Medicine: Toes to Fingers

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To any active boy a broken arm is bad enough, but when Terry McNamara broke his right arm he was completely disabled. He had been born with no fingers on his left hand—"nothing but little buttons." in the words of Patrick Clarkson, one of Britain's ranking plastic surgeons. But the broken arm proved to be a good thing for Terry in the long run: his mother, who runs a fruit stand in the grubby Elephant & Castle area of South London, took him to Guy's Hospital. There. Surgeon Clarkson saw him and got an idea.

"It may leave you with a limp." Mr. Clarkson told Terry, but the boy, then n, thought it was worth while, and his mother agreed. So he spent six weeks in an uncomfortable position, with his fingerless left hand joined to the toes of his left foot by a skin flap. Then Surgeon Clarkson amputated the toes and grafted them in place of the missing fingers. That was 4½ years ago.

There have been 16 more operations, many of them of surpassing delicacy, to graft tendons from the foot to the hand and connect them with muscles in the boy's forearm. One of the most crucial, done early this year, was a tendon transfer to give Terry an apposable left thumb. It worked. Last week, as the bandages came off after a minor operation, Terry could appose his thumb well enough to hold his fork in his left hand. British style.

So far as Surgeon Clarkson knows, this is the first transfer of a complete set of five digits. Terry's new fingers will probably never grow longer than they would have as toes. But there is hope that they will keep on growing for a while. As for that limp, his shortened left foot does not keep Terry, now 16, from playing soccer with his schoolmates.