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Soft Tissue Management of Partial Hand Amputation.

Evan M Guerrero1, Julia C Mastracci2, Michael S Gart1

  • 1OrthoCarolina Hand Center, Charlotte, NC; OrthoCarolina Research Institute, Charlotte, NC.

The Journal of Hand Surgery
|March 9, 2023
PubMed
Summary

For partial hand amputations, prioritizing thin, durable soft tissue coverage improves prosthesis fit and function. This approach enhances prosthetic rehabilitation outcomes, enabling earlier use of advanced prosthetics.

Keywords:
Amputationcoveragepartial handsoft tissue

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Area of Science:

  • Reconstructive surgery
  • Prosthetic rehabilitation

Background:

  • Conventional management of partial hand amputations often involves flaps for soft tissue coverage, prioritizing residual limb length.
  • Excessive tissue from prior reconstructions can impede prosthesis function, fit, and myoelectric control.
  • Advances in prosthetics and nerve transfer techniques offer new functional possibilities.

Purpose of the Study:

  • To evolve the reconstruction algorithm for partial hand amputations towards achieving the thinnest possible soft tissue coverage while maintaining adequate durability.
  • To improve prosthesis fitting, surface electrode detection, and enable earlier prosthetic use.

Main Methods:

  • Development and application of a refined reconstruction algorithm focusing on minimal, durable soft tissue coverage.
  • Evaluation of outcomes related to prosthesis fit, function, and electrode performance.

Main Results:

  • The evolved algorithm provides the thinnest coverage, facilitating faster and more secure prosthesis fitting.
  • Improved surface electrode detection was observed, enhancing myoelectric control.
  • Patients experienced earlier and improved utilization of both simple and advanced partial hand prostheses.

Conclusions:

  • A shift towards prioritizing minimal, durable soft tissue coverage in partial hand amputations optimizes prosthetic rehabilitation.
  • This approach directly addresses limitations associated with bulky reconstructions, leading to superior functional outcomes.