NEW ORLEANS — Developing relationships with patients’ surgeons and rehabilitation teams can make all the difference in creating solutions for partial hand amputees, according to a presenter here at the American Academy of Orthotists and Prosthetists Annual Meeting and Scientific Symposium.
Patrick Prigge, CP, FAAOP, clinical manager for Advanced Arm Dynamics, said during a free paper presentation that about 16,000 amputations distal to the wrist occur annually.
“We do not have a lot of information or resources for [wrist distal amputees],” he said, adding that wrist distal amputations present themselves differently in almost every amputee.
“It seems like every partial hand patient I see is a brand new amputation level, something I have never experienced before,” he said. That means that optimal residual limb lengths can vary. “There could be more to the story than just keeping as much [residual limb length] as you can … We want to try to preserve length but not at the cost of something else that might be more functional.”
This could mean getting creative with socket design or working with passive functional options.
Prigge acknowledged that each person involved in the case – from the amputee to the surgeon to the prosthetist to the therapist – has different goals.
A collaborative surgical and prosthetic plan allows the prosthetist to contribute to important decisions rather than work with decisions that may provide fewer prosthetic options.
“[The surgeon’s] number one goal is to preserve length. So the conversation has to start some place with the surgeon as to what we are looking for. Optimal length, optimal musculature, optimal anatomy. Those are not easy to achieve and especially not when we do not have the conversation going and we are given what we get and we try to work around it,” he said. Conversations with the surgeon need to start early.
“We are going to take a look at: What are the options for this patient? How can we make them more functional? And what can you give me to make my job better to give this patient more function?” – by Amanda Alexander
Prigge P. Partial-hand solutions involving a collaborative multidisciplinary approach. Presented at: American Academy of Orthotists and Prosthetists Annual Meeting and Scientific Symposium; Feb. 18-21, 2015; New Orleans.