In a scene stranger than science fiction, the 19-year-old woman lived for eight months after the accident last December with the three undamaged fingers of her right hand attached to her left forearm, just below the elbow.
The fingers, which were supplied with blood by an artery from the arm, had to be stored while surgeons rebuilt the right hand, the centre of which was destroyed in the accident, in a series of operations.
Last Wednesday, the team at St James's University Hospital, Leeds, transplanted the fingers back to the prepared right hand, with a toe from the woman's foot that will serve as a thumb. The rebuilt hand is expected to give the woman some movement and grip, which will allow her to perform everyday tasks.
Simon Kay, consultant plastic surgeon and an expert in hand surgery who has performed more than 50 toe-to-hand transfers in children, said: "We are delighted with the patient's condition, things are looking good and we don't anticipate any problems. Although the concept is very simple, it is a technical challenge to put all of the pieces together."
The woman, who has not been identified, underwent several procedures to improve the appearance of the hand before Wednesday's surgery. Skin was grafted from her hip and she also had daily physiotherapy to keep the joints in her damaged hand and the fingers, which were usually hidden under a bandage, supple.
She said: "I was shocked when I came round fully from the surgery last year and a bit bewildered. I realised it would change my life. It was a big step to take the dressing off my damaged hand and go into the pub. The people who have seen the fingers have been amazed but shocked as well."
She added: "There was a time when I thought why don't I just leave the hand, because I've had a lot of scars to get used to. But even if I can just pick up a piece of paper it'll be wonderful."
The preservation of amputated parts of a body by storing them elsewhere has been attempted before but only three or four successful cases are known worldwide. One included saving a hand by attaching it to the patient's armpit.
This week's operation to replace the severed fingers lasted 12 hours. The fingers were first detached from the left forearm with the artery that had kept them supplied with blood and chilled, as in any transplant. Plastic tendons were fitted to each finger and the artery was connected to an artery in the right wrist. Nerves for each finger were created from those taken from the woman's ankle.
Mr Kay is one of the most skilled microsurgeons in the country and has an international reputation in reconstructing damaged limbs. Three years ago, he reattached the hand of a man that had been severed by an assailant wielding a samurai sword.Reuse content