Lifchez SD, Matloub HS, and Nguyen HH. Department of Plastic Surgery, Medical College of Wisconsin, 9200 W. Wisconsin Ave, Milwaukee, WI, USA
Patients who sustain the traumatic amputation of multiple fingers suffer both a functional and psychological loss. Previous studies of prosthesis use for finger amputees have focused primarily on the psychological benefits. As of yet, no studies using objective tesing have been published on this patient group that show that use of a prosthesis improves function. Clinically, our group noticed a functional improvement on hand function tests in multiple digit amputees with the use of a prosthesis. Given the significant expense of multiple finger prostheses, we sought to determine if there was a consistent functional improvement in these patients. Nine consecutive patients performed a battery of hand function tests and rated their ability to perform a variety of activities of daily living both with and without using their prosthesis. Our results show a significant improvement in 3-finger pinch strength (10.3 pounds vs 5.3 pounds, p=0.0039) and grip strength (Jamar dynamometer position 3) (29.4 pounds vs 25.5 pounds, p=0.0341) as well as a trend of improvement of tip pinch, lateral pinch, and grip strength (Jamar positions 1, 2, 4, 5) in these patients when tested with and without their prosthesis. In addition, patients’ ability to perform many activities of daily living, as assessed by the Rosén questionnaire (Rosén 1996), is improved with prosthesis use (3.4 vs 2.8, p=0.0014). Specifically ability to perform activities such as key use, writing, and telephone use were increased to a larger extent with prosthesis use (3.5 vs 2.6, p=0.0049). These results demonstrate a functional benefit to these patients due to prosthesis use in addition to the psychological benefit. This information may better allow physicians and prosthetists to obtain insurance coverage for prostheses for their patients with multiple finger amputations.