Article

We describe reconstructive surgeries, therapy, prostheses, and adaptations for a
patient who experienced bilateral amputation of all five fingers of both hands
through the proximal phalanges in January 1992.
The patient made considerable
progress in the use of his hands in the 10 mo after amputation, including nearly
a 120% increase in the active range of flexion of metacarpophalangeal joints. In
late 1992 and early 1993, the patient had "on-top plasty" surgeries, in which the
index finger remnants were transferred onto the thumb stumps, performed on both
hands. The increased web space and functional pinch resulting from these
procedures made many tasks much easier. The patient and occupational therapists
set challenging goals at all times. Moreover, the patient was actively involved
in the design and fabrication of all prostheses and adaptations or he developed
them himself. Although he was discharged from occupational therapy in 1997, the
patient continues to actively find new solutions for prehension and grip strength
18 yr after amputation.

Langue : ANGLAIS