Fabrication of a Functional Finger Prosthesis With ..
The complete adaptation of the tissue to the anchorage element continues even after the prosthesis is in place. When, via the prosthesis, the titanium screw begins to be loaded, for example by chewing, the next step takes place. The tissue around the fixture remodels itself in a way which is dependent on the size, direction and frequency of the loading force.
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Background: A small series of patients with traumatic amputation of fingers have undergone treatment with a new technique using endomedullar osseointegrated titanium implant device that magnetically holds the finger prosthesis. Methods: A two-stage reconstruction procedure with endomedullar osseointegrated titanium implants was performed to attach a finger prosthesis to the proximal, middle and distal phalanx. The first stage included implantation of the titanium fixture into the medullary cavity canal of the phalanx. After a 2-month rest period to allow the fixture to firmly osseointegrate with the phalanx of the bone, a skin-penetrating titan-magnetic abutment was placed on top of the fixture, to which the prosthesis was firmly attached. Results: Good stability could be achieved using an endomedullar osseointegrated prosthesis. Easy handling is possible with the magnetic connection between finger and prosthesis. In the clinical use were no complications observed. We observed no infections and no problems with the soft tissue. Conclusions: The combination of osseointegrated titanium implants and magnetics for finger prosthetics provides several advantages. Such as stable fixation of the prosthetic finger to the bone, restoration of some sensory feedback with better osseoperception as well as an excellent cosmetic result.
Finger reconstruction of proximal phalange and metacarpal requires complex surgical procedures. Digital transposition or toe-foot-transfer may able to achieve the best functional recovery of the missing finger in spite of doubtful cosmetic results; usually of compromised shape and size with unpleasant result . In these two cases, we gave them both options; surgical and prosthetic reconstruction of the finger by explaining its advantages and disadvantages. But both the patients did not choose surgical reconstruction. Once rejected the possibility of surgical reconstructive techniques, we focused toward the least invasive technique which could solve the aesthetic need of the patient: osseointegrated implant is, without any doubt, a valid alternative to reconstruct the missing finger. An implant placed in the intramedullary canal of the residual bone of the amputated digit offers additional advantages, because the technique enables short stumps, where a traditional prosthesis is not successful as in Case 1 [,].