Dear Robert
I am an occupational therapist and a guitarist myself. You have quite an interesting
challenge. Does your client play the guitar for pleasure or as a vocation? Does he
play to accompany himself while singing, or does he play classical style. You will
need to problem solve with him to come up with a compromise. If he wears a
prosthesis, it will obliterate sensation which seems undesirable, and probably limit
PIP motion. It seems to me that unless he is too hypersensitive, he should learn to
play without a prosthesis. Perhaps he has trouble fretting individual strings
because his middle phalanx is too wide, especially since it is the site of the
amputation. Perhaps a simple ring of thin low temperature thermoplastic around the
middle phalanx would compress the soft tissue, although you would need to be
careful not to compromise the circulation. Does he have hypersensitivity of his
residual finger?
Good luck. Let us know how you proceed. This is an interesting challenge for you
and the client.
Pat McKee, M.Sc., O.T.(C),
Assistant Professor,
Department of Occupational Therapy,
University of Toronto
416-978-1817
author of “Orthotics in Rehabilitation: Splinting the Hand and Body” F.A. Davis,
Philadelphia, 1998
On Fri, 28 Aug 1998 14:58:46 -0400 Robert Brown wrote:
> From: Robert Brown
> Date: Fri, 28 Aug 1998 14:58:46 -0400
> Subject: Finger Prosthesis for Guitarist
> To: [email protected]
>
> Greetings List-members,
>
> I have a patient who sustained an amputation of his left 2nd distal
> phalanx. He plays guitar right handed therefore the left hand must
> “fret” the strings. He is able to “bar” chords using the residuum flat
> against the strings. But, lacking the ability to flex the absent DIP
> joint, fretting individual strings is not possible without ‘buzzing”
> adjacent strings.
>
> If anyone has experience with this particular (or similar) scenario,
> please share. Creative ideas are also welcome.
>
> Patients idea:
> A prosthetic finger that has a functional DIP operated through tenodesis
> by the PIP would lay flat against the guitar neck for bar chords and
> flex for individual notes.
>
> A more practical solution may be a prosthetic finger with 30-45 degrees
> of fixed DIP flexion, allowing individual notes to be depressed. Bar
> chords may be impossible unless the material is resilient enough to
> simulate DIP extension, laying flat against the guitar neck. But,
> suspension may be problem; the force required to depress the strings
> may leverage the prosthesis off the finger, restriction of PIP motion
> may limit ability to place finger tip on the desired string to be
> played.
>
> Looking forward to many responses.
>
> Best regards,
>
> Robert Brown, MS, CPO
> Clinical Director of Orthotics and Prosthetics
> University of Rochester Medical Center
