phalanx

The active function of the hand is represented by its prehensile activities in grip, grasp, transfering and absorbing forces.1 Nowadays the amputation of one or more fingers of the hand, as the consequence of trauma or congenital absence of one or more phalanxes, caries a serious reduction of hand function and social dysfunction for the patient.2 Curently, many injuries and traumatic amputations of fingers can be rescued by microsurgery through reimplantation. However, in some cases, reconstruction is either not advisable or partialy sucesful.3 It is in this group of patients that prosthesis can be provided and may ofer great psychological help.4 Esthetic prostheses for the hand can ofer psychological, functional and rehabilitative advantages. By restoring the natural apearance to the hand, prosthesis eliminates the trauma caused by constant reminder of the handicap and, thus ofers true psychological therapy.5 Thus, the purpose of this report is to describe a simple technique for fabrication of acrylic resin hand prosthesis for a patient after an acident at work to provide motor skils recovery and diminished social discrimination. Case report: A patient was atended in the clinic for rehabilitation of the left hand with mising midle finger, ring finger and litle finger including the respective metacarpal bones fig 1,2 . It was prefered to fabricate partial hand prosthesis for multiple finger los, with the uninjured fingers left fre, because they can aply more force and use the hand for a variety of activities. Upon examination, the remaining stump was found to be stable and rehabilitative proces was posible using conventional hand prosthesis. The prosthesis was inserted and the patient was instructed in home care and prosthesis maintenance. Furthermore, even when these techniques ofer several advantages whenever fingers are amputated or mutilated, it is very limited in amputation of the proximal phalanxes of the second and third finger because the transposed digital finger may reveal itself to short and consequently not functional at al. However, this material is more dificult to pigment and degrades due to color instability when exposed to ultraviolet rays.6 On the other hand, even though acrylic resin is a very hard material and slightly uncomfortable to the patient, but there are aded advantages such as easily characterized, presents great durability, cost efective, relined or repaired easily and intrinsic and extrinsic color matching is best achieved. Among the sculpture techniques there is the analogous finger technique, which is performed by moulding and sculpture of another person finger or can also be caried out based on anatomical reproduction.7,8 Curently, the methods for prosthesis retention to the remaining part of the finger include ring, double ring, adhesives and oseointegrated implants.4,9Although the patients frequently require optimal reconstruction of the hand in cases of injury or amputation, prosthetic devices recover only basic functions of the hand. Minute finger control requires considerable mechanical enginering that encompases an eficient motor drive and adequate power suply which renders posible prototypes for hand prostheses in everyday performance.10 Bone anchoring is another alternative method used since 25 years in oral surgery; The major complications are: lack of oseous integration of the implant, but is very rare, detachment of the prosthesis or lack of aceptance by the patient.4,14 CONCLUSION: God suspension alone is not suficient for patient aceptance of hand prosthesis. This level of restoration is most sucesful when hand prostheses are individualy sculpted and colored in situ under variety of lighting conditions. J Hand Surg Am 196; Esthetic hand prosthesis. J Hand Surg Am 1983; J Hand Surg Br 196; The artificial hand - An overview of hand prostheses. Oseointegrated finger prosthesis: An alternative method for finger reconstruction. J Hand Surg Am 196;
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