Functional Prosthesis for a Child with Partial Achiria: A Developmental Concept

ANTHONY BALLARD, MD, HELGA ROBINETTE, OTR, PT,WAYNE ROSEN, CO AND OSCAR ORTIZ, CP*


A 3-year-old girl was seen in the Pediatric Amputee Clinic at Jackson Memorial Hospital/University of Miami Medical Center. She has congenital absence of all four fingers and thumb of the right hand. She was evaluated by the team for a functional and cosmetic prosthesis. A low-temperature thermoplastic prototype was designed utilizing orthotic and prosthetic principles. A full range of wrist flexion and extension was harnessed by means of a laminated forearm cuff, a mechanical radiocarpal joint and a prosthetic socket to fit the amputation limb. A double-pulley system was attached to a mechanical metacarpophalangeal (first and second) joint and to the patient's amputation limb, producing a tenodesis effect. A thumb was affixed in opposition and abduction to provide prehension with the index and middle fingers. A cosmetic glove was fitted and trimmed for aesthetic purposes.

*Jackson Memorial Hospital, University of Miami Medical Center, 1611 NW 12th Avenue, Miami, FL 33136