Summary
Complete hand amputation has been considered conventionally as an indication for the
use of mechanical prosthetic devices in order to regain some hand like function.
A microsurgical option to create a new pinching ability after wrist amputation has
been used in a series of 13 patients. The actual operation technique is presented
in detail. It was designed by the senior author in 1981 and applied into clinical
use in 1983. In order to evaluate the functional results and patient satisfaction
in long-term, a questionnaire was sent to 12 patients and 11 patients were interviewed,
examined clinically and studied with a hand function scoring test according Sollerman.
The operated series consist of 12 adults with posttraumatic distal antebrachial or
wrist amputations and 1 adolescent boy with a congenital wrist level amputation. There
were 3 females and 10 males in the series. The satisfaction to achieved result was
generally good.
The ADL section of Tamai score and the one we used correlated well with each other
and patient satisfaction. Sollerman hand function test gave worse results in two blind
patients and same occurred in two short antebrachial stump patients. However the satisfaction
was much better in Tamai score among blind patients, with wrist amputation level amputations.
In our opinion this single toe transfer method gives an acceptable pinch reconstruction
for hand amputation patients. We measured pinch strength and total active motion.
They averaged about half of the normal values. The reconstruction is suitable to the
patients, who are not willing to donate multiple toes or who are aware and concerned
about the risks of human hand transplantation, which necessarily will need a life-long
immunosuppressive medication to prevent from rejection.
Keywords
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Article info
Publication history
Published online: April 24, 2007
Accepted:
February 6,
2007
Received:
December 6,
2006
Identification
Copyright
© 2007 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
