says Dr. Lee.

Now, a month and a half after his microvascular surgery, Garrett's new "thumb" is recovering nicely.

"As long as I don't put this hand near it, It looks like a normal thumb."

As for the loss of his big toe, Garrett's getting used to that as well.

"The big toe helps in stabilizing you in that first step, but as he learns to walk without his big toe, he'll be able to run and function normally. Nobody would ever know when he has his shoe on," says Dr. Hansen.

He's diligent with his hand therapy. Within six months, he should have about 80 percent function. He's not sure if he'll ever return to carpentry, but Garrett is confident. Thanks to the team effort of the St. Mary's doctors, he'll have a hand that works.

Extra info: St. Mary's Plastic, Reconstructive and Orthopedic Surgery (PROS) Center
450 Stanyan Street
San Francisco, CA 94117
Dr. Charles Lee's website:
Dr. Hansen's webpage: