Orthopedic surgeons from OrthoCarolina, Charlotte, North Carolina, partnering with the OrthoCarolina Research Institute (OCRI), Charlotte, have completed the first successful surgery on a person with an amputation that allows for a prosthetic hand with individual finger control. R. Glenn Gaston, MD, and Bryan Loeffler, MD, conceptualized and performed the procedure that transferred existing muscle from the fingers to the back of the hand and wrist without damaging the nerves and blood vessels to the muscles. The patient who underwent the test surgery is now able to control individual prosthetic fingers using the same muscles that controlled his fingers prior to his amputation.
Hypothesizing that existing muscle in the back of human fingers could be transferred to the back of the hand and wrist without damaging the nerves and blood vessels to those muscles, the surgeons first performed cadaveric testing to ensure feasibility. The goal of the initial project was for the small muscles that control individual fingers to regain control of prosthetic fingers by maintaining enough blood and nerve supply to allow the prosthetic limb to recognize individual digits. Gaston and Loeffler then collaborated with Hanger Clinic, headquartered in Austin, Texas, to determine how much bone would be required to be removed from the hand, allowing the prosthetic componentry enough space to maintain a normal hand length. The surgery was conducted as a pilot case, moving the muscles while still allowing the prosthesis to detect signals from the transferred muscles; a procedure never before reported in orthopedic literature, according to the team.
Loeffler and Gaston have also completed a cadaver model demonstrating the capability of the same type of surgery for a more proximal level total hand amputation. They presented their research at the First International Symposium on Innovations in Amputation Surgery and Prosthetic Technologies held on May 12-13 in Chicago.