A father-of-one has shown off his unusual new thumb after he lost his original in a carpentry accident.
James Byrne, 29, had his big toe grafted on to his hand after he severed his left thumb while sawing through a piece of wood last December.
Surgeons had first tried to sew his original thumb back on but the blood would not start flowing again despite months of treatment, including using leeches.
That's when the surgeons made their unusual suggestion of using his dominant toe. They said losing a toe would only affect his balance in the short term - therefore outweighing the loss to his foot.
His consultant Umraz Khan at Frenchay Hospital in Bristol carried out the operation in September.
Now, two months after the operation, the paver from Bristol has a working 'thumb' - which he has nicknamed 'Toby'.
'I never thought it would work but the surgical teams and nurses have done such a fantastic job. The care has been amazing,' he said.
'I can't bend it yet but I hope to be able to do so soon. It rotates and I can give it a good wiggle.
'I am so, so pleased that I had it done. It is just such a relief that I'll be able to get back to work soon.'
He said that people reacted to it in very different ways.
'Some think it's really funny while others are a bit disgusted by it,' he said.
'When I meet people, they ask "what did you do to your thumb, it's so big and swollen". They can't believe it when I tell them it's actually my toe instead.
'My son thinks it's great, I showed it to all of his mates and became a bit of a celebrity in the playground for a while.'
James's thumb was vital in his job as a paver and plant operator and as a father to son Connor, eight.
James currently has limited movement in his thumb but is expected to regain full use of it after intense physiotherapy.
He will later have an operation to remove a piece of wire fusing the bones together.
James hopes to return to paving job in the New Year and then play rugby shortly after.
Frenchay Hospital is a regional micro-surgery centre and has an international reputation for such complex surgery.
Mr Khan led two teams of surgeons during the eight-hour operation - with one amputating James's toe while the other worked on his hand at the same time.
The plastic surgeon said: 'It is quite a rare thing to do and is a very complex procedure, which involves re-attaching the bone, nerves, arteries, tendons, ligaments and skin of the toe to the hand.
'James will have to learn to re-balance, without his left great toe, on to the ball of his foot but he will be able to walk and jog normally.
'The thumb is the dominant digit. Without it, James would not be able to do the things that we take for granted, like holding a pen or opening a door.
'It is still early days for him and he might need additional surgery to make it look more like a thumb.
'The loss of a great toe is not as disabling as losing a thumb, so the loss far outweighs the gain.'