Treatment of the Partial Hand Amputation: An Engineering Perspective

Partial hand amputation is perhaps the most frequent amputation level, worldwide. Although its annual incidence in western countries is roughly 1:18000 inhabitants, the treatments of partial hand amputations have modestly progressed so far. We have identified three main limitation factors to this progress: (i) the wide range of anatomical and functional presentations which makes difficult to find standardized and scalable solutions, (ii) the technological complexity in replacing the motor and sensory function of a lost digit in the size of a digit and (iii) the fact that a partial hand can be functionally successful mostly when it restores a lost opposition movement, i.e. the ability to oppose the thumb against the fingers while providing enough grasping force and aperture width. This paper presents an overview of the existing surgical and technological solutions for treating partial hand amputations, and is specifically targeted to (biomedical) engineers. We critically highlighted the advantages, limitations and open challenges. Remarkably, current fitting procedures rely on manual approaches by skilled prosthetic technicians rather than on modern engineering methods. Hence the objective of this work is to comprehensively but concisely overview the field in order to inspire engineers to develop new systems and procedures able to address current open issues.