FITTING A HAND-GLOVE PROSTHESIS TO ENHANCE THE RECONSTRUCTED MUTILATED HAND

Microsurgical reconstruction of the severely mutilated hand aimed at i mproving prehensile functions often does not address the esthetic aspe cts of the hand. The poor appearance of the reconstructed hand affects its active display and use. A hand-glove prosthesis may be prescribed in this instance to enhance the overall form and function of the muti lated hand. We reviewed 16 cases of mutilating hand injuries in which surgical reconstructions were performed and the patients were subseque ntly fitted with a hand-glove prosthesis to augment the outcome. An im proved appearance was achieved in all patients fitted with the prosthe sis. The patients' sense of confidence was also enhanced, which in tur n promoted the active and open use of the reconstructed hands. While p rescribed primarily to improve the appearance of the reconstructed han ds, these prostheses were documented to enhance the physical hand func tions in 11 cases by increasing the span of the hand and providing an opposable post and a palmar base for holding and for anchorage. The pr osthesis enhanced assistive functions of the reconstructed hands and f reed the contralateral normal hand for use in bimanual activities, suc h as holding a wallet and taking out money, supporting a note pad for writing, and holding a plate at buffet receptions. At the 18-month fol low-up visit, 13 (87%) of the patients continued to use their prosthes is, Wear and tear were problems associated with the frequent use of th e prosthesis. The expected life span of the prosthesis with daily use ranged from 2 to 3 years. All the patients acknowledged that the prost hesis played a role in their rehabilitation and that it helped them to overcome the initial psychological trauma and to come to terms with t heir physical loss. Copyright (C) 1998 by the American Society for Sur gery of the Hand.