His scarred right hand trembling, Francisco del Alamo-Benavente gripped a plastic clothespin between his thumb — which used to be his index finger — and his ring finger. Squeezing with all his might, he pried the clothespin about a quarter-inch apart and fastened it to a metal rod.
“This is new today,” says Dale Eckhaus, his occupational therapist, with admiration in her voice.
Without being prompted, he did the same with the left hand, using a thumb that until recently was his toe. He gripped another clothespin with twice as much resistance.
Six weeks after surgeons at the Curtis National Hand Center at Union Memorial Hospital fashioned new thumbs for him, del Alamo-Benavente is ready to go home. On Friday, he will return to his native Peru, though he still has more therapy ahead of him.
On the plane, as he proudly demonstrated, he’ll be able to pick up a can of soda — one of many small tasks he was unable to do after his thumbs and left index finger were blown off by a bomb in an accident last year while he was serving in the Peruvian army.
Doctors in Lima had offered to reconstruct his thumbs by amputating two toes, but he and his father decided instead to explore options in the United States.
Surgeons at Union Memorial converted an index finger into a thumb, a procedure often performed on children born without a thumb. They used the second toe on his right foot as a thumb on his left hand, a surgery that is often a viable option for people whose thumbs are severed.
Del Alamo-Benavente’s case was unusual because both surgeries were performed on the same patient simultaneously, said Dr. Thomas J. Graham, chief of the hand center, who performed the surgery on the right hand. Del Alamo-Benavente no longer had the bone structure on his right hand to support the toe-to-hand transplant, which is why Graham decided to rearrange the index finger instead.
“He’s currently walking without any difficulty. He’ll be able to run,” Higgins said. “He should not have any significant deficit in terms of his ability to use his foot.”
Doctors were impressed with del Alamo-Benavente’s positive attitude throughout the surgery and rehabilitation.
“The same type of bravery that Francisco showed in his military service, he showed facing this significant event,” Graham said. “Now he has opportunities that were probably heretofore unreachable for him, with his devastating hand problem.”
Among those opportunities is culinary school. Del Alamo-Benavente aspires to become a chef, he said through a translator. His surgeons are confident he can achieve that goal.
“He’s got an incredible spirit and an incredible determination to achieve what he wants to achieve,” Higgins said. “I would say, absolutely, that’s well within the realm of possibility for him.”