|Microsurgery: Transplantation and Replantation by Harry J. Buncke, MD, et al.|
| If the stump has a pinch, an aesthetic prosthesis is not recommended because it would be more awkward than useful. When the patient reaches adolescence, he will be more conscious of its advantages. If the stump has no pinch, prosthetic fitting may be prescribed as soon as possible, but we prefer waiting until the child is 18 months old to avoid skin problems. The prosthesis helps balance when walking and aids in bimanual grasp.
Reasons for the Aesthetic Prosthesis
The aesthetic prosthesis was conceived to give psychologic help to acquired and congenital amputees. As a matter of fact, their demand is mostly to have normal appearance restored to an injured hand. Amputees wish to have the same appearance as nonamputees and not be stared at with curiosity or pity. By restoring normal appearance to the injured hand, the prosthesis removes the trauma linked with the constant sight of the stump.
Some patients who have been wearing their prostheses for 10, 20, or 30 years, tell us that the prostheses are functional because they use them.
What are the actual functional possibilities of prostheses?
| The prosthesis allows the use of the remaining structures. It lengthens and makes usable a digital stump that is too short. It works as an opposition to a mobile thumb. Its thinness preserves mobility of the joints and skin sensation. Its thickness protects a sensitive stump and removes the patient's apprehension about using it.
The aesthetic prosthesis may have a relatively functional role. Sometimes a surgically obtained functional pinch on a mutilated or congenitally deformed hand, which is considered by the amputee as too repulsive to be used, can be covered by an aesthetic prosthesis and be used functionally (see Figs. 43-3, 43-4).
THE ROLE OF REHABILITATION
The functional and psychologic help obtained from the aesthetic prosthesis promotes social rehabilitation by allowing the amputee to forget his handicap. It makes the return to professional activity easier, especially when contact with the public is required (see Figs. 43-5 through 43-8).
Requirements for the Aesthetic Prosthesis
To achieve good results, the aesthetic prosthesis has clearly defined requirements for the stump and for itself.
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