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Making the Best of a Bad Situation: Case Report of a Nonreplantable Four-finger Amputation with Flap Coverage and Partial Hand Prosthesis Utilization

Partial hand amputations (PHAs) are often associated with detriments to self-expression, independence, and employment. Modern partial hand prostheses, coupled with reconstructive surgery, may greatly mitigate the physical, psychological, social, and financial impairments caused by PHAs. The MCPDrive...

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Autores principales: Graham, Emily M., Arbon, Jantz, Baschuk, Christopher M., Duncan, Adam, Mendenhall, Shaun D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9007195/
https://www.ncbi.nlm.nih.gov/pubmed/35433159
http://dx.doi.org/10.1097/GOX.0000000000004253
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author Graham, Emily M.
Arbon, Jantz
Baschuk, Christopher M.
Duncan, Adam
Mendenhall, Shaun D.
author_facet Graham, Emily M.
Arbon, Jantz
Baschuk, Christopher M.
Duncan, Adam
Mendenhall, Shaun D.
author_sort Graham, Emily M.
collection PubMed
description Partial hand amputations (PHAs) are often associated with detriments to self-expression, independence, and employment. Modern partial hand prostheses, coupled with reconstructive surgery, may greatly mitigate the physical, psychological, social, and financial impairments caused by PHAs. The MCPDriver is a body-powered prosthesis and is an example of one of these modern, easy-to-use prostheses. This case report describes a 30-year-old man who experienced a traumatic, nonreplantable four finger degloving amputation of digits 2–5 at the level of the proximal phalanges. Initial reconstruction included preserving the length of the amputated phalanges and using a pedicled groin flap for soft tissue coverage with the goal to ultimately facilitate the use of a partial hand prosthesis. Once the PHA was stable, the multidisciplinary hand team held several discussions to review how to revise the flap for an MCPDriver. Staged debulking surgeries and syndactyly releases facilitated a successful fitting with the prosthesis. The patient resumed employment and bimanual tasks shortly after being fit with the prosthesis. The patient also reported significant improvements in his mental health and in the quality of his social interactions. This case illustrates how reconstructive surgeries coupled with partial hand prosthesis utilization can restore form and function following amputation. Familiarity with the modern classes of upper extremity prostheses and collaborating within a multidisciplinary hand team will likely enhance reconstructive outcomes following traumatic PHAs.
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spelling pubmed-90071952022-04-14 Making the Best of a Bad Situation: Case Report of a Nonreplantable Four-finger Amputation with Flap Coverage and Partial Hand Prosthesis Utilization Graham, Emily M. Arbon, Jantz Baschuk, Christopher M. Duncan, Adam Mendenhall, Shaun D. Plast Reconstr Surg Glob Open Hand Partial hand amputations (PHAs) are often associated with detriments to self-expression, independence, and employment. Modern partial hand prostheses, coupled with reconstructive surgery, may greatly mitigate the physical, psychological, social, and financial impairments caused by PHAs. The MCPDriver is a body-powered prosthesis and is an example of one of these modern, easy-to-use prostheses. This case report describes a 30-year-old man who experienced a traumatic, nonreplantable four finger degloving amputation of digits 2–5 at the level of the proximal phalanges. Initial reconstruction included preserving the length of the amputated phalanges and using a pedicled groin flap for soft tissue coverage with the goal to ultimately facilitate the use of a partial hand prosthesis. Once the PHA was stable, the multidisciplinary hand team held several discussions to review how to revise the flap for an MCPDriver. Staged debulking surgeries and syndactyly releases facilitated a successful fitting with the prosthesis. The patient resumed employment and bimanual tasks shortly after being fit with the prosthesis. The patient also reported significant improvements in his mental health and in the quality of his social interactions. This case illustrates how reconstructive surgeries coupled with partial hand prosthesis utilization can restore form and function following amputation. Familiarity with the modern classes of upper extremity prostheses and collaborating within a multidisciplinary hand team will likely enhance reconstructive outcomes following traumatic PHAs. Lippincott Williams & Wilkins 2022-04-13 /pmc/articles/PMC9007195/ /pubmed/35433159 http://dx.doi.org/10.1097/GOX.0000000000004253 Text en Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Hand
Graham, Emily M.
Arbon, Jantz
Baschuk, Christopher M.
Duncan, Adam
Mendenhall, Shaun D.
Making the Best of a Bad Situation: Case Report of a Nonreplantable Four-finger Amputation with Flap Coverage and Partial Hand Prosthesis Utilization
title Making the Best of a Bad Situation: Case Report of a Nonreplantable Four-finger Amputation with Flap Coverage and Partial Hand Prosthesis Utilization
title_full Making the Best of a Bad Situation: Case Report of a Nonreplantable Four-finger Amputation with Flap Coverage and Partial Hand Prosthesis Utilization
title_fullStr Making the Best of a Bad Situation: Case Report of a Nonreplantable Four-finger Amputation with Flap Coverage and Partial Hand Prosthesis Utilization
title_full_unstemmed Making the Best of a Bad Situation: Case Report of a Nonreplantable Four-finger Amputation with Flap Coverage and Partial Hand Prosthesis Utilization
title_short Making the Best of a Bad Situation: Case Report of a Nonreplantable Four-finger Amputation with Flap Coverage and Partial Hand Prosthesis Utilization
title_sort making the best of a bad situation: case report of a nonreplantable four-finger amputation with flap coverage and partial hand prosthesis utilization
topic Hand
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9007195/
https://www.ncbi.nlm.nih.gov/pubmed/35433159
http://dx.doi.org/10.1097/GOX.0000000000004253
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