Thumbs up for plastic surgery procedure

AUSTIN (KXAN) - Feb. 17, 2010, was just another day on the job for Tom Bury. Then it wasn’t.

“I got into a battle with a forklift,” Bury said, “and the forklift won, actually.”

The man was using the forklift to move some material from one spot to another, but because the stuff didn’t fit comfortably on the forks, he grabbed some filament banding material to hold it in place. He was holding onto the banding while he moved the machine, when he noticed a sharp pain in his hand.

“I won't use the language I probably usually would use,” said Bury, recalling the experience, “but it was kind of like, 'Ah that hurt!’”

He kept driving the forklift for a bit, but as the pain continued, Bury raised his left hand to his face to see what was hurting. He was horrified to discover a substantial part of his thumb missing in action.

“It was snipped real clean, actually,” he said. “That filament banding material they use is very, very sharp, very, very tough material. It went all the way through bone. So what I had left was probably about half, roughly. And the little bone was still sticking out so I could actually kind of wave to you.”

Co-workers stuffed Bury in a car and rushed him and his iced-down severed thumb to Seton Hospital . The news there was not good. Not only did the thumb get snapped off, it got mangled in the process, rendering it useless for replacement surgery.

Doctors patched up the stump and sent Bury home, after first making him an appointment for the following day with Dr. Steven Henry from the Seton Institute of Reconstructive Plastic Surgery .

When the patient showed up at Henry’s office, he got a surprise even more astonishing than the loss of his thumb.

“He looked at it and said, 'Yeah, we can put your toe on there real quick, no problem,’ Bury recalled. “That was his idea. He's the one that said it; I wasn't even thinking about toes at that point.”

The patient had questions, of course and the doctor had answers.

“A lot of people, when you present this option to them,” said Henry, “they're afraid to use their toe for fear of functional compromise at the foot. I assured Tom that that is not the case, that unless he were an Olympic long jumper, that he wouldn't even notice it.”

Bury was sold. “Let’s do it!” he told Henry.

The man had only had 24 hours to experience thumblessness, but he knew he didn’t want the condition as a part of his future.

“With two thumbs, I can work on cars,” he said. “I do a little woodworking, also. If I want to change the oil in the vehicle, you've got full dexterity to be able to grab, do, hold, whatever it might be.”

So on March 4, some three weeks after the mishap, Dr. Henry went to work on Bury in a Seton-run Brackenridge Hospital operating room.

“You have to restore bone and cartilage,” the surgeon said, “and joint and the ligaments that hold the joints together, the tendons that move the joints, the sheath that the tendon runs through, and then the stuff on the surface: the skin and the nail and, of course, the nerves and the arteries and the veins.”

The procedure can take anywhere from four to nine hours, depending on the complications involved.

So how does a plastic surgeon learn how to cut off a man’s toe and sew it onto his stump of a thumb? He goes to Taiwan, that’s how. Dr. Henry studied the procedure in that country and performed half-a-dozen operations there.

“In Taiwan they have a lot of patients who need the surgery because the industrial safety standards aren't as great,” said Henry.

“It's also very paternalistic there. The surgeon suggests something and the patient says, 'Okay.' In the U.S., it's not like that; it's much more of a dialogue and a decision that's come to mutually.”

So with many more available patients and a “If it can be done, it will be done,” mentality, Taiwan is a perfect training ground.

Back in the U.S., the doctor has done three such procedures so far, each of them successful. Batting a thousand, it’s hard to predict the odds for such success, but Henry tells his patients there’s a 5 per cent chance they could wind up without a thumb and a toe.

For Bury, those were pretty good odds. During the three weeks between his injury and the fix on the operating table, he experienced first hand, so to speak, what life would be like if he didn’t take Henry up on the idea.

He had trouble with everything from picking up coins, to holding a glass, to pulling up his pants, to buttoning his sleeve, to tying his shoes.

Now that the job is done, life is so much better.

“I'm just happy as an owl up in the tree looking at a rat, I guess,” said Bury. “You know, it's just really, really a great thing to have done.”

There is still, though, some healing to be done.

“Nerves, feeling, sensitivity is getting pretty good,” Bury said. “It's just everything is growing. You have to remember, all the nerves have to regrow.

“The only problem I have that is still a little lingering is going down steps. I think it's that little extra push that you get going down with the