A Functional-Cosmetic Prosthetic Thumb
Gael R. Frank, M.D. Lester J. Sabolich, C.P.O.
A 27-year-old white male was referred to our clinic recently for prosthetic fitting of both upper limbs following amputations for severe electrical burns. On the left side the patient had a very short above-elbow amputation which required a modified shoulder-disarticulation prosthesis. On the right hand the thumb and index finger had been amputated. Since the patient had what amounted to a shoulder disarticulation on the left limb, we felt it was quite important that some type of thumb prosthesis be provided for the right hand.
The Prosthetic Device
A prosthetic thumb was manufactured for this patient and attached to a wrist-strap cuff. The thumb portion of the prosthesis was fabricated by first making a plaster-of-paris cast of the remaining portion of his hand. From this cast a modified wax-mold check socket was prepared. A clay thumb was attached to the check socket and aligned in apposition to the center finger, since the index digit was also missing. The wax-mold check socket and clay thumb were reinforced with a "rigid dressing" of plaster of paris to prevent distortion during its shipment to Realastic® Industries of Oakland, California, where the prosthesis itself was constructed of cosmetic materials.
The patient feels that the prosthetic thumb is very satisfactory both cosmetically and functionally. The result is illustrated in Fig. 1 and 2 . Fig. 1 shows the prosthesis applied to the hand. In Fig. 2 the patient illustrates the functional value of the thumb by grasping a water glass.
Gael R. Frank, M.D. and Lester J. Sabolich, C.P.O. are associated with the University of Oklahoma Medical Center Oklahoma City, Oklahoma