DeSOTO Three-year-old Vaughn Washington can count just four perfect little piggies on his right foot, but the fifth toe isn't that far away.
Vaughn lost his thumb in foster care after a well-meaning adult wrapped it in duct tape to discourage thumb-sucking.
It caused his thumb to lose circulation and set up gangrene, and they had to amputate it, said Kim Washington, Vaughn's adoptive mother.
Experts say about 50 percent of the hand's function comes from the thumb. But when doctors asked Vaughn's parents if they would consider a rare toe-to-hand transplant, they were more than cautious.
I was afraid, said Don Washington, Vaughn's father. I was literally afraid. I had never seen anything like that, number one.
Children's Medical Center of Dallas had never performed such an operation, either.
But on March 12, during a complicated surgery, doctors Michel Saint-Cyr and Sean Bidic of UT Southwestern Medical Center moved the second toe on Vaughn's right foot to the right hand.
Bones, tendons, nerves and vessels had to be reconnected during the operation.
It will grow normally, Bidic said. It has growth plates just like any other fingers have, and it should grow to be the size of the thumb on the other hand, and it should last forever.
Bidic said two months after the transplant, it's clear Vaughn's brain already thinks the toe is his thumb.
He'll be able to be a piano player, a guitar player, a musician, any kind of athlete, Bidic said. He can do any job he wants to. He can be a surgeon; he can be an astronaut; he can be anything. It's just his thumb, and it's normal, and that's important.
It's just a self-esteem builder, and it just helps him to do things that he wouldn't have been able to do as simple as picking a quarter off the floor, Kim Washington said.
Don Washington said at first he was concerned that missing a toe would influence Vaughn's gait.
And I thought maybe with his toe being taken off, it was going to affect his balance, he said. For the most part, as we see now, he's fine. It hasn't affected his ability to walk. He can run fine; he's fine.
With physical therapy, both parents believe their son's new thumb will give him a better grip on the future.