Case ReportNo Access

Challenges and Solutions in Prosthetic Fitting of Digits after Flap Reconstruction

Department of Hand and Reconstructive Microsurgery, National University Hospital, Singapore

E-mail Address: michael_el_leow@nuhs.edu.sg

Correspondence to: Michael E. L. Leow, Chief Prosthetist, Department of Hand & Reconstructive Microsurgery, NUHS Tower Block, Level 11, 1E Kent Ridge Road, 119288, Singapore. Tel: +65-6772-4596, Fax: +65-6773-2558.

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Soumen DAS DE

Department of Hand and Reconstructive Microsurgery, National University Hospital, Singapore

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Mark E. PUHAINDRAN

Department of Hand and Reconstructive Microsurgery, National University Hospital, Singapore

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, and

Alphonsus K. S. CHONG

Department of Hand and Reconstructive Microsurgery, National University Hospital, Singapore

Department of Orthopaedic Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore

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https://doi.org/10.1142/S2424835524720032Cited by:1 (Source: Crossref)

Abstract

Surgical reconstruction can restore length and function, but cannot adequately resolve the problem of disfigurement. Prosthetic fitting can play a complementary role in enhancing the aesthetic outcomes post reconstruction. However, complex reconstruction involving flaps coupled with the surgical imperative for limb length preservation can lead to outcomes where the reconstructed stumps are challenging to fit with prosthesis. This article describes how prosthetic fitting was tackled in a case of a triple-digit amputation after reconstruction that presented with finger stumps that were bulky, long and stiff in extension contracture, compounded by the presence of substantive scar tissues. We discuss major prosthesis modifications that were unconventional but necessary to enable fitting, the techniques involved, as well as the aesthetic and functional considerations behind the modifications. The results showed that enhanced aesthetic appearance, together with a marginal improvement in hand function, was achieved post-prosthetically, meeting the patient’s and the clinical team’s fitting objective.

Level of Evidence: Level V (Therapeutic)

Keywords:

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