About hand osseointegration
Quick facts
- Osseointegration (OI) can help to give you greater confidence about your finger or thumb prosthesis, and can provide more functionality.
- It involves a 2-step procedure, with a minimum gap of 3 months between each step.
If you have lost a finger or thumb because of cancer or injury, you may wish to use a silicone prosthesis to restore the appearance of your hand. Appearance is one of the most overlooked aspects of hand function and restoration of appearance with a prosthesis can help to relieve much of the psychological distress caused by loss of a digit. However, securing a silicone prosthesis to your hand requires the residual digit to be at least 2.5 cm long. If it is any shorter, your prosthetic finger or thumb will tend to fall off – regularly.
A more reliable solution is to use an osseointegrated bone-anchor. This is a metal implant that creates a secure point of fixation for your prosthesis to the hand. The implant ensures that the prosthesis always stays in place, and it can also improve the function of the prosthesis. For example, it allows you to apply more pressure to the end of the prosthesis, so that you can carry out light duties such as typing or gripping small objects.
What to expect
Planning
We will begin by working with you to learn about out your unique needs. The way we place your bone anchor is critical, so we will carefully plan your procedure in collaboration with our prosthetic partners. This may require X-rays or (rarely) CT scans in advance of surgery.
Procedure
The surgery to place your bone-anchor is relatively simple and can be performed under local anaesthetic or a short general anaesthetic.
Surgery is usually a 2-stage process. During stage 1, we will clear the soft tissue from the end of your residual digit and replace it with a skin graft, to prevent problems with soft tissue overgrowth. Your surgeon will then place the bone-anchor inside your residual bone and will leave it to osseointegrate for 3 months.
Following this, your surgeon will begin stage 2; inserting the metal fixture that will eventually attach to your prosthesis. You will be able to see our prosthetist for a final fitting of your prosthesis as quickly as 6 weeks after this second step.
Aftercare
Stage 1
You must focus on looking after the skin graft, which covers your bone anchor. Around 1-2 weeks after your surgery, we will remove any dressings and you can begin showering your wound (but do not soak the area in a bath). Remember to allow any crusts on your wound to fall off naturally; do not pick at them. After 2-3 weeks, the skin will become stable enough to start moisturising it with Vaseline. You can also do the same with the donor site where your skin graft was taken from.
Stage 2
You will now be able to see the metal fixture attached to your bone-anchor. We will change your dressing 7-10 days after surgery and you will not need to have another dressing applied. From this point onwards, you should begin applying Savlon antiseptic ointment around the base of the fixture. You will need to continue doing this indefinitely to keep the area clean and prevent bacterial over-growth.