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Garrett La Fever

Man Replaces Severed Thumb With Toe

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The Division of Plastic and Reconstructive Surgery at UCSF provides service to patients from literally head to toe. Surgeons have the technical expertise to perform a wide array of cosmetic procedures and also provide highly specialized surgical procedures for a host of other problems including craniofacial and cleft lip surgery, microvascular reconstruction, and treatment of complex wounds.

For patients like Garrett La Fever, who lost his thumb in a woodworking accident, this expertise can mean all the difference. Using a novel technique, Dr. Scott Hansen collaborated with Dr. Charles Lee to replace Garrett's thumb- which is responsible for 40 percent of the function of the hand- with his big toe. The approach paid off. In the years since his successful surgery, Garrett has regained much of the function of his hand. "Most people say they wouldn't notice unless I showed them, compared it to my other thumb. I think it looks pretty natural," says Garrett.

In fact, Garrett can now sign his name, button his clothes, and hold objects in his hand. "This has definitely been a big step up compared to what I had and the surgeons did an incredible job," says Garrett.

What's more, Garrett's missing toe hasn't restrained him from leading an active and normal life. "I can go on long hikes, I can play Frisbee, I can wear any type of shoe I want, I can play basketball," he has said.

"His second toe now has compensated and deviated toward that side and created a more symmetric foot," says Dr. Hansen.

In addition to trauma, other hand conditions may affect function as well - these include congenital abnormalities, sometimes with missing thumb or other fingers, and problems of aging such as rheumatoid arthritis. The program's combined plastic and orthopedic surgery hand service can provide comprehensive evaluation and treatment of these problems.

About the Program

Physician-scientists within the Division of Plastic & Reconstructive Surgery at UCSF also seek to discover new techniques for treatment of problems such as hand reconstruction, wound healing, and congenital deformity while they work to develop new procedures that are more effective and less invasive for the benefit of the patients and their families.

Care is tailored to each patient's unique needs and the surgeons and investigators have a history of research innovations and patient care programs that are models of excellence throughout academic medicine.

The expert team of plastic and reconstructive surgeons and researchers is comprised of physician-scientists like Dr. Hansen whose novel investigations are focused on wound healing, hemangiomas and reconstructive microsurgery. Dr. Hansen's lab is actively pursuing research projects in diabetic wound healing, bone fractures, nerve repair, and stem cell biology as it relates to wound healing in adults, as well as ongoing clinical research to evaluate and improve surgical outcomes. These translational research efforts will form the basis for new treatments in the future.

As Chief of Hand and Microvascular Surgery at UCSF, Dr. Hansen and his team are helping to pioneer new therapies in hand surgery, which encompasses problems such as congenital malformations, lacerations, nerve injuries and fractures. Because the hand is critical to daily activity and work, return to normal capacity as soon as possible is important to every patient. Restoration of form and function is the cornerstone of surgical efforts.

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Tags: Microvascular Surgery
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