Factors influencing use of digital prostheses in workers' compensation recipients

User experiences of digital prostheses in daily functioning in people with an amputation of thumb or finger

STUDY DESIGN": Qualitative research design using interpretative phenomenological analysis (IPA) to interpret users' experiences with digital prostheses.

BACKGROUND

Digital prostheses are rarely used, and little is known about the experiences of traumatic finger amputees with digital prostheses. When advising patients regarding digital prostheses, it is crucial for professionals to understand users experiences of wearing a digital prosthesis and the meaning attached to wearing a digital prosthesis.

PURPOSE OF STUDY

The aim of this study was to explore and understand users experiences of wearing a digital prostheses in daily functioning.

METHODS

Individual semi-structured interviews were conducted, recorded, and transcribed. The written interview texts were analysed following Interpretative phenomenological analysis guidelines.

RESULTS

Four participants were interviewed. They experienced the prostheses as valuable additions to their daily functioning. Three different themes relating to wearing and using digital prostheses emerged from in-depth analysis of the data: How the prosthesis supporting them regaining a 'grip' on life, reduced overload on unaffected side and restored body image.

CONCLUSIONS

This study provides a deeper understanding of the experiences of people with digital amputations who use prostheses. Most importantly, that a prosthesis is of crucial importance for participants to be able to act independently and autonomously as well as to participate in family, work and social environments. This insight will help practitioners when considering, with clients the most appropriate digital prosthesis to meet their goals.

Impact of silicone prosthesis on hand function, grip power and grip-force tracking ability after finger amputation

BACKGROUND

Literature mostly describes the cosmetic role of prostheses for finger amputation. The impact on hand function has not been systematically explored.

OBJECTIVES

Our aim was to describe the impact of silicone finger prostheses on hand function and gripping ability.

STUDY DESIGN

Prospective descriptive cross-sectional study.

METHODS

We included 42 adult patients with partial or complete single- or multiple-digit amputation of one hand. We evaluated hand function of the injured hand without and with the prosthesis with the Southampton Hand Assessment Procedure, and grip power and tracking ability with a grip-force tracking system.

RESULTS

Southampton Hand Assessment Procedure grip index scores were slightly higher when using the prosthesis as compared to not using it (though not reaching the minimum real difference reported in the literature), except for lateral grip. Grip power was not significantly affected by prosthesis use for power grip and lateral grip and slightly diminished for tip grip. Tracking errors only differed with respect to the signal type but not with respect to using the prosthesis.

CONCLUSION

A minimum improvement of hand function can be expected at best with silicone prostheses for finger amputation, accompanied by a slight decrease in tip grip power.

CLINICAL RELEVANCE

Based on our results, an evidence-based explanation can be given to patients after finger amputation regarding the functional benefits that can be expected from a silicone prosthesis.

Osseointegrated finger prostheses

Amputation of a digit can lead to functional and psychological problems and patients can benefit from digital prostheses. Unfortunately, standard prostheses are often unstable, particularly when fitted over short amputation stumps. Prosthesis fixation by osseointegration is widely used in oral and extraoral applications and may help avoid the problem of instability. This paper reports the results of four patients with five finger amputations who were treated with osseointegrated implants to attach finger prostheses. One implant failed to osseointegrate and the procedure was abandoned. Three patients were successfully treated to completion of three finger prostheses and are extremely satisfied with their outcomes, both cosmetically and functionally, with osseoperception reported by all three patients.