AESTHETIC LIFE-LIKE FINGER AND HAND PROSTHESES : PROSTHETIC PRESCRIPTION AND FACTORS INFLUENCING CHOICES

: This paper reviews the authors' experience with fitting life-like finger and hand prosthesis. The methodology and technical considerations in producing these prostheses, the prosthetic prescription according to the level of amputation and the challenges faced with each level are discussed. In cases where the amputation is sufficiently distal, a thimble prosthesis has been used. This is compared to fitting a full-length finger prosthesis. Besides allowing free range of motion of the proximal finger joints which would otherwise be covered and restricted with fitting a finger prosthesis, a thimble prosthesis minimises skin coverage for optimal sensibility and is easier to don and doff. In cases of amputations where a digital fitting is precluded, a partial or a total hand is prescribed. A comparison between fitting a finger, a partial hand prosthesis and a total hand prosthesis is also discussed. Cases of a digital, transcarpal and a more proximal transmetacarpal amputations are relatively easy to fit with a prosthesis. An incomplete transmetacarpal amputation where much of the breadth of the hand is preserved presents a difficult challenge as it necessitates fitting with a partial hand prosthesis. Besides the need to cover a large area of the intact skin and the associated problems with reduced sensibility and stump perspiration, a partial hand prosthesis is difficult to don and doff.