Surgeons build thumb from seaman's toe
Saturday 19 December 1998
Emilio Valerio, 35, had his thumb ripped out when a rope with a 15- ton breaking strain snapped. Surgeons at Guy's and St Thomas' NHS Trust in London spent six months rebuilding his hand, culminating in the transplant of a toe to create a substitute thumb.
Yesterday, doctors removed a pin from Mr Valerio's new "thumb" in the final stage of the surgery.
Mr Valerio was loading oil by hose on to the 100,000-ton tanker in Nigeria when the accident happened last May. A crane driver manoeuvring the hose did not see him and when the rope broke it whipped backwards with explosive force. "I am lucky it was only my thumb," he said yesterday.
A helicopter took him to hospital in Lagos with his severed thumb packed in ice. His employers, Chevron, the United States oil company, arranged an air ambulance to fly him to London the same night. However, delays in obtaining the necessary exit papers prevented his departure until four days later. By that time, his Nigerian doctors decided his thumb would be no use and discarded it. "If they had sent it with me, the surgeons at St Thomas' could have salvaged the bone and tendons," he said.
Ciaran Healy, consultant plastic surgeon at St Thomas', said the injury had left a deep hole in Mr Valerio's hand which had to be rebuilt. First, he took bone from his hip and transferred it to his hand to create the foundation for a new digit. For three weeks Mr Valerio had his hand sewn into an incision in his groin to provide it with a substitute blood supply. And in the final operation, which lasted eight hours, surgeons transplanted the second toe from his foot using microscopes to attach blood vessels and nerves. Mr Healy said: "Each stage in the operation worked wonderfully."
Surgeons say he will eventually have a near normal grip, but Mr Valerio said he could already pick up small objects.
Today he is flying home to the Philippines for Christmas. When he returns to work in the new year, Chevron has promised that an offer of promotion to chief officer, made before his injury, remains open.
"It is like having a blank cheque," Mr Valerio said.
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