Living with finger amputation
Our hands combine sensory, motor and social functions. They are permanently visible – a kind of business card for the first impression. Are the hands clean? Are the fingernails groomed? We often shake hands when meeting people. A successful business deal is sealed with a handshake. How do I handle my amputation in such situations?
Today, amputated limbs can be replaced by a hand and finger prosthesis. The prostheses are made of silicone and are very realistic looking. A silicone hand or finger prosthesis is often not even noticeable at first glance.
Causes for the amputation
Why is a finger/partial hand amputated?
Health Preservation Doctors always try to avoid amputating fingers or hands. Thanks to advances in surgical techniques, it is increasingly possible to preserve fingers and hands with most of their functions intact. However, for serious diseases or injuries, it may still be necessary to amputate to preserve your health in the long term.
The most frequent causes for finger amputations are accidents (trauma). Accidents may occur at work or in your free time, for example while participating in sports or hobbies . Accidents can lead to amputation in all age groups. Another cause is congenital malformations (dysmelia) as well. The malformation can be caused by a genetic defect or by external factors such as infections or as a side effect of drugs (e.g. thalidomide).
Replantation – not always possible
In some cases, severed fingers or hands can be reattached (replantation). Replantation is always a difficult operation. The surgeon is faced with a highly complex task, particularly when a hand is involved, that does not always succeed. The decision is made on a case-by-case basis.
The severed part must be protected from moisture. Pack it in
1. dry, sterile compresses and
2. then in a waterproof plastic bag.
To keep the part cool during transport, the closed plastic bag holding the part should be placed in a mixture of water and ice. The body part may not be in direct contact with water or ice.
What kinds of amputations are there?
We make varied and complex movements with our hands; there are numerous uses of fingers and hands every day.
Your surgeon will make every attempt to save as much of your hand as possible. Hands and fingers are amputated at different places, known as amputation levels. The amputation level is determined by the extent of the injury. It depends on the extent of the area affected – is the fingertip severed or the entire hand affected?
When the whole hand up to the wrist must be amputated, it is termed a hand amputation. When one or more fingers need to be amputated, it is called a finger amputation. All procedures between a finger and a hand amputation are called partial hand amputation.
The new hand
Modern orthopaedic technology makes it possible to fit the affected hand with a hand, partial hand or finger prosthesis after an amputation.
Basically, you use your fingers for many activities. How your finger prosthesis is designed depends on the amputation level. If the residual limb is still 2 cm long after amputation, it is usually possible to fit a silicone finger prosthesis. If the residual limb is shorter or part of the hand is missing, a silicone partial hand prosthesis is used. The number of amputated fingers does not affect the decision on whether a finger prosthesis or a partial hand prosthesis will be used.
There is no general rule about what functions will be possible with a prosthesis – or what your hand will look like after amputation. Residual limb conditions are unique. Any questions you may have can be answered in an individual consultation and in the trial fitting phase for the prosthesis.
What happens after a finger/partial hand amputation?
Further treatment begins immediately after amputation. The wound has to heal and the residual limb must be shaped.
The postoperative care of the residual limb is handled by medical professionals who regularly change the compression dressings. The goal is to support the rapid absorption of blood and fluid build-up in the tissues around the wound. The goal is to reduce the volume of the residual limb. In addition, slight pressure is applied using compression dressings to compress the residual limb as much as possible. If the residual limb is to be fitted with a silicone prosthesis later, it is advisable to use compression aids made of silicone now.
It cannot be predicted how long you need until the wound is healed. The healing period varies greatly and is affected by other factors such as concomitant diseases (diabetes) or nicotine use.
Living with an amputation
Take your time to adjust to your new situation. While the amputation of a finger is a relatively minor amputation, it is still an operation. An amputation affects not only the function of your hand, but its appearance as well. Initially, the situation will be unusual for you - you have to learn what you can still do after the amputation and what functions you no longer have. For many of those affected, the initial impact of an amputation is major.
The loss of a finger or parts of the hand sometimes affects behaviour in public. Some of those affected want to conceal the hand from others. In rare cases, the patient has difficulty accepting his or her own hand after an amputation. If this is the case, the person should seek help and take part in post-amputation therapy as well as occupational therapy.
The important thing is that you alone decide how to deal with your amputation.
Being fitted with a prosthesis can be an option that will help you to return to your normal life after an amputation.
Living with a prosthesis
Thanks to modern materials and technology, the lost fingers or parts of the hand can be replaced with a finger or partial hand prosthesis. The decision to wear a prosthesis or not is entirely up to you.
If you can answer the following questions with "yes", it should be possible to fit you with a prosthesis. However, this "quick check" is not a substitute for a personal consultation with a prosthetist:
- Has your residual limb healed?
- Is the volume of your residual limb stable?
Even if the residual limb is bony or has areas of sensitive skin, a prosthesis can generally be used. Sometimes fitting with a prosthesis is even recommended in this case. The prosthesis protects the sensitive residual limb from direct contact with objects and the socket is individually fitted to the particular situation. Please note that a prosthesis is an aid, but cannot entirely replace the complex functions of a hand. You must anticipate certain limitations, even with a prosthesis.
What will I be able to do with a finger/partial hand prosthesis?
The prosthesis will help you to regain as much as possible of the function lost due to the amputation. You will again be able to hold and grasp objects passively - the prosthesis will allow you to hold them against your remaining fingers or thumb. This will avoid unilateral strain and enable a balanced sequence of movements. Restoring the whole palm also enlarges the usable area of the amputated hand. Regaining these functions can help restore your confidence and independence.
There is also an aesthetic benefit. The natural-looking appearance of the prosthesis will support your social integration in everyday activities - day after day.
Exactly how much your finger prosthesis will be capable of depends mainly on the function remaining in your residual hand. The silicone prosthesis is controlled by the residual hand. The custom-made socket ensures firm support that makes precise movements possible.
What are the advantages of a finger/partial hand prosthesis?
Your silicone prosthesis fulfills many technical and social functions. To be precise, a silicone prosthesis gives you:
- Secure hold
- Excellent wearer comfort
- Thin socket edges
- Good skin tolerance
- High form stability
- Anatomically correct shape
- Aesthetic appearance
- Easy handling
- Easy care
The secure hold and good wearer comfort are achieved by the socket of the prosthesis. The socket connects the residual limb and the prosthesis. It is custom fabricated for your residual limb. A firm, direct connection between the prosthesis and your residual limb is created by vacuum. The finger prosthesis adheres firmly to the residual limb in every position and for every grasp movement.
Simultaneously, a greater degree of wearer comfort is achieved by the use of different levels of material stiffness in a custom-fabricated socket. This is an advantage especially for those with a difficult stump situation - for example if the skin at the stump is especially sensitive or the end is bony.
It seems strange, but appearance is a function of its own. A hand that you accept optically will not be hidden in your pocket. The realistic-looking restoration of the anatomically accurate shape and colour of your hand helps you feel more confident around people and makes an important contribution to integration in social life and at work.
Treatment experts on site
Frequently asked questions about the finger/partial hand prosthesis
How can I obtain a silicone prosthesis?
Prescribing a prosthesis involves your doctor, the prosthetist you selected and the paying party. If you have health insurance, you need a prescription from your doctor to be fitted for a prosthesis in a medical supply company.
First talk to your doctor about the possibility of a partial hand or finger prosthesis.
At your first appointment in the medical supply company of your choice, your prosthetist will inform you of the available options. In addition, the requirements of your silicone prosthesis will be determined.
After you have decided on a prosthesis, you will have a second appointment at the medical supply company. Measurements will be made. The prosthetist will measure your hand, make impressions, and take pictures. A trial prosthesis will be made based on these data.
Shortly thereafter, you will receive the trial prosthesis to wear and test for 2-4 weeks. It is important that you try out the finger position in various everyday situations. This is the only way to find out the optimal finger position for you. The trial prosthesis is also used to test the exact fit to your residual limb so that you will benefit from good wearer comfort in the long term.
On the basis of your experience with the trial prosthesis, the definitive prosthesis will be made after consulting with your prosthetist. You will receive the definitive prosthesis about 3 weeks after the end of the trial phase.
How do I put on and take off a finger/partial hand prosthesis?
Your hand or finger prosthesis is very easy to use. The silicone used is very elastic and stretches when you put it on. No zippers or other openings are needed.
To help glide into the socket, we recommend using Pro Comfort Gel. Please do not use any other product without consulting your prosthetist - the contents may damage your skin or your prosthesis.
The hand or finger prosthesis is also easy to take off. Specific motions at the edge of the socket admit air and release the vacuum adhesion. Using a small rod to admit air makes it easier to take off. No other tools are needed.
How do I care for a silicone prosthesis?
Cleaning is as easy as washing your hands - it is best to clean your prosthesis using only lukewarm water and ph-neutral soap. Clean it on the inside as well to remove residue from sweat. To remove tough stains and grease, we recommend putting the prosthesis in boiling tap water for 30 minutes once every 6 weeks.
It is important to protect your prosthesis from solvents or other chemicals. This applies when wearing the prosthesis as well as when cleaning it. Solvents not only penetrate the silicone and destroy it, they can also be released to the skin. You should also keep creams, e.g. hand lotion, and perfume away from the prosthesis.
You can continue to wear any kind of jewellery with a silicone prosthesis. When you polish the (acrylic) nails of your finger prosthesis, please ensure that neither nail polish nor remover comes in contact with the silicone areas of the prosthesis. This will damage the silicone. Acrylic nails are also suitable for nail design.
How is a finger/partial hand prosthesis reimbursed?
If you have private insurance, the amount of reimbursement depends on your specific contract. If the contract covers reimbursement for the prosthesis, you may need a physician's prescription. If your health insurance rejects the application for reimbursement, you may appeal the decision. Self-payers may contact the prosthetist of their choice directly and without a prescription.
After the consultation, the prosthetist takes care of the application for reimbursement. When the cost estimate has been approved, your medical supply company will be notified. Sometimes reimbursement for your prosthesis is not approved. The medical supply company will then receive notification of rejection. If this happens, you can appeal the decision. This appeal may initially be made without stating the grounds in order to meet the deadline.
How do I care for my residual limb?
The properties of the "medical grade silicone" Ottobck uses have a positive effect on your skin. The silicone is breathable, skin friendly and helps prevent skin irritation.
If you have a very sensitive area on your residual limb, e.g. especially thin skin or retracting scar tissue, the prosthesis protects these areas from direct contact. This is especially beneficial if the residual limb is sensitive and helps avoid pain and further injury.
Please check for changes in your residual limb and contact your physician if you find any. You should also consult your physician if your scar becomes hard or less flexible.
Please take your prosthesis off at night to allow the skin on the residual limb to regenerate.
What do silicone finger and partial hand prostheses look like?
With silicone, the shape and length of the fingers in proportion to the body can be precisely reproduced. Silicone also allows great versatility of design. It makes it possible to reproduce the external appearance down to the smallest detail.
Silicone makes it easy to replicate your exact skin tone. In addition, there are almost unlimited possibilities for detail. If desired, birthmarks, veins, or hair can be integrated into the prosthesis.
Please be aware of the fact that your skin tone is always subject to slight changes. Unlike your hand, the silicone of the prosthesis is not alive and will not be able to adapt to these natural fluctuations in colour.
The fingernails will also be custom made for you. Up to 5 colours are used to design the fingernails. If desired, you can also apply nail polish or use nail design.
There are 2 different options for prosthesis design. Different configurations can be selected for these options. The finger prosthesis will be custom made based on your selection.
What is a silicone prosthesis made of?
Your prosthesis is made of skin-friendly silicone. Silicone does not cause any allergic reactions. This means that you can wear your silicone finger prosthesis frequently and for long periods. The prosthesis also keeps its shape.
Silicone also looks more realistic. It allows for the finest details of your amputated finger to be replicated for a realistic-looking prosthesis. You can even use nail polish and wear jewellery with a silicone prosthesis.
Silicone is resistant to fresh water, salt water and UV rays. A silicone prosthesis also has excellent hygienic properties.