Dear List,
Thank you very much to everyone who posted a reply. After some discussions with the patient, he has decided that the best fit for his lifestyle (and wallet) is to proceed with a cosmetic hand (potentially living skin) and a functional hand. The functional hand will be a urethane based device that wraps around the hand like a glove and has solid fingers in a fixed position. This will allow him to hang onto objects at the gym, his motocross bike, and his snowmobile, while still keeping somewhat of a hand-like shape and appearance.
Here is my original post:
I have a patient who has a partial hand presentation, with the 4th and 5th fingers and metacarpals absent. He is looking for a cosmetic restoration, but also a device (or multiple devices) to use for his very active lifestyle. He participates in motocross, skiing, snowmobiling, skydiving, and weightlifting. His main concern is the loss of his gripping ability and the pressure distribution over his now much smaller palm.
I have a few ideas involving passive devices, but I would like to ensure I present the best possible options to him. He inquired about the i-limb digits, but I’m not sure that it would be appropriate or worth it for the 4th and 5th fingers only. Please share your ideas and experiences.
Here are the responses:
1) Isolator strap system for weightlifting. TRS also has some neat ideas: http://www.trsprosthetics.com/sports-recreation/weight_lifting.asp.
2) ProCuff by TRS. It is a pretty slick little device and if you got TRS’s kayak attachment that might work well for grip stability for your patient for some of his activities, not so cosmetic though. Or you could make something custom using duraflex (easy to mould and grind, and can easily add more material as needed) a 1/2-20 thread adapter can be imbedded into it as well.
3) NABLER from Texas Assistive
4) Aesthetic Prosthetics makes a utility hand geared towards functionality. Mde from multiple durometers of rubber.
5) Alternative Prosthetics makes a silicone partial hand that is excellent for cosmetics and continued use of the other digits.
6) Prodigits
7) Touch Bionics / Living Skin
8) Urethane partial hand prosthesis; it’s durable, and could continue the grip pattern of his 1st and 2nd digits, and distribute palmar pressure for the activities you mentioned. I would assume it would be on the heavy side, but it doesn’t seem like that would be an issue for these activities. Myrdal Orthopedic is a good resource for this. They offer fabrication services (see this link…the 2 last pictures) http://myrdalorthopedics.com/products/fabrication or they sell the urethane of various durometers for fabrication.
—
Mr. Loren Schubert
Certified Prosthetist
P 604-321-1115 | F 604-321-7681
www.barberprosthetics.com
