Simple thumb prosthesis: a cheap and useful alternative to expensive and complex solutions.

Abstract

Traumatic of oncologic amputation of the digit (digits) is fairly common injury affecting the upper extremities. Amputation of the thumb causes significant disability as loss of the thumb accounts for 40% of the entire loss of hand function. In the case of thumb amputation, replantation is the best option, allowing almost full recovery of the hand function. However, for various reasons, replantation is not always possible or successful and in these cases other methods of thumb reconstruction such as toe-to-thumb transfer, lengthening procedures and index pollicization are considered. Other, reasonable option is use of various prostheses such as naked prostheses, vacuum-retained prostheses, or osteo-integrated prostheses. In the article we present a case of young men who underwent amputation of the distal phalanx of his thumb in right (dominant) hand due to malignant tumour. He had relatively long stump of the digit and he found in the internet simple thumb prostheses made of rubber material, which were advertised as stage props and toys used to depict magic tricks. Total cost of the prosthesis was 20 PLN. He started using it in his daily activities and at work. At follow-up at 3 months after amputation the patient filled the DASH questionnaire and  obtained score of 8 points, indicating normal hand function, both with and without the prosthesis. However, in the subscale “professional activity” the difference of 4 points appeared, favouring using a prosthesis. The patient reported also that use of prosthesis  allows him to tie laces in his shoes, fasten clothes buttons and use scissors more efficiently. The patient believes that this simple prosthesis makes for him easier performing activities of daily living and professional work.