Partial Hand Prosthesis Responses
Doug Wacker, CPO
Description
Collection
Title:
Partial Hand Prosthesis Responses
Creator:
Doug Wacker, CPO
Date:
1/14/2008
Text:
As a review, I have a patient who was referred to us with a partial hand amputation at the MCP level of digits 2,3,4 and 5. Cosmetics will be a problem with regards to length of the prosthetic digits. Below are the responses recieved so far. Thank all for their input.
============================================================================
I am responding back to your email regarding the partial hand patient that
you are currently seeing. I have been working directly with Touch Bionics,
as part of their development team, and have begun to use with the ProDigits
for partial hand level amputees.? In addition, I have been fitting this
level with electric prostheses for approximately five to six years and
currently have several patients that we are working with.
This design and level of amputation is very difficult secondary to the
various presentations that one will appreciate secondary to the level of
trauma as well as reconstructive surgery, scarring and any other anatomical
remodeling that may have occurred after the amputation.? That being said, we
carefully pick the candidates that will be a part of the initial fittings
for this specific type of electric prosthetic management.? We find that
electric partial hands are very functional because they provide essentially
an adjustable opposition post that does not require the sound side for
prepositioning.? This helps enhance bimanual tasks and function.?
Specific to your case, I would recommend the fitting of a silicone passive
prosthesis, as this will most likely give the best aesthetic result for the
patient.? If she is interested in something that is more functional, I would
be happy to discuss this further with you over the phone.
Please do not hesitate to contact me regarding this lady's case.? I wish you
success in your future endeavors.
-------------------------------------------------------------------------------------------------
Look at Regal gloves on the Homer.com website. They do semi-custom silicone partial hands and the price is very good.
See below-
Hosmer provides semi custom Regal gloves for partial hands. Looks good and the price is right.
------------------------------------------------------------------------------------------------
You can use a modified tenodesis whfo where you build in prosthetic fingers. If
you needed to get fancy you could build in a powered unit (like the powergrip
from broadened horizons) and run it with myo switches (if the patient didnt like
or couldnt use wrist extension to close the fingers).
-------------------------------------------------------------------------------------------------
From a silicone/cosmetic stanpoint I have had sucess
with Livingskin. They do a very nice job and as long
as there is no residual swelling left, the skin
suction fit of there hands/fingers is very good.
Another option may be the X-finger, which works as on
a tenodesis principle, although at her amputation
level I am not sure they have the appropriate
componentry yet. Becker Oregon also makes a nice WHO
that I have used on a couple partial hands but can be
a bit bulky and less cosmetically appealing. I would
be interested to hear any other responses you get.
--------------------------------------------------------------------------------------------------
Didrick Medical is working on their partial hand. It may be ready for primetime.
Most cost effective and functional product that can be manufacturered that I am
aware of, in the body-powered options. Homemade for specific tasks are always
tried and true.? Otherwise, myo options through Otto Bock and Touch Bionics are
worth mentioning just for patient education even if funding is an issue. Please
do not hesitate to contact me directly for brainstorming.
--------------------------------------------------------------------------------------------------
We have fit 2 partial hand touch bionic pro digit systems so far.? Some things to consider and discuss with the patient if you intend to go this route.? (1) It is very hard to conceal the electronics associated with the digits.? We have had to construct a wrist band for the patient to wear to house the cpu's and batteries etc.? (2) we are still trying to work out a way to make a protective cover that will provide protection from dust dirt and water that will still allow the patient to have an exposed thumb, right now all the fingers are exposed.? (3) cosmeses.? We havent even started down that road, but its going to be tough as the MCP joints on the pro digits can't line up with the natural joints, giving a gorilla type look to the hand.
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Milbrand type device specifically suited to tasks would work for her.
---------------------------------------------------------------------------------------------------------------------------------------------------------------------------
If she has any of the phalanges left, she may be a candidate for digit lengthening.? Osteotomy and osteogenesis of the digits.? Talk to a hand surgeon about this.? Healthy young non-smoker can get a mm per day.? Good luck with it.
--------------------------------------------------------------------------------------------------
I have a similar patient & situation, I am checking with the company named DIDRICK, I have also e-mailed them?pictures of my patient. They are working for the functional design for my patient & also the L-codes & cost. They will reply me back by Feb 2008. On touchbionic, technology & functions are real good, but not sure how to bill as they suggest a miscellanous code.
?
If you are interested,? to know more about didrick, you can check there web-site www.didrickmedical.com.
I am not sure how good they are. I am just giving a try.
--------------------------------------------------------------------------------------------------
You can use a modified tenodesis whfo where you build in prosthetic fingers. If
you needed to get fancy you could build in a powered unit (like the powergrip
from broadened horizons) and run it with myo switches (if the patient didnt like
or couldnt use wrist extension to close the fingers).
--------------------------------------------------------------------------------------------------
Douglass J. Wacker, CPO, LPO
NUTECH Orthotics & Prosthetics, LLC
2422 E. Tyler Ave., Ste. A
Harlingen, TX. 78550
PH. 956-412-LEGS(5347)
FX. 956-412-3563
E-mail: <Email Address Redacted>
www.nutechoandp.net
Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you received this email in error please delete and notify the sender.
________________________________________________________________________
More new features than ever. Check out the new AOL Mail ! - <URL Redacted>
============================================================================
I am responding back to your email regarding the partial hand patient that
you are currently seeing. I have been working directly with Touch Bionics,
as part of their development team, and have begun to use with the ProDigits
for partial hand level amputees.? In addition, I have been fitting this
level with electric prostheses for approximately five to six years and
currently have several patients that we are working with.
This design and level of amputation is very difficult secondary to the
various presentations that one will appreciate secondary to the level of
trauma as well as reconstructive surgery, scarring and any other anatomical
remodeling that may have occurred after the amputation.? That being said, we
carefully pick the candidates that will be a part of the initial fittings
for this specific type of electric prosthetic management.? We find that
electric partial hands are very functional because they provide essentially
an adjustable opposition post that does not require the sound side for
prepositioning.? This helps enhance bimanual tasks and function.?
Specific to your case, I would recommend the fitting of a silicone passive
prosthesis, as this will most likely give the best aesthetic result for the
patient.? If she is interested in something that is more functional, I would
be happy to discuss this further with you over the phone.
Please do not hesitate to contact me regarding this lady's case.? I wish you
success in your future endeavors.
-------------------------------------------------------------------------------------------------
Look at Regal gloves on the Homer.com website. They do semi-custom silicone partial hands and the price is very good.
See below-
Hosmer provides semi custom Regal gloves for partial hands. Looks good and the price is right.
------------------------------------------------------------------------------------------------
You can use a modified tenodesis whfo where you build in prosthetic fingers. If
you needed to get fancy you could build in a powered unit (like the powergrip
from broadened horizons) and run it with myo switches (if the patient didnt like
or couldnt use wrist extension to close the fingers).
-------------------------------------------------------------------------------------------------
From a silicone/cosmetic stanpoint I have had sucess
with Livingskin. They do a very nice job and as long
as there is no residual swelling left, the skin
suction fit of there hands/fingers is very good.
Another option may be the X-finger, which works as on
a tenodesis principle, although at her amputation
level I am not sure they have the appropriate
componentry yet. Becker Oregon also makes a nice WHO
that I have used on a couple partial hands but can be
a bit bulky and less cosmetically appealing. I would
be interested to hear any other responses you get.
--------------------------------------------------------------------------------------------------
Didrick Medical is working on their partial hand. It may be ready for primetime.
Most cost effective and functional product that can be manufacturered that I am
aware of, in the body-powered options. Homemade for specific tasks are always
tried and true.? Otherwise, myo options through Otto Bock and Touch Bionics are
worth mentioning just for patient education even if funding is an issue. Please
do not hesitate to contact me directly for brainstorming.
--------------------------------------------------------------------------------------------------
We have fit 2 partial hand touch bionic pro digit systems so far.? Some things to consider and discuss with the patient if you intend to go this route.? (1) It is very hard to conceal the electronics associated with the digits.? We have had to construct a wrist band for the patient to wear to house the cpu's and batteries etc.? (2) we are still trying to work out a way to make a protective cover that will provide protection from dust dirt and water that will still allow the patient to have an exposed thumb, right now all the fingers are exposed.? (3) cosmeses.? We havent even started down that road, but its going to be tough as the MCP joints on the pro digits can't line up with the natural joints, giving a gorilla type look to the hand.
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Milbrand type device specifically suited to tasks would work for her.
---------------------------------------------------------------------------------------------------------------------------------------------------------------------------
If she has any of the phalanges left, she may be a candidate for digit lengthening.? Osteotomy and osteogenesis of the digits.? Talk to a hand surgeon about this.? Healthy young non-smoker can get a mm per day.? Good luck with it.
--------------------------------------------------------------------------------------------------
I have a similar patient & situation, I am checking with the company named DIDRICK, I have also e-mailed them?pictures of my patient. They are working for the functional design for my patient & also the L-codes & cost. They will reply me back by Feb 2008. On touchbionic, technology & functions are real good, but not sure how to bill as they suggest a miscellanous code.
?
If you are interested,? to know more about didrick, you can check there web-site www.didrickmedical.com.
I am not sure how good they are. I am just giving a try.
--------------------------------------------------------------------------------------------------
You can use a modified tenodesis whfo where you build in prosthetic fingers. If
you needed to get fancy you could build in a powered unit (like the powergrip
from broadened horizons) and run it with myo switches (if the patient didnt like
or couldnt use wrist extension to close the fingers).
--------------------------------------------------------------------------------------------------
Douglass J. Wacker, CPO, LPO
NUTECH Orthotics & Prosthetics, LLC
2422 E. Tyler Ave., Ste. A
Harlingen, TX. 78550
PH. 956-412-LEGS(5347)
FX. 956-412-3563
E-mail: <Email Address Redacted>
www.nutechoandp.net
Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you received this email in error please delete and notify the sender.
________________________________________________________________________
More new features than ever. Check out the new AOL Mail ! - <URL Redacted>
Citation
Doug Wacker, CPO, “Partial Hand Prosthesis Responses,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 1, 2024, https://library.drfop.org/items/show/228942.
