gms | German Medical Science

Objectives/Interrogation: Thumb amputation after traumatic injury or due to tumor resection leads to significant impairment of hand function, as well as psychological burden.

Various techniques have been described, ranging from pollicization, phalangisation to complex microsurgical procedures, such as toe-to-thumb transfer.

An osseointegrated thumb prosthesis via titanium fixation to the residual bone can provide a functionally and aesthetically viable reconstruction alternative for patients in which microsurgical techniques are not indicated. This retrospective study compares osseointegrated thumb prosthesis to other secondary reconstructive procedures (pollicization, toe to thumb transfer and lengthening).

Methods: We present one male patient who was treated with an osseointegrated thumb prosthesis 12 months after thumb amputation in the metacarpal joint because of an epitheloid cell sarcoma. There was no specific rehabilitation necessary. The outcome measures 9 and 24 months postoperatively included SHAP Test and were compared to patients with other secondary reconstructive procedures (pollicization, toe to thumb transfer and lengthening).

Results and Conclusions: In the performed SHAP Test (Southampton Hand Assessment Procedure) the patient with the osseointegrated thumb prosthesis reached 98 points. This correlates with standard values of healthy population. Furthermore the patient was very satisfied with the aesthetic appearance of the prosthesis.

No complication (e.g. wound infection, implant loosening) were observed 24 months postoperatively.

An osseointegrated thumb prosthesis via titanium fixation to the residual bone can provide a functionally and aesthetically viable reconstruction alternative for patients in which microsurgical techniques are not indicated. Due to a stable fixation of the prosthetic finger to the bone, restoration of some sensory feedback with osseoperception can be achieved.