Innovative Solutions for Missing Fingers and Thumbs: Hand Prosthetics with Bone-Anchors

Losing a finger or thumb due to injury or illness can be a challenging experience, affecting both the function and appearance of the hand. While it’s sometimes not essential to replace the missing digit for functional purposes, improving the appearance of the hand can be important. A well-fitted silicone prosthesis can be a great solution, providing both cosmetic and practical benefits. Here’s how osseointegrated bone-anchors can help secure these prosthetics effectively.

The Challenge of Secure Attachment

For a silicone prosthesis to be effective, it needs to be securely attached to the residual part of the hand. Ideally, this should be done without using straps or other visible means, which can detract from the natural look of the prosthetic. Typically, a residual stump of at least 2.5 cm is needed to ensure the prosthesis stays in place. Shorter stumps often lead to the prosthesis falling off, making it more of an inconvenience than a help.

Osseointegrated Bone-Anchors: A Secure Solution

One of the most effective ways to secure a prosthetic finger or thumb is by using osseointegrated bone-anchors. These anchors provide a stable attachment point for the silicone prosthesis, allowing it to function more naturally. Relimb™ has extensive experience with various bone-anchors, favoring those from Southern Implants for their reliability.

Benefits of Osseointegration

Using bone-anchors not only ensures a secure attachment but also allows the prosthesis to handle light tasks such as typing or gripping small objects. However, it’s important to note that these prosthetics are not designed for heavy-duty tasks like construction work or lifting.

The Procedure: Step-by-Step

Planning

Proper placement of the bone-anchor is crucial. Ideally, the anchor should integrate with at least 2.5 cm of bone to ensure stability. Pre-operative assessments, including x-rays or sometimes CT scans, help in planning the procedure. Your surgeon will discuss the details with you and coordinate with prosthetic specialists to ensure the best outcome.

Surgery

The surgery is conducted in two stages:

First Stage:

  • The surgeon prepares the end of the stump by removing soft tissues and applying a thin skin graft or skin flap.
  • The bone-anchor is then placed into the residual bone under image guidance.
  • The bone-anchor needs to integrate with the bone for at least six weeks, preferably three months.

Second Stage:

  • After the initial integration period, transcutaneous abutments (external connectors) are attached to the bone-anchor.
  • Six weeks later the prosthetist will fit the final silicone prosthesis.

Aftercare

First Stage:

  • Initially the bone-anchors are hidden under the skin requiring minimal care.
  • Once the dressing is removed (one to two weeks post-surgery) you can shower but should avoid soaking in a bath.
  • Allow any crusts to fall off naturally and start moisturizing the skin graft with Vaseline after two to three weeks.

Second Stage:

  • The abutments will be visible and require regular cleaning with antiseptic ointment like Savlon to prevent bacterial growth.
  • No additional dressings are needed after the first change (seven to ten days post-surgery).

Real-Life Example

Consider a patient who lost his thumb and the tips of his fingers in a lawnmower accident. Despite functioning well with his remaining fingers he lost significant hand function without his thumb. After a failed attempt with a non-functional prosthesis he underwent osseointegration surgery:

First Stage:

  • Placement of the bone-anchor in the residual thumb.

Second Stage:

  • Fitting the transcutaneous abutments and, eventually, the prosthetic thumb.

Outcome:

  • Six months post-surgery, the patient can use his prosthetic thumb for daily tasks, significantly improving his hand function and quality of life.

Osseointegrated bone-anchors provide a reliable and effective way to secure hand prosthetics, offering both functional and cosmetic benefits for those missing a finger or thumb. If you or someone you know is dealing with such a loss, contact us to explore this innovative solution. With the right care and planning, these prosthetics can help restore both appearance and confidence.