Finger Reconstruction with Osseointegrated Prosthesis.

Hwang, Young Joong; Jeoung, Seuk Mo; Chung, Il Hwa

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Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 1999;26(4):611-616.
Published online July 1, 1999.

Finger Reconstruction with Osseointegrated Prosthesis.

Young Joong Hwang, Seuk Mo Jeoung, Il Hwa Chung

Abstract

Traumatic loss of a finger in part or in which inevitably leads to significant functional deficit and a distortion in body image of the inflicted individual. The available reconstructive option in these circumstances have been toe to finger transfer using microsurgical technique, flap coverage after bone graft, and osteodistraction of the remnant finger. Each method carries advantages and drawbacks inherent in the technique, and generally requires long operative time and hospitalization. Furthermore, the postoperative results after such procedures can be said to be less satisfactory in aesthetic perspectives. Apart from the toe to finger transfer, not much can be sought in terms of functional recovery of the reconstructed part, For a long time finger prosthesis have been used as a replacement of the lost finger part, but it fails to deliver functional strength and tends to be dislodged rather easily. To overcome these shortcomings in the technique, an osseointegrated finger prosthesis has recently been devel-oped. Thumb, index and middle finger in 3 patients were reconstructed with this osseointegrated finger prosthesis. The procedure requires two procedures; the first stage involves placement of a titanium screw in the phalangeal or metacarpal bone proper, followed by fixation of an abutment onto the titanium screw 3 months after the primary operation. The skin surrounding the abutment is thinned out to minimize mobility of the prosthesis at this second stage of operation. After wound stabilization in 2-3 weeks, a custom-made silicone finger prosthesis is made and attached to the implanted abutment using super power magnets. The entire procedure requires 4 months up to the completion, but the procedures can be carried out on the outpatient basis under local anesthesia, not having to interfere with the daily activities of the patient. The aesthetic results with osseoperception have been found to be rewarding, and usual activity like a hand writing and typewriting have been possible. This alternative method could be used for finger reconstruction in cases of usual reconstructive surgery being impossible.

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