Hanoi’ hospital successfully replaces thumb with toe using microsurgical technique

Toe replacement surgery for thumb rehabilitation is a difficult technique that has been performed successfully at the Department of Maxillo-Facial, Plastic and Aesthetic Surgery, under the Hanoi-based Viet Duc Friendship Hospital, for many years, helping to restore working ability and hand function to many less fortunate labourers who have lost their thumbs.

A thumb reconnection surgery at Viet Duc Hospital. (Photo provided by Viet Duc Hospital)
A thumb reconnection surgery at Viet Duc Hospital. (Photo provided by Viet Duc Hospital)

Dr. Dao Van Giang, Deputy Head of the Department, said that the thumb makes up 50% of the hand function, as one side of the pincer, and missing the other side would make it hard for the patients to be able to handle and work normally.

Patients with a thumb dislocation due to congenital malformations or injuries from traffic accidents and daily activities should undergo surgery to restore the thumb by replacing the damaged ones with toes.

At present, Viet Duc Hospital is applying the microsurgical technique, in which moving the whole one-toed complex, including skin, tendon, and toenails and then using neurosurgery to replace the damaged thumb.

"Depending on the similarity of the thumb, we will take the big toe or second toe to replace the thumb. Normally, doctors will take the toe in the middle next to the great toe because of the similarity and aesthetic aspect, while the function of the foot is not too affected much. When moving the toe into the place of the thumb, we also combine surgeries to reconnect the bone, tendon, blood vessels and nerves," Dr. Giang said.

A micro-surgery normally takes 6-8 hours. The new “thumb” after restoration has the full function of folding, stretching and sensations.